Hip Fracture Caregiver Intervention - Function Focused Care: Fracture Care at Home
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 1
- 试验地点
- 2
- 主要终点
- Feasibility of the Intervention
研究概览
简要总结
This pilot study will evaluate the feasibility of implementing an intervention in the home setting that is specifically designed to coach and mentor caregivers as they assist individuals with Alzheimer's disease and related dementia (ADRD) who have fractured a hip to perform everyday activities and engage in more physical activity.
详细描述
Prior research by the Baltimore Hip Studies (BHS) has shown that it is possible to improve function, increase physical activity, and improve behavioral symptoms among long term care residents with ADRD and to effectively coach and mentor caregivers through a care practice, Function Focused Care for the Cognitively Impaired (FFC-CI), that focuses on having caregivers teach, cue, model, and assist cognitively impaired individuals to perform functional tasks and engage in physical activity, while minimizing behavioral symptoms. This study will determine if a revised intervention, Function Focused Care for the Cognitively Impaired: Hip Care at Home (aka, Hip Care at Home), can be implemented in a home setting.
The Hip Care at Home intervention will include an initial evaluation of the hip fracture participant, caregiver, and home setting by an interdisciplinary care team including a physical therapist (PT), occupational therapist (OT), and a coach (nurse or nurse's aide) trained in the function focused care (FFC) approach. The FFC coach will then work with the primary informal (family or friend, unpaid) caregiver to integrate the recommended environmental, behavioral, and physical interventions into the home setting, with weekly visits.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Fragility fracture (hip, spine, femur/thigh, wrist, humerus/arm)
- •Pre-fracture diagnosis of Alzheimer's disease or related dementia from chart, informant, or through AD8 score of 2+
- •Age 65+ at time of fracture
- •Completed usual rehabilitation
- •Discharged to the community after rehabilitation ends (i.e., private home or assisted living)
- •Availability of a caregiver (i.e., family relative or non-relative, unpaid, informal) providing ADL or IADL care or oversight at least weekly
排除标准
- •Pathologic fracture
- •Not community-dwelling (e.g., nursing home resident) prior to fracture
- •Bedbound during the 6 months prior to fracture
- •No caregiver or caregiver refuses study participation
- •Study clinician thinks participant is not a good candidate for study
- •Not returning to the community before one year after fracture (can go to assisted living)
- •CAREGIVER PARTICIPANTS
- •Inclusion Criteria:
- •Identified as a caregiver (i.e., family relative or non-relative, unpaid, informal) who will help or supervise the fracture participant with ADL or IADL tasks after discharge from rehab
- •Helping or supervising thefracture participant with one or more ADL or IADL tasks at least weekly when screened for this study OR plans to be the primary person providing care at least weekly after the fracture participant is discharged from rehab
- •Exclusion Criteria:
- •Not English speaking
- •Living more than 40 miles from the hip fracture participant
- •Unable to provide informed consent
结局指标
主要结局
Feasibility of the Intervention
时间窗: 8 weeks
Data regarding feasibility will include numbers of participants contacted, enrolled, drop-outs/withdrawals, and completing intervention, adverse events, and total time to implement intervention.
Treatment Fidelity
时间窗: 8 weeks
Treatment fidelity of the intervention will include recording of adherence and logs of intervention tasks and problems by the interdisciplinary care team and FFC coach regarding barriers to implementation of the intervention and open-ended interviews with caregivers about their experiences with the intervention.
次要结局
- Instrumental Activities of Daily Living (IADLs) - fracture participant outcome(8 weeks)
- Short Physical Performance Battery (SPPB) - fracture participant outcome(8 weeks)
- Improvement in Knowledge of FFC - caregiver outcome(2 weeks and 8 weeks after the start of the intervention)
- Self-Efficacy for Functional and Physical Activities - caregiver outcome(8 weeks)
- Physical Activities of Daily Living (PADLs) - fracture participant outcome(8 weeks)
- MotionWatch to Monitor Physical Movement - fracture participant outcome(8 weeks)
- Neuropsychiatric Inventory (NPI) - fracture participant outcome(8 weeks)
- Outcomes Expectations for Function and Physical Activity - caregiver outcome(8 weeks)
- Zarit Burden Interview - caregiver outcome(8 weeks)
- Modified Mini-Mental State Examination (3MS) - fracture participant outcome(8 weeks)
- Cornell Scale for Depression in Dementia (CSDD) - fracture participant outcome(8 weeks)
- Adverse Events(8 weeks)
- Improvement in Performance of FFC - caregiver outcome(3 weeks and 6 weeks after the start of the intervention)
- Falls Efficacy Scale International (FES-I)(8 weeks)
- Center for Epidemiologic Studies Depression Scale (CES-D) - caregiver outcome(8 weeks)
研究者
Ann Gruber-Baldini
Professor
University of Maryland, Baltimore