title: [Maintenance of health and relief for caregivers of elderly with dementia by using "initial case management": experiences from the Lighthouse Project on Dementia, Ulm, ULTDEM-study].
abstract: BACKGROUND
  When facing the well-known demographic development with an increasing number of people suffering from dementia, there is a need of programmes to support nursing relatives and care at home. Many support services have been established in the past few years but they are rarely used by the relatives and the patients. The purpose of the Lighthouse Project Ulm (ULTDEM Study) was to prove the effectiveness of a single advisory approach in order to provide support services after care level classification and to relieve the burden placed on relatives caring for family members suffering from dementia ("initial case management").
  
  
  METHODS
  The ULTDEM Study is a prospective, open, randomized, controlled, interventional study with different parallel outcome measures (burden of caring, quality of life and mood). After the randomization, the interventional group was given comprehensive, individual advice about available treatment possibilities for dementia patients. Control group participants received standard treatment. Inclusion criteria were application of a care level (0 or 1) as well as dementia diagnosis. All participants (patients/relatives) underwent an initial and a 6 month comprehensive assessment.
  
  
  RESULTS
  Our results show that a single advisory approach does not lead to a significant difference in outcome measures in interventional and control groups. Those tendencies described have to be interpreted as clinically not relevant. Although utilization of support services increases, it remains similar in both study groups. A confirmatory interpretation has not been possible due to a lack of adjustment to the findings regarding multiple testing and an insufficient degree of recruitment. Possible causes will be discussed such as premature intervention during the course of the disease, a lack of intervention blinding, recruitment bias and lack of an influence on adherence with regard to the use of support services.
  
  
  CONCLUSIONS
  The study demonstrates that there is a substantial information deficit for persons affected by dementia and their relatives. Innovative ways still have to be developed to ensure that this information actually reaches the target audience.
authors.affiliation: AGAPLESION Bethesda Klinik Ulm, Akademisches Krankenhaus der Universität Ulm, Zollernring 26-28, 89073 Ulm. albert.lukas@bethesda-ulm.de
authors.forename: A
authors.initials: A
authors.lastname: Lukas
authors.forename: R
authors.initials: R
authors.lastname: Kilian
authors.forename: B
authors.initials: B
authors.lastname: Hay
authors.forename: R
authors.initials: R
authors.lastname: Muche
authors.forename: C A F
authors.initials: CA
authors.lastname: von Arnim
authors.forename: M
authors.initials: M
authors.lastname: Otto
authors.forename: M
authors.initials: M
authors.lastname: Riepe
authors.forename: M
authors.initials: M
authors.lastname: Jamour
authors.forename: M D
authors.initials: MD
authors.lastname: Denkinger
authors.forename: T
authors.initials: T
authors.lastname: Nikolaus
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D019090:Case Management / Q000706:statistics & numerical data*; D003704:Dementia / Q000453:epidemiology* / Q000451:nursing*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012144:Respite Care / Q000523:psychology*; D016896:Treatment Outcome; D055815:Young Adult