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P208: The activities of Initial- phase Intensive Support Team for Dementia (IPIST) in Japan

Published online by Cambridge University Press:  02 February 2024

Yuto Satake
Affiliation:
Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
Daiki Taomoto
Affiliation:
Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
Maki Suzuki
Affiliation:
Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Suita, Japan
Kazue Shigenobu
Affiliation:
Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Suita, Japan Department of Psychiatry, Asakayama Hospital, Sakai, Japan
Hideki Kanemoto
Affiliation:
Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
Kenji Yoshiyama
Affiliation:
Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
Manabu Ikeda
Affiliation:
Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
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Abstract

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Objective:

The Intensive Initial Support Team for Dementia (IPIST) is a multidisciplinary outreach team that provides intensive initial assessment and support for dementia in Japan, introduced based on the Memory Service in the UK. All municipalities are required to establish at least one team, which consists of at least one physician and two professional staffs such as public health nurses and care workers. IPIST usually complete the work within approximately six months, including consultation with medical specialists and introduction of public supports. IPIST sometimes faces “complex case” that is difficult to manage. Because complex cases often have psychiatric problems, accessibility to psychiatric resources is important for IPIST. This study investigated the percentage of psychiatric professionals among IPIST members and the characteristics of complex cases they face.

Methods:

Through all 1741 municipalities in Japan, a questionnaire was distributed to each IPIST regarding the complex cases they experienced during April-September 2020. The questionnaire asked for the characteristics of each IPIST (e.g., specialty of the team physician, availability of staff with psychiatric expertise, etc.) and which of the 12 categories each complex case fit into, allowing multiple choice.

Results:

We could collect responses from 1291 IPISTs. 43.3% of IPISTs had a psychiatrist, 43.1% had an internal medicine physician, 13.4% had a neurologist, and 17.0% had some other physician as their team physician. In addition, 59.4% of the teams had medical staff members with psychiatric experience, including psychiatrists. A total of 7340 cases were reported as complex cases. While the most common category for difficulties in case management was “refusal of services” (19.5%), factors requiring psychiatric intervention such as “behavioral and psychological symptoms of dementia” (16.0%), “co-occurring mental illness” (7.3%), “complaints from neighbors” (7.1%), and “trash-house” (4.3%) were also frequently observed.

Conclusion:

The survey revealed that many IPISTs already had psychiatrists and other professionals with clinical psychiatric experience, and that they managed a lot of complex cases with issues that would be the target of psychiatric intervention. We believe early psychiatric engagement is important in many complex cases in outreach support for community residents with suspected dementia.

Type
Posters
Copyright
© International Psychogeriatric Association 2024