Integrative Health Care of Dementia in Upper Bavaria – The "Light House" Project IDOB

Das Leuchtturmprojekt Demenz "Integrierte Demenzversorgung in Oberbayern – IDOB" hat zum Ziel, in den Modellregionen München-Ost und Berchtesgadener Land die Versorgung demenzkranker Menschen zu verbessern, mit Hilfe regionaler Versorgungsverbünde, die am individuellen Bedarf Demenzkranker angepasst sind. Demenz-Schweregrad und soziale Situation der teilnehmenden Patienten unterscheiden sich: Patienten in München-Ost sind schwerer erkrankt und leben größtenteils allein; dagegen lebt die Hälfte der Patienten im Berchtesgadener Land im Familienverbund. Die Projekterfahrungen sind in beiden Modellregionen ähnlich: Die Lebensqualität der Patienten hat sich verbessert; während die Versorgung Lücken bei aufsuchender Hilfe und Informations- und Unterstützungsangeboten für Angehörige aufweistThe dementia light house project "integrated care of dementia in Oberbayern – IDOB" aims at improving the care of people with dementia in the German model regions Munich and “Berchtesgadener Land“ by regional care-networks adapted to the individual demand of dementia patients. Severity of dementia and the social situation of participating patients differ: Patients in the city (Munich-East) are more severely demented and are mostly living alone; in contrast half of the patients in the rural “Berchtesgadener Land“ live with their families. Experiences with the project are similar in both model regions: The quality of life of the patients has improved. However, there is lack of health care regarding calling on assistance and information and support for caring family members

Psychological Intrusion – An Overlooked Aspect of Dental Fear

Dental fear/anxiety is a widely recognised problem affecting a large proportion of the population. It can result in avoidance and/or difficulty accepting dental care. We believe that psychological intrusion may play a role in the aetiology and maintenance of dental fear for at least some individuals. In this narrative review we will take a developmental perspective in order to understand its impact across the lifespan. We will consider the nature of ‘self,’ parenting styles, the details of intrusive parenting or parental psychological control, and briefly touch upon child temperament and parental anxiety. Finally, we draw together the supporting (largely unrecognised) evidence available in the dental literature. We illustrate the paper with clinical examples and discuss possibly effective ways of addressing the problem. We conclude that psychological intrusion appears to play an important role in dental fear, for at least some individuals, and we call for detailed research into the extent and exact nature of the problem. A simple means of identifying individuals who are vulnerable to psychological intrusion would be useful for dentists