scholarly journals Virtual Interdisciplinary Collaboration in Statewide Implementation of the MIND at Home Dementia Care Program

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 549-549
Author(s):  
Deirdre Johnston ◽  
Jennifer Bourquin ◽  
Morgan Spliedt ◽  
Inga Antonsdottir ◽  
Cody Stringer ◽  
...  
Keyword(s):  
Health Plan ◽  
Care Program ◽  
Dementia Care ◽  
Community Dwelling ◽  
Care Plans ◽  
Individualized Care ◽  
Memory Care ◽  
Collaborative Sessions ◽  
Case Based ◽  
At Home

Abstract MIND at Home, a well-researched holistic, family-centered dementia care coordination program, provides collaborative support to community-dwelling persons living with dementia (PLWD) and their informal care partners (CP). Through comprehensive home-based assessment of 13 memory-care domains covering PLWD and CPs, individualized care plans are created, implemented, monitored, and revised over the course of the illness. Non-clinical Memory Care Coordinators (MCCs) working with an interdisciplinary team provide education and coaching to PLWD and their identified CP, and serve as a critical liaison and resource and between families, medical professional, and formal and informal community resources. This paper will describe a statewide pilot implementation of the program within a health plan across diverse sites in Texas and will present qualitative and quantitative descriptions of a key component of the program's effective translation to practice, the virtual collaborative case-based learning sessions. Health plan teams completed online interactive training modules and an intensive in-person case-based training with the Johns Hopkins team prior to program launch, and then engaged in weekly, hour-long virtual collaborative sessions that included health plan teams (site-based field teams, health plan clinical supervisory and specialty personnel [RNs, pharmacists, a geriatric psychiatrist, behavioral health specialists] and Johns Hopkins MIND program experts and geriatric psychiatrists. To date, the program has enrolled 350 health plan members, conducted 65 virtual collaborative sessions, and provided 423 CME/CEU units to team members. We will provide an overview of virtual collaborative session structure, participant contributions and discussion topics, case complexity, as well as didactic learning topics covered.

scholarly journals Process evaluation of a reablement training program for homecare staff to encourage independence in community-dwelling older adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Teuni H. Rooijackers ◽  
G. A. Rixt Zijlstra ◽  
Erik van Rossum ◽  
Ruth G. M. Vogel ◽  
Marja Y. Veenstra ◽  
...  
Keyword(s):  
Older Adults ◽  
Training Program ◽  
Process Evaluation ◽  
Community Dwelling ◽  
Team Approach ◽  
Staff Members ◽  
Care Plans ◽  
Lump Sum ◽  
Community Dwelling Older Adults ◽  
At Home

Abstract Background Many community-dwelling older adults experience limitations in (instrumental) activities of daily living, resulting in the need for homecare services. Whereas services should ideally aim at maintaining independence, homecare staff often take over activities, thereby undermining older adults’ self-care skills and jeopardizing their ability to continue living at home. Reablement is an innovative care approach aimed at optimizing independence. The reablement training program ‘Stay Active at Home’ for homecare staff was designed to support the implementation of reablement in the delivery of homecare services. This study evaluated the implementation, mechanisms of impact and context of the program. Methods We conducted a process evaluation alongside a 12-month cluster randomized controlled trial, using an embedded mixed-methods design. One hundred fifty-four homecare staff members (23 nurses, 34 nurse assistants, 8 nurse aides and 89 domestic workers) from five working areas received the program. Data on the implementation (reach, dose, fidelity, adaptations and acceptability), possible mechanisms of impact (homecare staff's knowledge, attitude, skills and support) and context were collected using logbooks, registration forms, checklists, log data and focus group interviews with homecare staff (n = 23) and program trainers (n = 4). Results The program was largely implemented as intended. Homecare staff's average compliance to the program meetings was 73.4%; staff members accepted the program, and particularly valued its practical elements and team approach. They experienced positive changes in their knowledge, attitude and skills about reablement, and perceived social and organizational support from colleagues and team managers to implement reablement. However, the extent to which homecare staff implemented reablement in practice, varied. Perceived facilitators included digital care plans, the organization’s lump sum funding and newly referred clients. Perceived barriers included resistance to change from clients or their social network, complex care situations, time pressure and staff shortages. Conclusions The program was feasible to implement in the Dutch homecare setting, and was perceived as useful in daily practice. Nevertheless, integrating reablement into homecare staff's working practices remained challenging due to various personal and contextual factors. Future implementation of the program may benefit from minor program adaptations and a more stimulating work environment. Trial registration ClinicalTrials.gov (Identifier NCT03293303). Registered 26 September 2017.

