Adaptation and Piloting for Hospice Social Workers of Aliviado Dementia Care, a Dementia Symptom Management Program

2020 ◽  
pp. 104990912096245
Author(s):  
Tessa M. Jones ◽  
Abraham A. Brody
Keyword(s):  
Social Workers ◽  
Symptom Management ◽  
Repeated Measures ◽  
Psychological Symptoms ◽  
The United States ◽  
Management Program ◽  
Dementia Care ◽  
Home Healthcare ◽  
Behavioral Symptoms ◽  
Improvement Program

Background: Forty-five percent of hospice patients currently have a primary or secondary diagnosis of Alzheimer’s disease or related disorders. However, few programs have focused specifically on assisting hospices in providing evidence-based symptom management to persons living with dementia (PLWD). Objective: To adapt and pilot the training component of Aliviado Dementia Care, a dementia symptom management quality improvement program originally developed for home healthcare, for use by social workers as part of the hospice interdisciplinary team. Design: A prospective pre-post design was utilized, measuring knowledge, confidence, and attitudes at baseline, and immediately and 1-month post-training. Analysis was performed using paired t-tests and repeated measures ANOVA. Subjects: Hospice social workers currently practicing in the United States with at least 1 year of experience. Measurements: The Dementia Symptom Knowledge Assessment and a post-training continuing education evaluation form. Results: Forty-six subjects were enrolled, of whom 26 completed the first post-test and 23 both post-tests. There was a poor baseline level of knowledge and confidence in caring for PLWD. Significant improvements occurred following training, particularly in implementing non-pharmacologic interventions for behavioral and psychological symptoms of dementia (BPSD) (16.64% increase, p < .0001) and confidence in managing behavioral symptoms (16.86%, p = .01) and depression (25.18%, p < .0001). Changes were maintained over time. All respondents were either very satisfied or satisfied with the quality and content of the program. Conclusions: The training modules of Aliviado Dementia Care were successfully tailored for use by hospice social workers, showing significant improvement in knowledge and confidence in caring for behavioral symptoms in PLWD. Future work will examine whether the larger program, including this training, can subsequently improve patient outcomes in hospice.

Quality 101: What Every Audiologist and Speech-Language Pathologist Should Know But Is Afraid to Ask

2011 ◽  
Vol 7 (1) ◽  
pp. 4-7
Author(s):  
Tamala S. Bradham
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Quality Management ◽  
The United States ◽  
Management Program ◽  
Market Place ◽  
Improvement Program ◽  
Quality Health Care ◽  
Speech Language Pathologist ◽  
Quality Health

The United States has the highest per capita health care costs of any industrialized nation in the world. Increasing costs are reducing access to care and constitute an increasingly heavy burden on employers and consumers. Yet as much as 20 to 30 percent of these costs may be unnecessary, or even counterproductive, to improved health (Wennberg, Brownless, Fisher, Skinner, & Weinstein, 2008). Addressing these unwanted costs is essential in the survival of providing quality health care. This article reviews 11 dimensions that should be considered when starting a quality improvement program as well as one quality improvement tool, the Juran model, that is commonly used in the healthcare and business settings. Implementing a quality management program is essential for survival in today’s market place and is no longer an option. While it takes time to implement a quality management program, the costs are too high not to.

Abstract P126: Self-management Program And Black Women With Hypertension

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Willie M Abel
Keyword(s):  
Black Women ◽  
Repeated Measures ◽  
Care Management ◽  
Self Care ◽  
The United States ◽  
Management Program ◽  
Lifestyle Changes ◽  
Community Dwelling ◽  
Self Management ◽  
Effective Interventions

