Correlates of Sleep Indices among Community Dwelling Older Adults Enrolled in a Collaborative Care Management Program

Background: Chronic pain is a major health problem among older adults and their informal caregivers, which has negative effects on their physical and psychological status. The dyadic pain management program (DPMP) is provided to community-dwelling older adults and informal caregivers to help the dyads reduce pain symptoms, improve the quality of life, develop good exercise habits, as well as cope and break the vicious circle of pain. Methods: A pilot randomized controlled trial was designed and all the dyads were randomly divided into two groups: the DPMP group and control group. Dyads in the DPMP group participated in an 8-week DPMP (4-week face-to-face program and 4-week home-based program), whereas dyads in the control group received one page of simple pain-related information. Results: In total, 64 dyads participated in this study. For baseline comparisons, no significant differences were found between the two groups. After the interventions, the pain score was significantly reduced from 4.25 to 2.57 in the experimental group, respectively. In the repeated measures ANOVA, the differences in pain score (F = 107.787, p < 0.001, d = 0.777) was statistically significant for the group-by-time interaction. After the interventions, the experimental group participants demonstrated significantly higher pain self-efficacy compared with the control group (F = 80.535, p < 0.001, d = 0.722). Furthermore, the elderly increased exercise time significantly (F = 111.212, p < 0.001, d = 0.782) and reported developing good exercise habits. Conclusions: These results provide preliminary support for the effectiveness of a DPMP for relieving the symptoms of chronic pain among the elderly.

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Change in Burden and Distress among Caregivers of Community-Dwelling Older Adults with Dementia Enrolled in Care Management

American Journal of Geriatric Psychiatry ◽

10.1016/j.jagp.2012.12.127 ◽

2013 ◽

Vol 21 (3) ◽

pp. S95-S96

Author(s):

Amy Benson ◽

Shahrzad Mavandadi ◽

Samantha R. Wertheimer ◽

Joel E. Streim ◽

Suzanne DiFilippo ◽

...

Keyword(s):

Older Adults ◽

Care Management ◽

Community Dwelling ◽

Community Dwelling Older Adults

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Evidence for a Novel Care Management Program for Low-Income Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.2917 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 803-804

Author(s):

Rachel Lessem ◽

Margaret Danilovich

Keyword(s):

Older Adults ◽

Low Income ◽

Care Management ◽

Nutritional Assessment ◽

State Level ◽

Management Program ◽

Initial Assessment ◽

Care Management Program ◽

Item Quality

Abstract The purpose of this study was to evaluate the implementation and effectiveness of a novel care management program for low income older adults in Chicago. Older adults (n=200) who had annual income below $31,225 but about the state level for home and community based services were received care management. Program participants completed a battery of assessments (UCLA Loneliness Scale, single item Quality of Life and Physical Health scales, and Nutritional assessment) at initial assessment and 1-year follow-up. We also conducted interviews with clients and care managers. We used a t-test to evaluate participant outcomes and coded qualitative data to identify themes. Results showed no significant differences between baseline and 1 year follow-up indicating that this care management program kept participants stable. Only 5 of 200 (2.5%) of clients transitioned to a nursing home. This study contributes important results on a novel program to sustain vulnerable older adults in the community.

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Cost-effectiveness of a preventive self-care health management program for community-dwelling older adults: a randomised controlled trial

Age and Ageing ◽

10.1093/ageing/afaa127 ◽

2020 ◽

Author(s):

Arkers Kwan Ching Wong ◽

Frances Kam Yuet Wong ◽

Ching SO

Keyword(s):

