Dementia Symptom Management at Home Program
Study Details
Study Description
Brief Summary
Alzheimer's Disease and Related Disorders (dementia) poses a significant challenge to our public health. While many persons with dementia are cared for by friends and family in the community with the assistance of home healthcare, most home healthcare clinicians and agencies are ill prepared to care for this population and therefore have difficulty assisting patients and caregivers in maintaining quality of life leading to adverse patient outcomes, increased caregiver stress and burnout, and healthcare utilization. This study will therefore utilize a cluster randomized controlled design at 3 study sites to examine the ability of a multi-component evidence-based practice primary palliative care quality improvement program for home healthcare registered nurses, occupational therapists and physical therapists to improve the quality of life and reduce healthcare utilization for persons with dementia and their informal caregiver.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: QI program care DSM-H performance improvement program Patients in the performance improvement group will receive care from a care team who has received the DSM-H performance improvement program |
Behavioral: DSM-H
Multi-modal quality improvement program for improving the quality of care provided to PWD-informal caregiver dyads through HHC
|
| Active Comparator: Control provide usual carereceive usual care from a care team who has not received the performance improvement program |
Behavioral: Standard of Care
Subjects receive care through usual home healthcare assignment process.
|
Outcome Measures
Primary Outcome Measures
- Quality of Life-Alzheimer's Disease [60 Days]
The investigators will evaluate patient health-related quality of life (HRQOL) by proxy (caregiver) assessment using the 15-item Health Utilities Index (HUI2), a generic health state classification system with preference-based utility weights derived from the general population. The HUI is one of the more widely used utility measures and has been used in previous studies of elderly with dementia and their caregivers.
- Change in Caregiver-Targeted Quality of Life Measure [60 Days]
The Caregiver-Targeted Quality of Life (CG-QOL) measure covers 10 dimensions of QOL relevant to caregivers of persons with dementia, incorporates non-health related issues as well as positive aspects of caregiving, and has demonstrated feasibility as a phone-based instrument in both English and Spanish. Eighty items are distributed across 10 scales: assistance with ADLs, assistance with IADLs, personal time, role limitation due to caregiving, family involvement, demands of caregiving, worry, caregiver feelings, spirituality and faith, benefits of caregiving.
Eligibility Criteria
Criteria
Inclusion Criteria:
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PWD over the age of 65
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Admitted to one of the three HHC agencies
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The patient and family caregiver speak English and/or Spanish.
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The informal caregiver is ≥18 years of age and spends at least 8 hours per week with the patient.
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Patients who score ≥6 on the Quick Dementia Rating Scale (at least mild impairment).
Exclusion Criteria:
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Patients with a separate Axis 1 diagnosis other than forms of dementia, depression or anxiety.
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PWD residing in assisted living facilities or board and care homes
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PWD solely receiving infusion or home health aide services.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | New York University School of Medicine | New York | New York | United States | 10016 |
Sponsors and Collaborators
- NYU Langone Health
Investigators
- Principal Investigator: Abraham Brody, MD, NYU Langone Health
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 17-00810