Introduction: Prevalence rates of hypertension (HTN) among Black adults (males 58.3% and females 57.6%) in the United States is among the highest in the world. Black females (46%) experience a higher incidence of Stage 2 HTN than Black males (42%) contributing to a greater risk of heart failure, stroke, and kidney disease. Levels of awareness, treatment, and control of HTN among Black women are decreasing. Effective strategies to combat these trends are imperative. Lifestyle changes and medication adherence are proven strategies to facilitate blood pressure (BP) control. Getting individuals with HTN to incorporate these strategies into the context of their everyday physical and social environments where they can be performed independently requires active individual engagement in healthcare behaviors and self-care activities. Aim: This study examined the effects of the Chronic Disease Self-Management Program (CDSMP) on self-care (maintenance, management, and confidence) and BP control in Black women with HTN at baseline and then 3-, 6-, and 9-months post CDSMP. Methods: The current study used data from the Interactive Technology Enhanced Coaching Intervention RCT for Black Women with HTN study. All participants completed a 6-week CDSMP at the beginning of the study. Self-care data were collected using the Self-Care of HTN Inventory along with manual BP readings at baseline, and repeated measures at 3-, 6-, and 9-months. Results: Of the 90 community-dwelling Black women enrolled in the study, 83 completed the CDSMP and 69 completed the study. The mean age was 53.57 ( SD = 10.07) years and the average number of years diagnosed with HTN was 11.06 ( SD = 8.47). All participants had BP readings greater than 130/80 mmHg at baseline and 44.92% (31 of 69) moved to less than 130/80 mmHg at 9-months. A weak negative correlation occurred at 9-months between systolic BP and self-care management, r (67) = -.26, p = .029, and confidence, r (67) = -.25, p = .035; and diastolic BP and self-care management, r (67) = -.31, p = .009, and confidence, r (67) = -.28, p = .018. Conclusion: The CDSMP was feasible, successfully delivered, and well-received by those enrolled in the study. Future studies should evaluate effective interventions for self-care strategies to improve long-term BP control.

scholarly journals THE IMPACT OF ALIVIADO DEMENTIA CARE HOSPICE EDITION TRAINING PROGRAM ON HOSPICE STAFF’S DEMENTIA SYMPTOM KNOWLEDGE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S851-S851
Author(s):  
Catherine E Schneider ◽  
Alycia A Bristol ◽  
Ariel Ford ◽  
Shih-Yin Lin ◽  
Abraham A Brody
Keyword(s):  
Psychological Symptoms ◽  
Daily Practice ◽  
Dementia Care ◽  
Interdisciplinary Teams ◽  
Practice Change ◽  
P Value ◽  
Evidence Based ◽  
Improvement Program ◽  
Team Members ◽  
The Impact

Abstract A lack of high quality dementia training for healthcare workers is a key barrier to effective care for persons with dementia (PWD), a vulnerable and increasing population across the care continuum. Hospice agencies in particular are underprepared to care for this population, although annually about 17% of hospice patients have a primary diagnosis of dementia and an additional 28% as a comorbidity. Aliviado Dementia Care-Hospice Edition is an interdisciplinary, evidence-based quality improvement program developed to assist hospice interdisciplinary teams in caring for PWD and their caregivers. Interdisciplinary hospice team members in two agencies were enrolled in online training modules, which addressed multiple areas including pain, behavioral and psychological symptoms of dementia (BPSD), and working with caregivers. They were also provided a toolkit to integrate training in daily practice. Changes in knowledge, confidence and attitudes were tested before and after training and paired t-tests were utilized to evaluate the program’s effect. Thirty-five individuals completed the program and pre/post tests. Paired t-tests showed clinically and statistically significant increases in knowledge, attitudes and confidence in five of 10 domains including depression knowledge and confidence and BPSD knowledge, confidence and interventions. The greatest increase was in using BPSD interventions (18.5% increase, p-value: 0.0002), depression confidence (15.9% increase, p-value: 0.006) and BPSD confidence (12.6% increase, p-value: 0.02). Aliviado is an evidence-based, systems-level intervention shown to improve clinical knowledge, attitudes and confidence in treating pain and BPSD in PWD. This training could be used to produce systems-level practice change for hospice interdisciplinary team members serving PWD.

