Home is where the future is: The BrightFocus Foundation consensus panel on dementia care

INTRODUCTION

A national consensus panel was convened to develop recommendations on future directions for home-based dementia care (HBDC).

METHODS

The panel summarized advantages and challenges of shifting to HBDC as the nexus of care and developed consensus-based recommendations.

RESULTS

The panel developed five core recommendations: (1) HBDC should be considered the nexus of new dementia models, from diagnosis to end of life in dementia; (2) new payment models are needed to support HBDC and reward integration of care; (3) a diverse new workforce that spans the care continuum should be prepared urgently; (4) new technologies to promote communication, monitoring/safety, and symptoms management must be tested, integrated, and deployed; and (5) targeted dissemination efforts for HBDC must be employed.

DISCUSSION

HBDC represents a promising paradigm shift to improve care for those living with dementia and their family caregivers: these recommendations provide a framework to chart a course forward for HBDC.

Applied kinesiology unreliable for assessing nutrient status

Applied kinesiology is a technique used to assess nutritional status on the basis of the response of muscles to mechanical stress. In this study, 11 subjects were evaluated independently by three experienced applied kinesiologists for four nutrients (thiamin, zinc, vitamin A, and ascorbic acid). The results obtained by those applied kinesiologists were compared with (a) one another, (b) standard laboratory tests for nutrient status, and (c) computerized isometric muscle testing. Statistical analysis yielded no significant interjudge reliability, no significant correlation between the testers and standard biochemical tests for nutrient status, and no significant correlation between mechanical and manual determinations of relative muscle strength. In addition, the subjects were exposed in a double-blind fashion to supplements of thiamin, zinc, vitamin A, and ascorbic acid and two placebos (pectin and sucrose) and then re-tested. According to applied kinesiology theory, "weak" (indicating deficiency) muscles are strengthened when the subject is exposed to an appropriate nutritional supplement. Statistical analysis revealed no significant differences in the response to placebo, nutrients previously determined (by muscle testing) to be deficient, and nutrients previously determined (by muscle testing) to be adequate. Even though the number of subjects (11) and nutrients (4) tested was limited, the results of this study indicated that the use of applied kinesiology to evaluate nutrient status is no more useful than random guessing.