scholarly journals Telehealth Use in a Home-Based Dementia Care-Coordination Program

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 195-196
Author(s):  
Deirdre Johnston ◽  
Melissa Reuland ◽  
Kelly Marshall ◽  
Inga Antonsdottir ◽  
Morgan Bunting ◽  
...  
Keyword(s):  
Clinical Supervision ◽  
Unmet Need ◽  
Dementia Care ◽  
Care Plan ◽  
Home Setting ◽  
Home Team ◽  
Individualized Care ◽  
Home Based ◽  
Increased Risk ◽  
At Home

Abstract In the coming decades, greater numbers of people will either have Alzheimer’s Disease or a related dementia or will take care of a family member with dementia. The dementia syndromes are associated with increased risk of medical, social, and behavioral complications in both the person with dementia (PWD) and the caregiver (CG), many of which are preventable. These complications, and the dementia itself, can impede access to care and ultimately hasten residential care placement, which can be both undesirable and costly. A nearly universal unmet need in PWD/CG dyads is dementia-specific education. Therefore, it is vital we find ways to support and provide education to CG/PWD dyads to manage dementia in the community and home setting. MIND at Home is a dementia-care model developed and tested at Johns Hopkins University School of Medicine to minimize dementia complications and delay institutionalization by training non-clinical Memory Care Coordinators (MCCs) working under clinical supervision to support and guide PWD/CG dyads in the community. MCCs collaborate with CGs and PWDs in the community using an individualized care plan structured around the dyads’ specific dementia-related needs. This presentation will describe how the MIND at Home team used handheld tablets to connect MCCs to clinicians from participants’ homes, and will report on challenges encountered, strategies to address them, and participant and caregiver satisfaction with the telehealth experience.

scholarly journals P2-509: INITIAL FINDINGS FROM A TECHNOLOGY-ENABLED DEMENTIA CARE PROGRAM IN A POLYCHRONIC PATIENT POPULATION LIVING AT HOME

2019 ◽  
Vol 15 ◽  
pp. P812-P813
Author(s):  
Kevin Liang ◽  
Dirk Soenksen ◽  
Sabita Lahiri ◽  
Christopher Dennis
Keyword(s):  
Patient Population ◽  
Care Program ◽  
Dementia Care ◽  
At Home

Needs, issues, and expectations on dementia care at home across Europe to inform policy development: findings from a transnational research study

Health Policy ◽  
2021 ◽  
Author(s):  
Valentina Bressan ◽  
Henriette Hansen ◽  
Kim Koldby ◽  
Knud Damgaard Andersen ◽  
Allette Snijder ◽  
...  
Keyword(s):  
Policy Development ◽  
Research Study ◽  
Dementia Care ◽  
Care At Home ◽  
At Home

scholarly journals Medication Experience and Adherence to Oral Chemotherapy: A Qualitative Study of Patients’ and Health Professionals’ Perspectives

2021 ◽  
Vol 18 (8) ◽  
pp. 4266
Author(s):  
Amparo Talens ◽  
Mercedes Guilabert ◽  
Blanca Lumbreras ◽  
María Teresa Aznar ◽  
Elsa López-Pintor
Keyword(s):  
Qualitative Study ◽  
Health Professionals ◽  
Real Life ◽  
Positive Influence ◽  
Barriers And Facilitators ◽  
University Hospital ◽  
Nominal Group ◽  
Care Plans ◽  
Individualized Care ◽  
Medication Experience