Racial and Sex Disparities in Trauma Outcomes Based on Geographical Region

2020 ◽  
pp. 000313482096006
Author(s):  
William Q. Duong ◽  
Areg Grigorian ◽  
Cyrus Farzaneh ◽  
Jeffry Nahmias ◽  
Theresa Chin ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Trauma Patients ◽  
Improvement Program ◽  
Trauma Outcomes ◽  
Risk Of Death ◽  
Hospital Access ◽  
Risk Of Mortality ◽  
Sex Disparities ◽  
Male Patients

Objectives Disparities in outcomes among trauma patients have been shown to be associated with race and sex. The purpose of this study was to analyze racial and sex mortality disparities in different regions of the United States, hypothesizing that the risk of mortality among black and Asian trauma patients, compared to white trauma patients, will be similar within all regions in the United States. Methods The Trauma Quality Improvement Program (2010-2016) was queried for adult trauma patients, separating by U.S. Census regions. Multivariable logistic regression analyses were performed for each region, controlling for known predictors of morbidity and mortality in trauma. Results Most trauma patients were treated in the South (n = 522 388, 40.7%). After risk adjustment, black trauma patients had a higher associated risk of death in all regions, except the Northeast, compared to white trauma patients. The highest associated risk of death for blacks (vs. whites) was in the Midwest (odds ratio [OR] 1.30, P < .001). Asian trauma patients only had a higher associated risk of death in the West (OR 1.39, P < .001). Male trauma patients, compared to women, had an increased associated risk of mortality in all four regions. Discussion This study found major differences in outcomes among different races within different regions of the United States. There was also both an increased rate and associated risk of mortality for male patients in all regions. Future prospective studies are needed to identify what regional differences in trauma systems including population density, transport times, hospital access, and other trauma resources explain these findings.

scholarly journals Moderating Roles of Resilience and Social Support on Psychiatric and Practice Outcomes in Nurses Working During the COVID-19 Pandemic

2021 ◽  
Vol 7 ◽  
pp. 237796082110242
Author(s):  
Anna E. Schierberl Scherr ◽  
Brian J. Ayotte ◽  
Marni B. Kellogg
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Online Survey ◽  
Psychological Symptoms ◽  
The United States ◽  
Direct Care ◽  
Behavioral Measure ◽  
Hierarchical Regression ◽  
Research Reporting ◽  
Symptoms Of Depression

Introduction Staff and equipment shortages and an easily transmissible virus make working in the COVID-19 pandemic demanding physically and psychologically. Nurses on the frontlines are particularly vulnerable to the adversity of working under these conditions, particularly with regard to mental health. Thus, understanding risk and protective factors for this vulnerable and essential group is critical for identifying potential targets of interventions. We had two aims for the current study: (a) to examine work functioning and symptoms of depression, anxiety, and posttraumatic stress (PTSD) among nurses who did and did not care for patients with COVID-19; and (b) to determine if resilience and social support moderate these relationships. Methods For three weeks in July 2020, nurses across the United States were invited to participate in an online survey collecting data on demographics, resilience, social support, and screening measures of depression, PTSD, anxiety, and distracted practice. Data were analyzed using descriptive statistics and hierarchical regression for each outcome measure. Conclusions Our findings support a growing body of research reporting that nurses are experiencing mental health sequelae during the COVID-19 pandemic, especially those providing direct care to patients with the virus. We found that compared to nurses who did not care for patients with COVID-19, those who did reported increased symptoms of PTSD, depression, and anxiety. A novel contribution is our finding that nurses providing direct COVID-19 care also experienced increased levels of distracted practice, a behavioral measure of distraction linking to a potential impact on patient care. We also found that resilience and social support acted as moderators of some of these relationships. Fostering resilience and social support may help buffer the effects of providing care to patients with COVID-19 and could potentially decrease nurse vulnerability to developing psychological symptoms and impairment on the job.

scholarly journals Changes in Parent and Child Skin Carotenoids, Weight, and Dietary Behaviors over Parental Weight Management