Older Adults ◽

Hong Kong ◽

Cost Effectiveness ◽

Health Management ◽

Self Care ◽

Management Program ◽

Community Dwelling ◽

Control Group ◽

Care Health ◽

Community Dwelling Older Adults

Abstract Objective To examine the cost-effectiveness of a preventive self-care health management program for community-dwelling older adults as compared to usual care. Design/Intervention A cost-effectiveness analysis was executed alongside a randomised controlled trial. Nurse case managers provided interventions, including holistic assessment, empowerment of self-care, preventive health behaviours and self-efficacy with co-produced care planning, supported by nursing students. The control group received social control calls. Participants/Setting Community-dwelling older adults were randomly assigned to the intervention (n = 271) or control (n = 269) group. The intervention was conducted in collaboration with 11 community centres under four non-government organisations in various districts of Hong Kong. Measurements Cost and quality-adjusted life years (QALYs) were collected pre (baseline, 0 months) and post intervention (3 months) and 3 months after completion of the program (6 months). Incremental cost-effectiveness ratios between the groups were calculated, dividing the difference in cost by the difference in QALYs. Results Analysis showed that the net incremental QALY gain was 0.0014 (3 months) and 0.0033 (6 months) when the intervention group was compared to the control group. The probability of being cost-effective at 6 months was 53.2% and 53.4%, based on the cost-effectiveness thresholds recommended by both the National Institute for Health and Clinical Excellence ($200,000/QALYs) and the World Health Organization (Hong Kong gross domestic product/capita, HK$381,780). Conclusions The results provide some evidence to suggest that the addition of a home-based, preventive self-care health management program may have effects on cost outcomes for community-dwelling older adults in Hong Kong.

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Acceptability and Feasibility of a Multicomponent Telehealth Care Management Program in Older Adults With Advanced Dementia in a Residential Memory Care Unit

Gerontology and Geriatric Medicine ◽

10.1177/2333721420924988 ◽

2020 ◽

Vol 6 ◽

pp. 233372142092498

Author(s):

Alyssa N. De Vito ◽

R. John Sawyer ◽

Ashley LaRoche ◽

Beth Arredondo ◽

Brian Mizuki ◽

...

Keyword(s):

Older Adults ◽

Care Management ◽

Intervention Program ◽

Activity Monitor ◽

Management Program ◽

Dementia Care ◽

Advanced Dementia ◽

Memory Care ◽

Care Management Program

The aim of the current study was to examine the acceptability and feasibility of a multicomponent care management program in older adults with advanced dementia in a long-term memory care unit. Eighteen older adults with moderate to severe dementia were asked to wear an activity monitor (Fitbit Charge 2 HR) and participate in a once monthly telehealth intervention via iPads over a 6-month period. Activity monitor data were used to assess compliance. Acceptability was assessed through qualitative interviews conducted with the caregiving staff on the memory unit. The care management program was acceptable to residents and their caregivers. Results indicated that the care management program is feasible in older adults with advanced dementia although activity monitor adherence was better during the day than at night. Telehealth session compliance was excellent throughout the study. A long-term multicomponent dementia care program is acceptable and feasible in individuals with advanced dementia. Future studies should aim to evaluate whether data received from activity monitors can be used in a dementia care intervention program.

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Transitional Care Management: Evidence for Novel Implementation Models and Rehabilitation Implications

Innovation in Aging ◽

10.1093/geroni/igaa057.2916 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 803-803

Author(s):

Margaret Danilovich ◽

Margaret Danilovich

Keyword(s):

Older Adults ◽

Decision Making ◽

Low Income ◽

Care Management ◽

Transitional Care ◽

Management Program ◽

Service Agency ◽

Program Outcomes ◽

Implementation Framework ◽

Care Management Program

Abstract The transition between healthcare settings is a complex process presenting challenges for effective and consistent communication between older adults, their caregivers, and healthcare providers. These challenges often result in adverse health events and re-hospitalizations. Further, once transitioned to home, older adults often need ongoing care management and support and evidence for models remains unclear as to the precise parameters of supports needed for comprehensive care. This symposium will provide an overview of the evidence for both interdisciplinary care management models and transitional care programs, present the implementation of a care management program for low income older adults at one social service agency, and provide evidence-based tools for older adult functional assessment and decision-making for transitional care. The speakers will present new tools from the American Physical Therapy Association home health toolbox that promote patient-centered health care decision-making to facilitate successful transitions that reduce resource use and hospital readmission. The speakers will also discuss the implementation of a care management program for older adults in a care gap (having too much income for Medicaid home and community-based services, but still <200% of the federal poverty line). An implementation framework for the needs assessment will be highlighted and 1-year program outcomes will be presented. Attendees will learn strategies for interprofessional collaboration, enhanced communication, and advocacy within the interprofessional team to facilitate improved care management and transitional services for older adults.

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