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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
TRIPLE
The DSM-H is a multi-modal interprofessional intervention that includes: 1. intensive training of clinician mentors; 2. disseminated online training for Registered Nurses, Physical Therapists, Occupational Therapists; 3. implementation of evidence-based care plans, assessment instruments, and teaching handouts.
The New Jewish Home
New York, New York, United States
New York University College of Nursing
New York, New York, United States
Person With Dementia Quality of Life
Quality of Life in Alzheimer's Disease survey instrument
Time frame: 60 Days
Caregiver Quality of Life
Caregiver Targeted Quality of Life survey instrument
Time frame: 60 Days
Person with Dementia Pain
Pain Assessment in Advanced Dementia or Brief Pain Inventory survey instrument
Time frame: 60 days
Person with Dementia Neuropsychiatric Symptom Burden
Healthy Aging Brain Care Monitor survey instrument
Time frame: 60 days
Caregiver Depression
Public Health Questionnaire-9 survey instrument
Time frame: 60 days
Person with Dementia ER Visits
Resource Utilization Inventory survey instrument
Time frame: 30, 60 days
Person with Dementia Hospital Admissions
Resource Utilization Inventory survey instrument
Time frame: 30, 60 days
Person with Dementia Functional Status
Katz Activities of Daily Living and Lawton Instrumental Activities of Daily Living assessments
Time frame: 60 days
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