Lack of adherence constitutes one of the most important challenges in patients undergoing treatment with oral antineoplastic drugs (ANEO). Understanding cancer patients’ experiences with respect to their medication is key for optimizing adherence and therapeutic results. We aimed to assess the medication experience (ME) in patients with cancer in treatment with ANEO, to describe the barriers and facilitators related to the disease and its treatment and to compare them with the healthcare professionals’ perspectives. We carried out an exploratory qualitative study in the University Hospital of San Juan de Alicante, Spain. Three focus groups and two nominal group discussions were conducted with 23 onco-hematological patients treated with ANEO and 18 health professionals, respectively. The data were analyzed using content analyses and were eventually triangulated. The most impactful aspects in patients’ ME were the presence of adverse effects; lack of information about treatment; beliefs, needs and expectations regarding medications; social and family support; and the relationship with the health professionals. Both patients and professionals agreed on considering the negative side effects and the information about treatment as the main barriers and facilitators of adherence, respectively, although the approaches differed between both profiles. The professionals offered a more technical vision while patients prioritized the emotional burden and motivation associated with the disease and medication. This study allowed us to understand the real-life experiences of patients being treated with ANEO and explore the factors which had an impact on adherence to treatment. This understanding enables professionals to have a positive influence on patients’ behavior and provide individualized care plans. Pharmacists’ assistance is relevant to support patients’ adherence and self-management.

scholarly journals Adaptive Reuse of Distressed Malls for Dementia-Friendly City Centers: Outcomes From Community Focus Groups

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 61-61
Author(s):  
Emily Roberts
Keyword(s):  
Spatial Configuration ◽  
Public Spaces ◽  
Dementia Care ◽  
Model Of Care ◽  
Community Revitalization ◽  
Existing Structures ◽  
Group Outcomes ◽  
Midwestern University ◽  
Memory Care

Abstract It is estimated that 5.4 million Americans have some form of dementia and these numbers are expected to rise in the coming decades, leading to an unprecedented demand for memory care housing and services. In searching for innovative options to create more autonomy and better quality of life in dementia care settings, repurposing existing structures, in particular vacant urban malls, may be one option for the large sites needed for the European model of dementia villages. These settings may become sustainable Dementia Friendly City Centers (DFCC), because in the case of enclosed mall construction, the internal infrastructure is in place for lighting, HVAC, with varied spatial configuration of public spaces. This presentation describes the community engagement research being conducted by a research team at a Midwestern university, laying groundwork for the DFCC model for centralized dementia programs, services and attached housing. Focus group outcomes from four disciplines (caregiver, physician, designer, community development) detailed four principle themes including : community revitalization, building sustainability, urban regreening and the nurturing of innovation to further a culture of dementia care which is inclusive, progressive and convergent with the needs of an aging. The DFCC model can be seen as one opportunity to make life better not only for those with needs associated with dementia now, but also for ourselves in the future, therefore educating and updating future stakeholders about the value of this model of care will be critical in transforming current hurdles into future opportunities.

scholarly journals Physical Restraint of Older Adults at Home: Preliminary Analysis of a Prospective Cohort Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 683-683
Author(s):  
Asa Inagaki ◽  
Ayumi Igarashi ◽  
Maiko Noguchi-Watanabe ◽  
Mariko Sakka ◽  
Chie Fukui ◽  
...  
Keyword(s):  
Older Adults ◽  
Online Survey ◽  
Physical Restraint ◽  
Community Dwelling ◽  
Physical Restraints ◽  
Care Nurse ◽  
Factors Associated ◽  
Home Care Nurse ◽  
Community Dwelling Older Adults ◽  
At Home

