Dementia Services Mini-Screen: A Simple Method to Identify Patients and Caregivers in Need of Enhanced Dementia Care Services

Abstract

Objective The National Alzheimer’s Plan calls for targeted health system change to improve outcomes for persons with dementia and their family caregivers. We explored whether dementia-specific service needs and gaps could be predicted from simple information that can be readily acquired in routine medical care settings. Method Primary family caregivers for cognitively impaired older adults (n=215) were asked about current stress, challenging patient behaviors, and prior-year needs and gaps in 16 medical and psychosocial services. Demographic data, caregiver stress, and patient clinical features were evaluated in regression analyses to identify unique predictors of service needs and gaps. Results Caregiver stress and patient behavior problems together accounted for an average of 24% of the whole-sample variance in total needs and gaps. Across all analyses, including total, medical, and psychosocial services needs and gaps, all other variables combined (comorbid chronic disease, dementia severity, age, caregiver relationship, and residence) accounted for an accounted for a mean of 3%, with no variable yielding more than 4% in any equation. We combined stress and behavior problem indicators into a simple screen. In early/mild dementia dyads (n=111) typical in primary care settings, the screen identified gaps in total and psychosocial care in 84% and 77%, respectively, of those with high stress/high behavior problems vs. 25% and 23%, respectively, of those with low stress/low behavior problems. Medical care gaps were dramatically higher in high stress/high behavior problem dyads (66%) than all others (12%). Conclusion A simple tool (likely completed in 1–2 minutes) which combines caregiver stress and patient behavior problems, the Dementia Services Mini-Screen, could help clinicians rapidly identify high need, high gap dyads. Health care systems could use it to estimate population needs for targeted dementia services and facilitate their development.

What do family caregivers of people with dementia need? A mixed‐method systematic review

“…Only in two studies, data regarding the sample recruitment process was poorly reported (Seike et al., 2014; Tatangelo et al., 2018). Moreover, seven quantitative studies adopted instruments developed ad hoc (Borson, Scanlan, Sadak, Lessig, & Vitaliano, 2014; De Cola et al., 2017; Hirakawa, Kuzuya, Enoki, & Uemura, 2011; Killen et al, 2016; Koenig, Steiner, & Pierce, 2011; Ryan et al, 2010; Steiner et al., 2016); four studies used tools not formally or totally evaluated for validity and reliability (Black et al., 2013; Ducharme et al., 2014; Tanner et al., 2015); four studies used both validated and non‐validated tools (Gallagher et al., 2011; Hughes et al., 2014; Rosa et al., 2010; Seike et al., 2014) and three used validated tools (Bakker et al, 2014; Muangpaisan et al., 2010; Zauszniewski, Lekhak, Yolpant, & Morris, 2015).…”

Taking Care of the Dyad: Frequency of Caregiver Assessment Among Veterans with Dementia

“…First, the AA Greater Los Angeles has developed a brief tool . Another useful tool, a “stress thermometer” rating form, can be provided to caregivers as a brief assessment of burden . Finally, the AA has a tool available to assess caregiver understanding of the disease, knowledge of how to get additional information, ability/willingness to provide care, and knowledge of support resources .…”

Nursing students’ knowledge about Alzheimer’s disease

“…The following resources should be incorporated when designing and delivering curricula for care of older adults: 1) ConsultGeri.org is a Hartford Nursing Institute for Geriatric Nursing resource that provides numerous different care protocols through their "Try This: Best Practices in Nursing Care of Older Adults" program. This includes user-friendly step-by-step guides for conducting a cognitive assessment using The Mini-Cog TM [21,22] or Montreal Cognitive Assessment, known as the MOCA. [23] The 2014 Alzheimer's Facts and Figures Report calls for more nurses to be trained in conducting cognitive screening.…”