Dementia Care: Crisis Response System

Caring for people with dementia can be challenging. This is especially true when the person’s behavior could make them a risk to themselves or others. Crisis intervention aims to keep everyone safe. It involves a three-pronged approach:

• The initial crisis response.
• Crisis stabilization.
• Providing long-term care for people with extremely challenging behaviors.

Efforts across the state have shown that local and regional initiatives can help to spur system improvements. These changes will make our current crisis systems better able to handle situations involving people with dementia. Below are strategies we’ve created to do that, and our progress so far.

Strategies

• Expand ability to respond to crisis:
  • Promote dementia capability in the existing crisis response system. This includes mobile crisis units, law enforcement, and other first responders.
  • Encourage coordination between local and regional crisis intervention systems.
  • Identify and catalog resources for counties and groups working on stabilization strategies.
• Clarify procedures for emergency protective placement and emergency protective services:
  • Provide technical assistance and training on the law, policies, and procedures relating to crisis response. This includes emergency protective services and emergency protective placement for people with dementia.
  • Clarify proper procedures for the use of psychotropic medications.
• Improve long-term care for people with challenging behaviors:
  • Identify obstacles to the designation of emergency protective placement facilities.
  • Increase access to trainings related to crisis and caring for persons with challenging behaviors.
  • Identify and pursue options to address facility concerns. Incentivize facilities designated to care for people in crisis.
  • Explore the need for specialized facilities for people with dementia who present challenging behaviors.

Milestones completed

• Published the results of a survey to establish how mobile crisis and emergency protective placement services are organized and function.
• Chapter 55 Emergency Protective Placements for Persons with Dementia in Crisis, P-00445 (PDF) (October 2015) describes a survey of adult protective services units. It discusses how the Wisconsin Department of Health Services (DHS) will use the results to identify what is working well and where to focus efforts to improve the dementia capability of Wisconsin’s crisis systems. The key takeaway is that almost all counties (90%) reported they do not have enough facilities willing to accept emergency protective placements of people with dementia who have challenging behaviors.
• Dementia Crisis Innovation Grants: Round One Final Report
  • Published the final report for Wisconsin’s first round of Dementia Crisis Innovation Grants, Improving Dementia-Related Crisis Response: Results of Six Innovation Grants, P-02327 (PDF). This report summarizes strategies employed and lessons learned by counties that received a Dementia Crisis Innovation Grant from DHS for the period of January 2016 through July 2017. The report is intended to help counties and their community partners take steps to improve the state of crisis response for those with dementia. It will also help identify gaps still in need of resolution.
• Dementia Crisis Innovation Grants: Round Two
  • DHS awarded eight counties grants in a second round of the Dementia Innovation Grants (July 2017). These grants encourage the development and expansion of dementia-capable crisis response systems. The 18-month grants totaled $421,000. Three counties from Round One of the Innovation Grants were awarded funds in Round Two. Through the grants, counties are:
    • Creating or continuing to build collaborations among key stakeholders.
    • Gathering data about system needs.
    • Implementing practices to ensure a more coordinated, dementia-capable approach in supporting persons with dementia in crisis.

DHS published a final report, P-02937 (PDF), for Wisconsin’s second round of Dementia Crisis Innovation Grants.

For more information

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Questions about the State Dementia Plan? Email dhsdementiawebmail@dhs.wisconsin.gov.