What's New?
New web site to be developed
The amalgamated North Simcoe Muskoka Dementia Network will create a new web site. Ww will provide information on network activities, innovations and education activities and opportunities. However we will not continue to offer the data base of services for People with Dementia. The listing of services in the area is available at the following 211 sites:
www.211SimcoeCounty.ca
OR
www.northsimcoemuskoka.info
First Link in North Simcoe Muskoka
First Link™ is an innovative program to be established for the first time in the Simcoe County and Muskoka region. It is funded under the province’s new Aging at Home Strategy. The program is designed to promote early access to support and education in the community for people who have been diagnosed with Alzheimer’s disease or a related disorder (ADRD). The program also links their families and/or caregivers to community supports, thereby enhancing their capacity to assist the person with ADRD to remain in their own home for as long as possible
Me & U-First!
www.u-first.ca
For more information on this exciting new program, go to the Me & U-First! pages of this web site.
Comments by Dr. Jack Diamond, Scientific Director, ASC
August 18, 2006
Thursday, April 27, 2006
Alzheimer's treatment all in your head
Chemical in brain blocks disease
U of T lab foresees drug in 10 years
By Joseph Hall
University of Toronto researchers have discovered a substance in the brain itself that can stop Alzheimer's disease and could lead to a "clean and direct treatment" for the degenerative disorder within the next decade.
"This is the starting block of something that could be tremendous," says U of T Alzheimer's researcher Dr. Peter St George-Hyslop. "This could be the blueprint for the development of a drug to treat the disease."
Calling it one of the most promising discoveries he's seen during his three decades of work on the disease, St George-Hyslop said the discovery could help create a drug regimen to treat the disorder.
"I think what we're going to have (in the next decade) are medicines that will stop the disease from progressing and I think we will have medicines that will prevent the disease from happening," St George-Hyslop said. "This is one of the key elements that will go into that regime."
The naturally occurring brain protein, which is described in this week's issue of the journal Nature, has been shown to block the creation of a destructive neurotoxin that sets Alzheimer's in motion, St George-Hyslop said.
Known as TPM21, the protein blocks the neurotoxin Abeta, also known as beta-amyloid peptide, which is responsible for the onset of Alzheimer's.
Abeta has been the target of numerous therapies to block its production, said St George-Hyslop, head of the university's Centre for Research in Neurodegenerative Diseases.
Those therapies, however, have been too coarse in their actions and have lead to intolerable side effects like encephalitis and the shutdown of a patent's gastrointestinal functions. But TPM21 appears to have no impact on the brain beyond its containment of Abeta production, said St George-Hyslop, who helped lead an international team responsible for the discovery.
"We now have a clean and direct way to inhibit the production of Abeta ... with potentially no side effects," he said in a news release detailing his Nature paper.
While the protein discovery holds much promise for an effective treatment, St George-Hyslop cautioned that it has yet to be tested in animals and that a drug to mimic its antitoxin effects is likely at least five years away.
"Obviously we now need to find a small molecule or a drug that looks like this protein and that does the same thing as this protein," he said.
"But this is a beautiful clue, it's biology doing what we want it to do. And if we're clever enough to make a drug that can mimic biology, then this is very, very promising."
He also said that, like the multiple-drug AIDS cocktail, an Abeta-blocking compound would likely be used in conjunction with other therapies, such as a promising new Alzheimer's vaccine. And like the AIDS cocktail, any Alzheimer's drug therapy would likely require ongoing doses over a patient's lifetime.
Dr. B. Lynn Beattie, chair of the research policy committee for the Alzheimer Society of Canada, cautioned that the disease has an enormously complex biochemistry and that this newly revealed protein represents just one step in the development of the disease.
"But it's an important step because it's a step right at our current understanding of the (origin and development) of this disease," Beattie said.
Alzheimer's is the most common form of dementia in Canada, affecting some five per cent of people over the age of 65. One in four people over the age of 85 have the disease.
"But the field has not been this optimistic for many years," St George-Hyslop said.