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2227
Author(s):  
Keeley J. Pratt ◽  
Emily B. Hill ◽  
Haley M. Kiser ◽  
Catherine E. VanFossen ◽  
Ashlea Braun ◽  
...  
Keyword(s):  
Weight Management ◽  
Repeated Measures ◽  
Fast Food ◽  
Weight Status ◽  
Vegetable Intake ◽  
Management Program ◽  
Family Meals ◽  
Parental Participation ◽  
Strongly Correlated ◽  
Medical Weight Management

(1) The objective was to determine changes in parent–child (ages 7–18) dyad skin carotenoids spanning parental participation in a medical weight management program (WMP), and associations with parent BMI, child BMIz, fruit/vegetable intake, and family meals and patterns. (2) The study design was a longitudinal dyadic observational study with assessment at WMP initiation, mid-point (3-months), and conclusion (6-months). Twenty-three dyads initiated the study, 16 provided assessments at 3 months, and 11 at program conclusion. Associations between parent and child carotenoids (dependent variables) and parent BMI, child BMIz, increases in fruit/vegetable intake, and family meals and patterns were analyzed using Pearson’s correlations and independent samples t-tests. Repeated measures ANOVA assessed changes in weight status and carotenoids. (3) Parents experienced significant declines in BMI and skin carotenoid levels over 6 months. Parent and child carotenoids were correlated at each assessment. At initiation, parent BMI and carotenoids were inversely correlated, child carotenoids were associated with increased family meals, and never consuming an evening fast food or restaurant meal were associated with increased parent and child carotenoids. (4) Results demonstrate skin carotenoids are strongly correlated within dyads and may be associated with lower parental BMI and positive family meal practices.

scholarly journals Facing the Journey Together: Using Digital Media to Support Dementia Care Among Asian Americans

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 542-542
Author(s):  
Angelica Yeh ◽  
Marie Mayen-Cho
Keyword(s):  
Los Angeles ◽  
Digital Media ◽  
The United States ◽  
Dementia Care ◽  
Pacific Islanders ◽  
Japanese American ◽  
Culturally Appropriate ◽  
Care Partners ◽  
Care Information ◽  
Depth Interviews

Abstract Asians and Pacific Islanders (APIs) in the United States have limited access to dementia care information that is linguistically and culturally appropriate. Alzheimer’s Los Angeles created “Faces of Caregiving”, a video project available with English/Japanese subtitles, documenting in-depth interviews with 7 Japanese/Japanese-American familial care partners of individuals living with dementia. It touched on the personal yet universal aspects of each journey embedded in a particular family context. The 5 video profiles were subsequently shown at 3 community sites to attendees comprised of mostly older-adult APIs. Among 85 attendee responses, approximately 90% stated they were more likely to seek out information on and support for Alzheimer’s disease, felt more open to talking about the disease, and were more likely to advocate and raise awareness for the disease. This program could be replicated for other API communities, allowing individuals to learn more effectively from a peer-to-peer experience in a culturally familiar setting. Part of a symposium sponsored by the Aging Among Asians Interest Group.

scholarly journals Person-Centered Care in Persons Living with Dementia: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Kyung Hee Lee ◽  
Ji Yeon Lee ◽  
Bora Kim
Keyword(s):  
Systematic Review ◽  
Cognitive Function ◽  
Effect Size ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
Healthcare Providers ◽  
Clinical Excellence ◽  
Dementia Care ◽  
Person Centered Care ◽  
Centered Care

