Year: 2013
Type: article
Study design: Clinical Trial
Abstract: Early diagnosis enables caregivers to plan for inevitable known consequences of Alzheimer's disease and to mitigate these through improved education and planning. We have developed proactive dementia care (PDC) - a program integrating health education and social work interventions into the management plan at time of diagnosis. The goal of PDC is to empower patients and family members with a unified plan tailored for their needs to maximize quality of life. We are conducting an ethics committee-approved randomized clinical trial, comparing the effectiveness of PDC and standard dementia specialist care (SDSC) in achieving important caregiver, patient, and health system outcomes: Attend support group Contact with AA support agency; DPOA Driving risks; Exercise on most days; Participate in daily activities; Plan if caregiver goes to hospital; Plan if caregiver no longer capable of helping; Preparedness to care for patient; Understanding of illness. SDSC is defined as the usual care a dementia specialist provides unassisted by social work or health education, which depends solely upon patient and family initiated psychosocial interventions. We compare PDC and SDSC outcomes at 12 months, Subjects clinically identified as likely to have a degenerative dementia in a specialty clinic are approached for enrollment in the study. 88 subjects were enrolled. Of these 8 failed screening and were excluded leaving 80 subjects. There were no demographic differences between the 2 groups at baseline. There was no statistical difference in any of the 10 proactive care measures between the intervention and control groups. However, there was a statistically significant difference in the whole group over a one-year period in understanding of the illness (p= 0.002), preparedness in case the primary caregiver goes to hospital (p= 0.002), or is no longer capable of helping (<0.001), and pre-emptive management of driving (p<0.001). See table. Attending a specialty care dementia clinic improves understanding of the illness, preparedness in case the primary caregiver is no longer capable of helping, and pre-emptive management of driving. Other areas of proactive care need additional attention. More research is needed to identify barriers to implementing proactive care measures.
Source: Alzheimer s & Dementia
Authors: Edward Zamrini, Troy Andersen, Cassidy Simpson, Angela Wang, Tom Greene, Jian Ying, Stephen Bergquist, Pramod Mandal, Richard King, Norman Foster
Institution: University of Utah
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2035912217