The purpose of this study is to assess the feasibility of enrollment, attrition, and adherence of Benjamin Rose Institute Care Consultation (BRI-CC) on unmet needs in low-income older adults who screen positive for dementia and their caregiver (CG).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
22
The BRI-CC is a telephone-based intervention designed for adults with chronic conditions and has been used in persons with dementia and their caregiver (CG). This assessment is guided by the use of assessment tools with domains that trigger specific and pertinent needs of the dyad such as relationship strain, depression, financial concerns, memory problems, and difficult behaviors. To address unmet needs, the care consultant and dyad develop action plans with specific action steps pertinent to the dyad. The intervention involves maintenance and support where the care consultant (CC) continues the relationship with the dyad through regular telephone contact, email and mail. CC use a web-based reporting system, to maintain and track dyad information, assessments, action plans, completed tasks, and ongoing contacts. At a minimum, the care consultant will contact the dyad by telephone once per month over the duration of the study period (i.e. 6 months).
The University of Texas Health Science Center at Houston
Houston, Texas, United States
Feasibility as assessed by enrollment rate
enrollment rate = # enrolled / # who met inclusion criteria
Time frame: 6 months
Feasibility as assessed by attrition rate
attrition rate = # not completing the study / # enrolled at baseline
Time frame: 6 months
Feasibility as assessed by adherence rate
adherence rate = # completing all BRI-CC sessions / # enrolled in intervention group
Time frame: 6 months
Feasibility as assessed by why subjects were not able to participate in BRI-CC
Time frame: 6 months
Feasibility as assessed by why subjects dropped out of BRI-CC
Time frame: 6 months
Unmet needs of participants who receive home-delivered meals as assessed by domains of the Unmet Needs Instrument
Responses will be entered onto a 10-item dichotomous response (need met or unmet) instrument that will be summed across six assessment domains: 1) understanding dementia, 2) accessing healthcare services, 3) accessing community services 4) accessing family services, 5) legal and financial issues, and 6) emotional support.
Time frame: baseline
Unmet needs of of participants who receive home-delivered meals as assessed by domains of the Unmet Needs Instrument
Responses will be entered onto a 10-item dichotomous response (need met or unmet) instrument that will be summed across six assessment domains: 1) understanding dementia, 2) accessing healthcare services, 3) accessing community services 4) accessing family services, 5) legal and financial issues, and 6) emotional support.
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Time frame: 3 months
Unmet needs of participants who receive home-delivered meals as assessed by domains of the Unmet Needs Instrument
Responses will be entered onto a 10-item dichotomous response (need met or unmet) instrument that will be summed across six assessment domains: 1) understanding dementia, 2) accessing healthcare services, 3) accessing community services 4) accessing family services, 5) legal and financial issues, and 6) emotional support.
Time frame: 6 months
Self Neglect as assessed by the Elder Self-Neglect Instrument (of participants who receive home-delivered meals)
The Elder Self-Neglect Assessment (ESNA) is a 25-item rating scale to assess for SN. Each item is a 5-point Likert scale to assess the participant and the participant's home. Scores are tallied with the following suggested interpretations: (1) if high scores for social behavioral SN (B) but not environmental SN (E), then there is high risk for SN, (2) if high scores are for both B \& E, then severe unintentional SN, and (3) if high E but not B, then intentional SN. An item example asks, "Does the older adult wear dirty clothes"?
Time frame: baseline
Self Neglect as assessed by the Elder Self-Neglect Instrument (of participants who receive home-delivered meals)
The Elder Self-Neglect Assessment (ESNA) is a 25-item rating scale to assess for SN. Each item is a 5-point Likert scale to assess the participant and the participant's home. Scores are tallied with the following suggested interpretations: (1) if high scores for social behavioral SN (B) but not environmental SN (E), then there is high risk for SN, (2) if high scores are for both B \& E, then severe unintentional SN, and (3) if high E but not B, then intentional SN. An item example asks, "Does the older adult wear dirty clothes"?
Time frame: 6 months
Number of participants who receive home-delivered meals who were admitted to the hospital
Time frame: 6 months
Number of participants who receive home-delivered meals who were readmitted to the hospital
Time frame: 6 months
Number participants who receive home-delivered meals who were relocated for long term care
Time frame: 6 months
Psychosocial well-being of the caregiver (CG) as assessed by the Zarit Burden Interview
The Zarit Burden Interview is a 22-item self-rated screen to assess CG burden. This measure uses a 5-point Likert scale to assess direct stress of the CG, specifically caregivers of persons with dementia. It has been shown to be sensitive to change.
Time frame: baseline
Psychosocial well-being of the informal caregiver as assessed by the Zarit Burden Interview
The Zarit Burden Interview is a 22-item self-rated screen to assess CG burden. This measure uses a 5-point Likert scale to assess direct stress of the CG, specifically caregivers of persons with dementia. It has been shown to be sensitive to change.
Time frame: 6 months
Caregiver depression as assessed by the Geriatric Depression Scale- Short Form
The Geriatric Depression Scale (Short-Form) (GDS-SF) is a 15-item "yes" and "no" self-rated screen to assess depression. Scores range from 0-15 with scores of 5 and greater are indicative of depression
Time frame: baseline
Caregiver depression as assessed by the Geriatric Depression Scale- Short Form
The Geriatric Depression Scale (Short-Form) (GDS-SF) is a 15-item "yes" and "no" self-rated screen to assess depression. Scores range from 0-15 with scores of 5 and greater are indicative of depression
Time frame: 6 months
Caregiver unmet needs as assessed by domains of the Unmet Needs Instrument
Responses will be entered onto a 10-item dichotomous response (need met or unmet) instrument that will be summed across six assessment domains: 1) understanding dementia, 2) accessing healthcare services, 3) accessing community services 4) accessing family services, 5) legal and financial issues, and 6) emotional support.
Time frame: baseline
Caregiver unmet needs as assessed by domains of the Unmet Needs Instrument
Responses will be entered onto a 10-item dichotomous response (need met or unmet) instrument that will be summed across six assessment domains: 1) understanding dementia, 2) accessing healthcare services, 3) accessing community services 4) accessing family services, 5) legal and financial issues, and 6) emotional support.
Time frame: 6 months
Emotional significance of pets to participants who receive home-delivered meals as assessed by the Monash Dog Owner Relationship Scale (MDORS)
Time frame: baseline
Unmet Pet Care needs of participants who receive home-delivered meals as assessed by the Unmet Pet Care Needs (UPCN) scale
The UPCN scale was developed by the researchers which taps a respondent's need for information or help surrounding pet-related issues. It is based on the Benjamin Rose Institute Unmet Needs Scale (see references). Response categories are dichotomous (0=No and 1=Yes). The total score is the sum of the items noted for each measure. Higher scores indicate greater unmet need for information or help. The individual scales may be summed to create a score for total unmet need.
Time frame: baseline
Barriers to pet caretaking as assessed by structured interviews over the telephone with participants who receive home-delivered meals
Time frame: baseline
Potential resources and services to support unmet pet caretaking needs as assessed by structured interviews over the telephone with participants who receive home-delivered meals
Time frame: baseline