The Dementia Symptom Management at Home Program
| Status: | Withdrawn |
|---|---|
| Conditions: | Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 65 - Any |
| Updated: | 9/16/2018 |
| Start Date: | August 1, 2017 |
| End Date: | March 1, 2018 |
The Dementia Symptom Management at Home Program: A Bundled Interprofessional Intervention to Improve Dementia Patient-Caregiver Dyad Quality of Care and Quality of Life Through Home Healthcare.
Persons with dementia and their caregivers are often cared for in the community through home
healthcare (HHC). While these patients and their caregivers need significant help and often
have difficulty maintaining their quality of life, home healthcare clinicians are often
unprepared to care for this population. This study will therefore examine the ability of an
integrated, multi-pronged evidence-based practice intervention for home healthcare registered
nurses, occupational therapists and physical therapists, the DSM-H, to improve the quality of
care and quality of life for persons with dementia and their family caregiver. The
investigators will enroll persons with dementia and their family caregiver upon admission to
the HHC agency and examine their quality of life over 60 days following admission, comparing
those who receive the intervention to those who serve as controls.
healthcare (HHC). While these patients and their caregivers need significant help and often
have difficulty maintaining their quality of life, home healthcare clinicians are often
unprepared to care for this population. This study will therefore examine the ability of an
integrated, multi-pronged evidence-based practice intervention for home healthcare registered
nurses, occupational therapists and physical therapists, the DSM-H, to improve the quality of
care and quality of life for persons with dementia and their family caregiver. The
investigators will enroll persons with dementia and their family caregiver upon admission to
the HHC agency and examine their quality of life over 60 days following admission, comparing
those who receive the intervention to those who serve as controls.
The Dementia Symptom Management at Home (DSM-H) Program is an integrated bundled
implementation science intervention to improve interprofessional care in home healthcare
(HHC). It consists of training, assessment instruments, patient-caregiver centered care plans
and workflow changes. The investigators will perform a cluster randomized controlled clinical
trial at a single, urban, non-profit HHC agency, randomizing care teams to either be trained
in performing the intervention or serve as controls. The aims of this program are to examine
the efficacy of this program to:
Aim 1: Measure the effects of DSM-H on pain, neuropsychiatric symptoms, and caregiver rated
QOL in the person with dementia receiving HHC.
Aim 2: Assess the effects of DSM-H on QOL, burden and depression for the informal caregiver
of persons with dementia receiving HHC.
Aim 3: Assess the effects of DSM-H on the number of emergency room visits and hospital
admissions.
implementation science intervention to improve interprofessional care in home healthcare
(HHC). It consists of training, assessment instruments, patient-caregiver centered care plans
and workflow changes. The investigators will perform a cluster randomized controlled clinical
trial at a single, urban, non-profit HHC agency, randomizing care teams to either be trained
in performing the intervention or serve as controls. The aims of this program are to examine
the efficacy of this program to:
Aim 1: Measure the effects of DSM-H on pain, neuropsychiatric symptoms, and caregiver rated
QOL in the person with dementia receiving HHC.
Aim 2: Assess the effects of DSM-H on QOL, burden and depression for the informal caregiver
of persons with dementia receiving HHC.
Aim 3: Assess the effects of DSM-H on the number of emergency room visits and hospital
admissions.
Inclusion Criteria:
- patient-caregiver dyad admitted to the HHC agency
- Patients must be 65 or older and speak English and/or Spanish.
- Patient must have an informal caregiver who is at least 18 years old and spends at
least 8 hours per week with the patient.
- Patients must score greater than 4 on the cognitive subscale of the Healthy Aging
Brain Care Monitor signifying at least mild impairment
Exclusion Criteria:
- Patients with concomitant axis I disorders other than dementia, depression, adjustment
disorders, sleep disorders.
- Patients being seen only in the behavioral health unit without another skilled need.
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2
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