No abstract

Family members and friends are the main providers of care for persons living with dementia. However, dementia caregivers are at greater risk than other caregivers of experiencing negative caregiving consequences. Despite the development of evidence-based programs to support dementia caregivers, few health or social service organizations offer any of these programs due, in part, to a lack of knowledge about their availability. Best Practice Caregiving is a newly launched website where professionals can get detailed information about these programs. Data collected to develop Best Practice Caregiving are analyzed for a sample of 42 evidence-based dementia caregiving programs to describe similarities and differences among programs including gaps in assistance available from these programs. Results show 64% of programs are delivered to caregivers only while the remaining are delivered to the caregiver and/or persons with dementia. Nearly half (43%) of the 42 programs are delivered in-person, 38% by phone, with 17% delivered all or in part online. Most programs are delivered by professionals (86%) followed by trained lay leaders (40%) and self-guided (12%). Most programs (95%) provide assistance with coping with illness/caregiving and the relationship of the dyad. Fewer than half of the programs assist caregivers with issues regarding finances (45%), end-of-life care (43%), and medical care (40%). Data from 233 delivery organizations show the most common challenge was getting caregivers to accept and complete the program (86%). Delivery sites reported more success with funding the program (mean=8.2 on a scale of 1-10) than with marketing and recruiting participants (mean=6.7).

The Caregiver Resource Center Network's implementation of a CHESS-like system (DementiaCare) demonstrates the value of an interactive health communication system (IHCS) in non-medical settings. No physician referral was required or even involved as part of this implementation. One site served as the "CHESS coordinator" and staff at the other resource centers received training and support for using CHESS with their population of caregivers of dementia patients. The staff could offer the program to all interested caregivers in their particular region of service.Eskenazi et al.

referring rural providers received 1098 recommendations regarding specialized dementia care.Common themes of recommendations included: referral to VA services n=650(59.2%), evaluation of sensory deficits n=69 (6.3%), treatment/ monitoring of orthostatic hypotension n=61 (5.6%), improving diabetic management n=73 (6.6%), recommendations related to reversible causes of symptoms n=144 (13.1%), Geri Psychiatry referral n=73(6.6%), gun safety, hunting, and driving n=71(6.6 %). . The majority of Veterans received recommendations related to adjusting medications. Fifty-one (15%) of Veteran also had documented polypharmacy. Themes of recommendations were related to specialists seen. Recommendations were similar to those in a face-to-face dementia clinic. Implementation of recommendations was initially low but improved when the geriatric team initiated consults, services, and follow-ups.Conclusion: Recommendations made in TeleDEMENTIA clinic are common to clinical recommendations made by geriatric professionals when Veterans are seen face to face. What makes these recommendations notable is these Veterans may never have received any recommendations without access to dementia care by telehealth. Implementation of recommendations improved when the team initiated services. Alliance, San Francisco, California, San Francisco, California, 4. Johns Hopkins University, Baltimore, Maryland, 5. San Francisco Department of Public Health, San Francisco, California, 6. Alzheimer's Association, Northern CA and Northern NV Chapter, San Jose, California, 7. San Francisco Department of Aging and Adults Services, San Francisco, California, 8. National Center on Caregiving, San Francisco, California Health disparities exist in LGBT older adult communities, a high risk population for chronic health conditions. Cognitive decline from Alzheimer's disease and related disorders (ADRD) is an increasing concern in LGBT communities due to natural aging. A 2010 report estimated an increase from 3 million to 7 million LGBT elders by 2030. Access to care challenges for LGBT elders, caregivers and service providers include lack of knowledge, discriminatory services, stigma, socioeconomic barriers, etc. To build ADRD awareness, a partnership of seven community and academic organizations held a one-day, highly-interactive conference on priority topics from results of a pre-event community survey. Sessions included: diagnosis/treatment/side-effects; AGING AND DIVERSE LGBT COMMUNITIES: BUILDING AWARENESS FOR COGNITIVE DECLINE AND CAREGIVING NEEDSLGBT affirming assessment and resources; substance use/effects on LGBT elders; health equity; diverse communities' needs; caregiving and mental health. About half of 227 attendees were service providers (nurses, social workers, public health workers, therapists, psychologists, etc.); the remainder were from the LGBT community (caregivers, care-recipients, care-partners, families). Half of attendees were white and the remainder reflected the diversity of greater San Francisco region (Asian, Black/African A...