Web site development
The Simcoe County Dementia Network web site is designed to help anyone affected by dementia, their families and caregivers, and health professionals. We hope that the directory of services will make it easier for all of us to connect to the services available. During the process of developing this directory we have identified gaps in service in Simcoe County that we, as a network, hope to address.
As we build this site we will update and improve it, including a map of the services that may be useful for different stages of dementia.
Columbine
We would like to thank Oro-Medonte artist Juliana Hawke, for allowing us to use the images from her watercolour painting of columbine. The columbine (AQUILEGIA CANADENSIS) has been Simcoe County's official flower since 1983 and in 1984, this original painting was presented to Pope John Paul II during his Papal visit to Huronia. Prints were then sold by the County to commemorate this visit and the crimson and yellow wildflower, which blooms throughout the County.
LHINs - Local Health Integration Networks
What the Ontario Ministry of Health and Long-Term Care's Health Results Team Says
What the Ontario Ministry of Health and Long-Term Care's Health Results Team Says
Local Health Integration Networks (LHINs) will not provide clinical services, but will coordinate service delivery. Existing provider organizations will continue to deliver services. The principles guiding the LHINs’ are:
• Equitable access based on patient need;
• Preserves patients’ choice;
• Measurable, results-driven outcomes based on strategic policy formulation, business planning and information management;
• People-centred, community-focused care that responds to local population health needs; and
• Shared accountability between providers, government, community and citizens.
The creation of the LHINs is in response to the existence of numerous unaligned programs and services, with conflicting and overlapping boundaries. A common set of boundaries will facilitate integration of health care services and help people to move across the continuum of care to get the best care, in the most appropriate setting, when they need it.
The 14 LHIN geographic boundaries were based on evidence and created in collaboration with the Institute for Clinical Evaluative Sciences (ICES). The boundaries follow the local areas where people naturally seek health care and are flexible, allowing people to continue to choose their health care provider as they do today. All 14 LHINs contain at least one high volume hospital. The steps in setting the boundaries were:
• Establishing Hospital Service Areas (HSAs);
• HSAs grouped further into larger Hospital Referral Regions (HRRs) following a similar methodology; and
• The appropriateness of the “fit” for each area was tested by calculating a “Localization Index” (The Localization Index is a measure that shows what percentage of the population receive health services locally).
LHINs will be governed by Board of Directors appointed by an Order-in-Council and bound by performance agreements with the Ministry. Board members will be selected using a merit-based process and the appointment process will be transparent and consistent.
Simcoe County Dementia Network Response to LHINs
Ontario Ministry of Health and Long Term Care Health Results Team
e-address: mailto:transforminghealth@moh.gov.on.ca
As a voice in the community for the unique and sizeable population affected by dementia, the Simcoe County Dementia Network is pleased to provide feedback in response to the questions posed by the Health Results Team regarding the development of Local Health Integration Networks (LHINs).
Dementia Networks were developed across the province as part of Ontario’s Strategy for Alzheimer Disease and Related Dementias. The Simcoe County Dementia Network was established two years ago with the goal of enhancing the well being of persons with dementia and their formal and informal caregivers through an improved system of care. The network facilitates people and resources coming together to improve the network of care, service delivery, education and research for persons affected by dementia. The Simcoe County Dementia Network consists of representatives from various sectors in the field of dementia care including consumers, physicians, the Alzheimer Society, the Community Care Access Centre Simcoe County, acute care hospitals, community health and social service agencies, community and institutional mental health services, long-term care facilities, educational institutions, supportive housing, aboriginal populations, the Psychogeriatric Resource Consultants, the Ministry of Health and Long Term Care, and the District Health Council.
What examples of health care integration already exist?
