Closing The Distance on Rural Dementia Care

For nearly two decades, the Rural Dementia Action Research (RaDAR) Team has been redesigning dementia care to make it more accessible for older adults living in rural communities.

In the early 2000s, demand for dementia care outside urban centres was on the rise. RaDAR was born to address this need and launched a dedicated Rural and Remote Memory Clinic in Saskatoon. It still exists today, with a focus on atypical and complex cases of suspected dementia.

A person living outside the city is referred to the clinic by a primary care physician and the clinic streamlines dementia assessment and diagnosis, transforming it into a one-day process. On the day of the visit, a CT scan is performed, along with assessments by a neurologist, a neuropsychology team, a physical therapist and a dietitian. Interested family members are also engaged in the process. By the end of the day, the RaDAR team provides a probable diagnosis and recommendations for management and care.

“Primary care providers know their patients and their communities and can provide ongoing support that's so essential."

– Dr. Debra Morgan

RaDAR's Rural and Remote Memory Clinic is in the Health Sciences E-wing Building at the University of Saskatchewan. Photo courtesy of RaDAR.

“Prior to that, it might take multiple visits and a half a year for a person to get a diagnosis, plus the different [health care] professionals they saw didn't have a way to talk to each other. We designed the one-day clinic to deal with those issues,” said Dr. Debra Morgan, who leads RaDAR and is a Professor and Chair in Rural Health Delivery at the Canadian Centre for Health and Safety in Agriculture (CCHSA) at the University of Saskatchewan. 

Morgan and her colleagues quickly realized that a single specialty clinic could not help every remote adult in need of a diagnosis, so RaDAR began working with primary health care (PHC) teams in rural southeastern Saskatchewan to enhance their ability to diagnose and manage dementia. Together, they established the first Rural PHC Memory Clinic in the town of Kipling in 2014. There are now clinics in Bengough, Weyburn, and Carlyle, and the model is expanding. Clinics are held every month or two by a primary health team in each community, eliminating the need to travel into the city.

“Primary care providers know their patients and their communities and can provide ongoing support that's so essential," said Morgan. 

Photo courtesy of Pexels.

RaDAR also uses telehealth to deliver services and education to people living in far-flung areas. In the beginning, the province had just 13 telehealth sites. Today, it has several hundred. RaDAR’s vision for the role telehealth can play in rural dementia care has grown alongside the network. The team offers virtual cognitive rehabilitation and insomnia treatment and is piloting several other programs. For example, “we’re co-designing with First Nations communities a caregiver support group to ensure we provide services that are culturally safe and appropriate for Indigenous peoples,” said Dr. Megan O’Connell, a neuropsychologist who leads RaDAR’s telehealth initiatives.  

RaDAR’s impact, via its clinics both real and virtual, has also grown: Morgan said she hears that families feel very supported in the community; people are also seeking help who wouldn’t have done so before; and the stigma associated with dementia is lessening. “To me,” she said, “that's been really important.”