Public–private partnerships improve health outcomes in individuals with early stage Alzheimer’s disease

Abstract

PurposeIn a collaborative effort between the Missouri Department of Health, Area Agencies on Aging (AAA), Alzheimer Association, and academic researchers, we tested whether early dementia detection and comprehensive care consultations would improve health outcomes in care receivers (CRs) and their family caregivers (FCGs), therefore addressing an important public health concern.Participants and methodsA total of 244 community-dwelling older adults screened for early-stage dementia by the AAA field staff were referred to the Alzheimer Association and participated in Project Learn MORE (Missouri Outreach and Referral Expanded) (PLM) – a 2-year, nonrandomized multisite intervention consisting of comprehensive care consultations to improve coping skills. PLM participants were compared against 96 controls receiving the Alzheimer Association’s “usual services” between January 2011 and December 2012. We examined CR and FCG outcomes, including burden, care confidence, and mood, as effects of PLM, on delaying transitions in level of care.ResultsCRs showed improved knowledge (P=0.002) and reduced depression (P=0.007), while FCGs demonstrated improved knowledge (P=0.003) and ability to identify sources of support for the CR (P=0.032) and for themselves (P=0.043). However, FCGs were more burdened after PLM (P=0.02), due to increased awareness of Alzheimer’s disease. PLM delayed transitions in care (odds ratio [OR] 3.32, 95% confidence level [CI]: 1.25–8.83) with the number needed to treat =6.82.ConclusionPLM was successful in improving detection of incident cases of dementia in the community and in connecting patients and their families with needed services. Our findings support the use of state agencies and community service partners to detect dementia. Early implementation of psychosocial interventions could have significant impact in improving patient- and family-centered outcomes, potentially providing a cost-efficient alternative to pharmacotherapy.

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

“…In conclusion, resources are available both within the VHA and the community to address caregiver needs (ie, psychoeducation and skills training, caregiver support programs, mental health and social work services, information about the AA, etc). Efforts to combine VHA and community care consultation efforts have demonstrated the ability to improve health outcomes in individuals with Alzheimer's disease and their caregivers . To ensure that PWDs and their caregivers are receiving crucial assistance, it is vital to ensure that healthcare providers are aware of these efforts and resources and the importance of assessing and documenting caregiver needs.…”

Academic-community partnerships improve outcomes in pediatric trauma care

“…Shared goals between institutions resulted in improved outcomes for injured children in an area previously without local access to specialized pediatric trauma care. Community-academic partnerships have been previously described in the adult literature to improve clinical care for vulnerable populations such as cancer survivors [13] and at-risk elders [14][15][16]. However, community-academic partnerships have been rarely described in pediatric trauma care delivery [17].…”

Collaborative Transdisciplinary Team Approach for Dementia Care

“…All team members should share the tasks of referral to concrete services (transportation services, home, meal delivery and adult day programs), taking advantage of particular ‘niche’ knowledge based on specialty. The components of our model include: ● Trained transdisciplinary care team (neurologist, nurse practitioner, social worker and health educator) to deliver care to patients and caregivers and interface with primary care providers;● Comprehensive assessment tools to measure and monitor patient and caregiver biopsycho-social needs and response to interventions;● Patient-centered, individualized care protocols that incorporate input from patient and caregiver;● Family-focused protocols to improve family care needs, provide enhanced social support with ready availability of phone or in-person consultation with NP or SW and limit inappropriate use of acute medical services (emergency department, hospitalizations);● Care consultation models [38] that incorporate patient and caregiver needs to improve knowledge, care confidence, mastery and coping skills; reducing caregiver burden, patient and caregiver depression and prepare transitions in care plans.…”

“…● Care consultation models [38] that incorporate patient and caregiver needs to improve knowledge, care confidence, mastery and coping skills; reducing caregiver burden, patient and caregiver depression and prepare transitions in care plans.…”

“…After all components of the assessment are completed, the patient, caregiver and collaborative team meet for a comprehensive care conference [38] where results are reviewed, a diagnosis is delivered and a tailored, individualized care plan is developed with input from all team members, the patient and caregiver, and questions are answered. This care conference includes ordering of additional labs and imaging (if not already completed), health promotion activities (nutrition, sleep, exercise and cognitive activities), nonpharmacologic approaches to behavior, referrals to community resources, counseling and a schedule for follow-up.…”