Implications From the Social Ecosystem Theory for the Patient-centered Supporting System for Caregivers of Alzheimer Disease in China

It is estimated that 4. 68 million people live with dementia worldwide, of which two third are Alzheimer disease (AD), and nearly a quarter of them are living in China. Most people living with AD rely on family members to care for them at home. Caregivers expect to experience a high level of care burden when AD progresses. The demand for establishing a caregiver support system with theoretical support has escalated in the context of rapidly ageing population in China. It has been discussed in the dementia care literature that the caregiver support system needs to be grounded on sound theories, reflects the socio-cultural context and has a wide applicability, and the system is of great significance in alleviating social and domestic burden and improves the quality of life of AD patients and caregivers. In this paper, we analyze the current status and challenges caregivers face in China and argue that incorporating a person-centered care concept into the social ecosystem theory is the most suitable theoretical framework for establishing and developing a support system for AD caregivers. We suggest that it is necessary to develop a three-level supporting system incorporating a macro supporting system that includes government's policies, finance, organization and supervision, a sub-macro supporting-system that comprises community healthcare organizations, comprehensive hospitals and community organizations, and a micro supporting system that includes AD patients' families and caregivers, with its main support from community health service settings. These systems need to support each other and work in collaboration and coordination in order to sustain family-based care model for AD patients.