The Simcoe County Dementia Network is an example of a vehicle highly successful in facilitating health care integration in the field of dementia care. With input from stakeholders across sectors involved in the field of dementia care, the network has established a model, vision, terms of reference, and a work plan with prioritized tasks. Three intersectoral task groups have been active over the past year and are well on their way to successfully completing their initial objectives. The Education/Training Standards Task Group prepared a report on the educational and support needs of personal support workers in the dementia field based on qualitative research; the Directory Task Group will launch a web based directory of dementia services on November 3, 2004; and in response to minimal physician involvement, the Physician Task Group has been actively engaged in ensuring the physician voice is well represented in the network, facilitating educational opportunities for family physicians, and developing strategies to enhance their linkages with community resources.
The process utilized by the Simcoe County Dementia Network in bringing people together has resulted in several new intersectoral cooperative initiatives. One example in response to identified needs is the development of the Cognitive Assessment and Support Service, involving The Royal Victoria Hospital, Dr. Kim McKenzie, Geriatrician, the Community Care Access Centre Simcoe County and the Alzheimer Society of Greater Simcoe County. This exciting collaborative initiative provides a diagnostic, support and education service for individuals affected by dementia. Other examples of intersectoral collaboration have resulted in new educational initiatives. We would be pleased to provide further details about these on request.
What are the critical factors for the successful implementation of the LHIN in your area?
The Simcoe County Dementia Network fully supports the guiding principles identified for the development of LHINs in the province. We commend the Ministry of Health and Long Term Care for maintaining the client as the focus for the restructuring of services and planning. As Dementia Networks place the needs of individuals affected by dementia at the forefront, the Simcoe County Dementia Network can be a valuable resource to the LHINs, both during their development and as part of their ongoing operations. We would also like to acknowledge the benefit of planning for services on a local basis, which will ensure that appropriate and affordable care is available and responsive to the unique needs of local communities.
It is noted that the geographic areas outlined for the LHINs do not necessarily coincide with the current service delivery areas for many organizations. It is anticipated that this may pose challenges in planning and implementation of services, which will impact on clients, as organizations may be delivering services within several LHIN areas. We trust that this has been recognized and that steps will be taken to minimize any negative impacts for clients.
As well, the realigned geographical boundaries do not take into account the fact that there are inequities in service resources. If current services were adequate, it is likely that referral patterns as indicated would change. We encourage the government to ensure that all Ontarians have equal access to common resources and levels of service.
Inevitably, with restructuring comes a wide range of rumours regarding the impact on health care agencies and health care providers. As well as expressing concerns regarding the impact of restructuring on client care, many health care providers have expressed concerns about how their jobs may change and about job security. We encourage the Ministry of Health and Long Term Care to consider the needs of health care workers, a critical element in an effective primary health care system, as they move through the transition to the new structure of health care delivery in Ontario.
While we endorse the government’s emphasis on a strong long-term community support system as a critical component of health care, the Simcoe County Dementia Network is somewhat concerned that the apparent emphasis on hospitals may overshadow the needs of long term community support services at this critical formative stage. The Simcoe County Dementia Network acknowledges the crucial role that acute care plays in supporting health, but also recognizes that many clients can be supported with promotive, preventative, curative, rehabilitative, and supportive/palliative care in the community setting. This will ensure that acute care services are there for those who truly need it. It is absolutely crucial that acute care and long term care sectors remain at the table as equal partners at all stages of planning for and restructuring of the health care system.
What role can you and your organization play in collaboration with the Ministry as the LHIN planning work continues in your area?
The Simcoe County Dementia Network is anticipating active participation in the planning and implementation of the LHINs. The Simcoe County Dementia Network has had success in bringing diverse stakeholders together, planning and prioritizing together and producing positive outcomes. The health care community in Simcoe County has had a strong history and culture of collaboration in planning and implementing client centered health care services. We feel we can bring this diverse valuable experience to the table.
Respectfully,
Debbie Islam,
Co-Chair, Simcoe County Dementia Network
Executive Director
Alzheimer Society of Greater Simcoe County
Christine Lee-Bun,
Co-Chair, Simcoe County Dementia Network
Dementia Assessment and Resource Team Coordinator
Community Care Access Centre Simcoe County
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