A new home-based program for older adults appears to provide significant health benefit for individuals with depression. In addition, the program also provides substantial stress reduction in family caregivers of dementia patients.
Indiana University researchers say the “The Aging Brain Care Medical Home” program demonstrated at least a 50 percent reduction in symptoms in two-thirds of patients with moderately severe depressive symptoms. Symptoms included feeling hopeless, feeling bad about oneself, or having trouble concentrating.
Investigators also found the program resulted in a 50 percent reduction in stress symptoms in half of caregivers of patients with dementia.
“Depression and dementia, which typically impact other medical conditions, are difficult for primary care doctors to treat during their limited time with patients,” said Regenstrief Institute investigator and Indiana University Center for Aging Research scientist Michael LaMantia, M.D., MPH, who led the study.
“The Aging Brain Care Medical Home program may be an attractive option in response to some of the challenges posed by our nation’s rapidly aging population and the anticipated lack of geriatricians and primary doctors to care for them.
“Care coordinator assistants go to patients’ homes, develop relationships with them, evaluate the safety of the home environment, focus on the needs of both patients and caregivers, and offer support to deal with the many consequences of a depression or dementia diagnosis.
“We send our teams out to patients’ homes with the tools they will need to work with older adults. Our team members are our front line who alert us to problems the medical team wouldn’t otherwise know about.”
The program is unique in the development of the position and in the training of care coordinator assistants.
Prior to joining the Aging Brain Care (ABC) Medical Home team and working with older adults, the care coordinator care assistants, who only have a high school diploma or two-years of post-high school education, participate in a two-week bootcamp that includes interaction with simulated patients. They also attend lectures, participate in discussions, observe home visits, and initially work with more experienced members of the team.
Supervised by a nurse and other members of the team that includes a social worker and a geriatrician, the care coordinator assistants monitor symptom burden, coach patients with history of depression on implementing behavioral activation and relapse prevention activities.
The care coordinator assistants also work with the family caregivers of those with dementia on implementing caregiver stress prevention strategies such as attending monthly support groups, creating crisis plans, taking regular weekly time off from caregiving tasks, and enhancing their self-management and problem solving capacity related to their loved one’s dementia symptoms.
In this study, ABC Medical Home participants received an average of 13 home visits over the 18-month period for which the preliminary data reported in the study was captured.
The ABC Medical Care team is automatically and immediately informed through the Indiana Network for Patient Care if a patient visits an emergency department or is admitted to a hospital anywhere in the state, enabling the team to coordinate services the patient will need upon discharge.
The study, “The Aging Brain Care Medical Home: Preliminary Data,” is current found online in advance of print publication in the Journal of the American Geriatrics Society.
Source: Indiana University/EurekAlert