Abstract Background and Objectives The concept of person-centered care has been utilized/adapted to various interventions to enhance health-related outcomes and ensure the quality of care delivered to persons living with dementia. A few systematic reviews have been conducted on the use of person-centered interventions in the context of dementia care, but to date, none have analyzed intervention effect by intervention type and target outcome. This study aimed to review person-centered interventions used in the context of dementia care and examine their effectiveness. Research Design and Methods A systematic review and meta-analysis were conducted. We searched through five databases for randomized controlled trials that utilized person-centered interventions in persons living with dementia from 1998 to 2019. Study quality was assessed using the National Institute for Health and Clinical Excellence. The outcomes of interest for the meta-analysis were behavioral and psychological symptoms in dementia (BPSD) and cognitive function assessed immediately after the baseline measurement. Results In total, 36 studies were systematically reviewed. Intervention types were: reminiscence, music, and cognitive therapies, and multisensory stimulation. Thirty studies were included in the meta-analysis. Results showed a moderate effect size for overall intervention, a small one for music therapy, and a moderate one for reminiscence therapy on BPSD and cognitive function. Discussion and Implications Generally speaking, person-centered interventions showed immediate intervention effects on reducing BPSD and improving cognitive function, although the effect size and significance of each outcome differed by intervention type. Thus, healthcare providers should consider person-centered interventions as a vital element in dementia care.

scholarly journals Ascertaining Consciousness in Identity Formation: Best Medical Practices in Dementia Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 567-567
Author(s):  
Angel Duncan
Keyword(s):  
Identity Formation ◽  
The United States ◽  
Dementia Care ◽  
Medical Practices ◽  
Arts And Sciences ◽  
The Arts ◽  
Testing Case ◽  
Clinical Research Trials ◽  
Common Misconceptions

Abstract This session identifies common misconceptions about identity for persons living with Alzheimer’s disease and related dementias (ADRD). Going beyond diagnostic brain imaging and neurocognitive testing, case studies and research in creativity from around the United States highlights consciousness of persons living with ADRD. Reviewing and discussing artworks is aimed to set dialogue in the question of where memory deposits emerge when engaged in creativity. Through art therapy techniques, this type of self-expression may provide new avenues in treatment for dementia care. Exploring the arts from those with Mild Cognitive Impairment to late stage Alzheimer’s and other forms of dementia, such as frontotemporal dementia, consciousness seems to remain intact despite neural death. This session aims to discourage poor spending allocations and establishing meaningful care. From clinical research trials to creativity of self-expression, the importance of why the arts and sciences matter are demonstrated as effective modalities that enhance quality of life.

scholarly journals Appendiceal adenocarcinoma found by surgery for acute appendicitis is associated with older age

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
John P. Skendelas ◽  
Victor S. Alemany ◽  
Vincent Au ◽  
Devika Rao ◽  
John McNelis ◽  
...  
Keyword(s):  
New York ◽  
Acute Appendicitis ◽  
Incidental Finding ◽  
Population Sample ◽  
Operative Therapy ◽  
Operative Management ◽  
The United States ◽  
Improvement Program ◽  
Common Procedure ◽  
Appendiceal Neoplasms

Abstract Background Appendectomy for acute appendicitis is the most common procedure performed emergently by general surgeons in the United States. The current management of acute appendicitis is increasingly controversial as non-operative management gains favor. Although rare, appendiceal neoplasms are often found as an incidental finding in the setting of appendectomy. Criteria and screening for appendiceal neoplasms are not standardized among surgical societies. Methods The National Surgical Quality Improvement Program (NSQIP) database was queried for all patients who underwent appendectomy over a 9-year period (2010–2018). Over the same time period, patients who underwent appendectomy in two municipal hospitals in The Bronx, New York City, USA were reviewed. Results We found a 1.7% incidence of appendiceal neoplasms locally and a 0.53% incidence of appendiceal tumors in a national population sample. Both groups demonstrated an increased incidence of appendiceal carcinoma by age. This finding was most pronounced after the age of 40 in both local and national populations. In our study, the incidence of appendiceal tumors increased with each decade interval up to the age of 80 and peaked at 2.1% in patients between 70 and 79 years. Conclusions Appendiceal adenocarcinomas were identified in patients with acute appendicitis that seem to be associated with increasing age. The presence of an appendiceal malignancy should be considered in the management of older patients with acute appendicitis before a decision to embark on non-operative therapy.

Sign in / Sign up

Export Citation Format

Share Document