Alzheimer’s Disease and Related Dementias
February 18, 2020
The Dementia Care EcoSystem: The Feasibility of a Care Management Program Addressing Healthcare Quality, Access, and Cost for Patients with Dementia and their Caregivers
R. John Sawyer, PhD; Co-Director, Cognitive Disorders and Brain Health Program
Summary of Research
Alzheimer’s and related dementias (ADRDs) are becoming one the largest public health issues of our time. With the population living longer and longer, this leads to greater incidence of ADRDs. Because people with dementia (PWD) endure progressive functional and cognitive decline, this leads to demand more from the US health care system that is not well positioned to care for them and their caregivers. This is due to an inadequate number of specialists, limited training for primary care providers, insufficient financial support to expand dementia care, and lack of coordinated care for PWD who need a team approach to manage multiple issues.
Programs designed to enhance patient care coordination (e.g., getting the right care at the right time) and caregiver education/support (e.g., connect them with resources to improve burden) can improve quality of life and the cost of care for health systems. The University of California, San Francisco (UCSF) piloted the Care Ecosystem (CE), a patient- and family-centered model of dementia care designed to improve quality of life for PWD and their caregivers while also being financially feasible.
Ochsner’s Cognitive Disorders and Brain Health Program has implemented Care Ecosystem with over 100 participants enrolled. The Care Ecosystem provides education and support to persons with dementia and their care partners to improve the care at home and decrease the need for risky, expensive emergency, or hospital-based services. This includes discussions and education about managing difficult behaviors, safety (e.g., use of technology, fall prevention), and advice about care partner well-being, in addition to resources related to advanced care planning and local community services.
Recent Success, Findings or Outcomes
Within six months of enrolling in the Cognitive Disorders and Brain Health Program , care partners reported significant improvement in their sense of their own ability to care for their loved one with dementia, and 100% of care partners would recommend the program to others and felt satisfied or very satisfied with the program. Utilization of the emergency department decreased by 40%, suggesting care partners felt more comfortable managing non-emergent issues at home or with their loved one’s local treatment team.