The Dementia Symptom Management at Home Program
- Conditions
- Dementia
- Interventions
- Behavioral: Dementia Symptom Management at Home Program
- Registration Number
- NCT02482623
- Lead Sponsor
- New York University
- Brief Summary
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.
- Detailed Description
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.
Recruitment & Eligibility
- Status
- WITHDRAWN
- Sex
- All
- Target Recruitment
- Not specified
- patient-caregiver dyad admitted to the HHC agency
- Patients must be 65 or older and speak English and/or Spanish.
- Patient must have an informal caregiver who is at least 18 years old and spends at least 8 hours per week with the patient.
- Patients must score greater than 4 on the cognitive subscale of the Healthy Aging Brain Care Monitor signifying at least mild impairment
- Patients with concomitant axis I disorders other than dementia, depression, adjustment disorders, sleep disorders.
- Patients being seen only in the behavioral health unit without another skilled need.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Intervention Dementia Symptom Management at Home Program Dyads in this arm will receive care provided by an interprofessional team trained through the DSM-H to provide patient/caregiver-centered dementia care through home healthcare.
- Primary Outcome Measures
Name Time Method Person With Dementia Quality of Life 60 Days Quality of Life in Alzheimer's Disease survey instrument
Caregiver Quality of Life 60 Days Caregiver Targeted Quality of Life survey instrument
- Secondary Outcome Measures
Name Time Method Person with Dementia Neuropsychiatric Symptom Burden 60 days Healthy Aging Brain Care Monitor survey instrument
Person with Dementia ER Visits 30, 60 days Resource Utilization Inventory survey instrument
Person with Dementia Hospital Admissions 30, 60 days Resource Utilization Inventory survey instrument
Person with Dementia Pain 60 days Pain Assessment in Advanced Dementia or Brief Pain Inventory survey instrument
Caregiver Depression 60 days Public Health Questionnaire-9 survey instrument
Person with Dementia Functional Status 60 days Katz Activities of Daily Living and Lawton Instrumental Activities of Daily Living assessments
Trial Locations
- Locations (2)
The New Jewish Home
🇺🇸New York, New York, United States
New York University College of Nursing
🇺🇸New York, New York, United States