Abstract Our study aimed to explore the prevalence and factors of physical restraints among frail to dependent older adults living at home. We conducted an online survey to ask about the physical/mental conditions, demographics, service utilization, and physical restraints of community-dwelling older adults. Either home care nurse or care managers who were responsible for the older adult answered the survey that were conducted at baseline and one month later. We obtained data from 1,278 individuals. Physical restraint was reported for 53 (4.1%) participants. Multiple logistic regression revealed the factors associated with physical restraints at home: having been restrained at baseline, having pneumonia or heart failure, receiving home bathing, or using rental assistive devices were associated with physical restraints at one month. The findings could be used to promote discussion about which services prevent physical restraints and what we should do to support clients and their family to stay at home safely.

scholarly journals 1000. HIV and the Treatment-Experienced Patient: The Positive Impact of Case-Based Education on Physicians’ Competence and Confidence

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S529-S529
Author(s):  
Simi Thomas Hurst ◽  
Don Blatherwick
Keyword(s):  
Positive Impact ◽  
Educational Effectiveness ◽  
Care Providers ◽  
Multiple Choice Questions ◽  
Activity Data ◽  
Noticeable Effect ◽  
Individualized Care ◽  
Post Assessment ◽  
Assessment Questions ◽  
Case Based

Abstract Background Despite therapeutic advances, treatment-experienced HIV patients can present a clinical challenge, even to experienced care providers. Table. Assessment of Educational Effectiveness Methods This study assessed the ability of digital education to improve HIV/ID specialists’ ability to develop tailored strategies for treatment-experienced patients. A CME/ABIM MOC/CE-certified, case-based, educational program was developed. Modeled after the interactive grand rounds approach, a “test then teach” strategy with multiple choice questions was used to elicit cognitive dissonance. Evidence-based feedback was provided following each response. Educational effectiveness was assessed with a repeated-pairs pre-/post-assessment study design; each individual served as his/her own control. A chi-square test assessed changes pre- to post-assessment. P values < 0.05 are statistically significant. Effect sizes were evaluated using Cramer’s V (< 0.05 modest; 0.06-0.15 noticeable effect; 0.16-0.26 considerable effect; > 0.26 extensive effect). The activity launched on a website dedicated to continuous professional development on 09/12/19. Data for this matched-learner analysis were collected through 11/06/19. Results To date, 14,181 HCPs (3128 physicians; 9518 nurses/NPs; 333 PAs; 172 pharmacists) have participated in the activity. Data from the subset of HIV/ID specialists (n=110) who answered all pre-/post-assessment questions during the initial study period were analyzed. Following activity participation, significant improvements were observed in the proportion of HIV/ID specialists who answered all assessment questions correctly (15% pre vs 81% post; P < .0001; V=.356). Improvements were also observed in several specific areas of assessment (Table). Additionally, 44% of HIV/ID specialists indicated they planned to modify their treatment approach for treatment experience patients because of participating in the education.Of note, this assessment also identified topics in which HIV/ID had a high degree of baseline knowledge. Conclusion Participation in this online, interactive, case-based, program significantly improved HIV/ID specialists’ ability to develop individualized care strategies for patients who are treatment experienced. Disclosures All Authors: No reported disclosures

Managed Care

PEDIATRICS ◽  
1992 ◽  
Vol 90 (2) ◽  
pp. 278-279
Author(s):  
JENIFER D. C. CARTLAND ◽  
BETH K. YUDKOWSKY
Keyword(s):  
Managed Care ◽  
Medical Care ◽  
Care Program ◽  
Kaiser Permanente ◽  
Care Plans

In Reply.— Doctors Sapin and Laws raise fundamental concerns about our article that was recently published in Pediatrics.1 We feel that these concerns are addressed adequately in the paper, but we would like to take this opportunity to clarify our findings. Dr Sapin argues that our study characterizes all managed care plans, such as the Kaiser Permanente Medical Care Program in which he practices, as having ineffective referral mechanisms. He holds that pediatricians at Kaiser experience "no barriers to appropriate referrals" and indicates that we did not stress this finding adequately.

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