Community-Dwelling Patients With Dementia and Their Informal Caregivers With and Without Case Management: 2-Year Outcomes of a Pragmatic Trial

2015 ◽  
Vol 16 (9) ◽  
pp. 800.e1-800.e8 ◽  
Author(s):  
Janet MacNeil Vroomen ◽  
Judith E. Bosmans ◽  
Peter M. van de Ven ◽  
Karlijn J. Joling ◽  
Lisa D. van Mierlo ◽  
...  
Keyword(s):  
Case Management ◽  
Informal Caregivers ◽  
Pragmatic Trial ◽  
Community Dwelling

Models of home care services for persons with dementia: a narrative review

2015 ◽  
Vol 27 (10) ◽  
pp. 1593-1600 ◽  
Author(s):  
Lee-Fay Low ◽  
Jennifer Fletcher
Keyword(s):  
Case Management ◽  
Home Care ◽  
Integrated Care ◽  
Community Dwelling ◽  
Narrative Review ◽  
Nursing Home Admission ◽  
Community Based ◽  
People With Dementia ◽  
The Impact ◽  
Community Based Services

ABSTRACTBackground:Worldwide trends of increasing dementia prevalence, have put economic and workforce pressures to shifting care for persons with dementia from residential care to home care.Methods:We reviewed the effects of the four dominant models of home care delivery on outcomes for community-dwelling persons with dementia. These models are: case management, integrated care, consumer directed care, and restorative care. This narrative review describes benefits and possible drawbacks for persons with dementia outcomes and elements that comprise successful programs.Results:Case management for persons with dementia may increase use of community-based services and delay nursing home admission. Integrated care is associated with greater client satisfaction, increased use of community based services, and reduced hospital days however the clinical impacts on persons with dementia and their carers are not known. Consumer directed care increases satisfaction with care and service usage, but had little effect on clinical outcomes. Restorative models of home care have been shown to improve function and quality of life however these trials have excluded persons with dementia, with the exception of a pilot study.Conclusions:There has been a little research into models of home care for people with dementia, and no head-to-head comparison of the different models. Research to inform evidence-based policy and service delivery for people with dementia needs to evaluate both the impact of different models on outcomes, and investigate how to best deliver these models to maximize outcomes.

scholarly journals The Informal Caregivers’ Viewpoint About Care Inhibitors for Community-Dwelling Elderly in an Iranian Context: A Qualitative Study

2016 ◽  
Vol 14 (3) ◽  
pp. 185-196
Author(s):  
Samaneh Pourhadi ◽  
Hamid Reza Khankeh ◽  
Reza Fadayevatan ◽  
Robab Sahaf ◽  
◽  
...  
Keyword(s):  
Qualitative Study ◽  
Informal Caregivers ◽  
Community Dwelling ◽  
Iranian Context

scholarly journals EXPLORING TECHNOLOGY-ENABLED ASSESSMENTS OF SYMPTOMS EXPERIENCE BY INFORMAL CAREGIVERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S336-S336
Author(s):  
Daniel J Schulman ◽  
Portia Singh ◽  
Mladen Milosevic ◽  
Ali Samadani
Keyword(s):  
Older Adults ◽  
Symptom Management ◽  
Information Source ◽  
Informal Caregivers ◽  
Smartphone Application ◽  
Relevant Information ◽  
Community Dwelling ◽  
Communication And Coordination ◽  
Community Dwelling Older Adults

Abstract For community-dwelling older adults with chronic conditions, effective symptom management is a determinant of quality of life. Providers often have poor knowledge of an individual’s symptoms experience, especially when contact is infrequent, leading to suboptimal symptom management. Many older adults receive frequent care and contact from family, friends, and other informal caregivers (ICGs). Subjective observation by ICGs is an underexplored information source, but faces barriers including ICG burden and lack of ICG knowledge. It is unclear what relevant information might be collected by ICG observations. We conducted a pilot evaluation of Philips CarePartners Mobile (CPM), a prototype smartphone application that provides communication and coordination support to a “circle” of ICGs assisting an older adult. CPM includes features enabling ICGs to share semi-structured observations. 19 caregivers (in 8 circles) used CPM for 12 weeks, contributing 397 observations and participating in interviews and other assessments. We performed a qualitative analysis of the observations, coding for presence of content relevant to dimensions in the UCSF Symptom Management Theory (perception of, evaluation of, and response to symptoms). Relevant content was found in 150 observations, with perception and assessment more common (141) than response (32). Common symptoms included mobility difficulty (31), fatigue (23), dizziness (21), pain (19), and confusion (18). Among observations without symptom-relevant content, many reported on overall mood (92), and reference to social activities was frequent. These results demonstrate that symptoms experience can be assessed using caregiver observations, although further work may be needed to enable caregivers to provide a comprehensive assessment.

End-of-life care research in Hong Kong: A systematic review of peer-reviewed publications

2015 ◽  
Vol 13 (6) ◽  
pp. 1711-1720 ◽  
Author(s):  
Chong-Wen Wang ◽  
Cecilia L.W. Chan
Keyword(s):  
Systematic Review ◽  
Hong Kong ◽  
End Of Life ◽  
Informal Caregivers ◽  
Physical Symptoms ◽  
Community Dwelling ◽  
Care Staff ◽  
Care Research ◽  
Research Themes ◽  
Eol Care

ABSTRACTObjective:This systematic review aimed to examine end-of-life (EoL) care research undertaken in an Eastern cultural context—Hong Kong—with the hope of better informing EoL care professionals and policy makers and providing lessons for other countries or areas that share similar EoL care challenges.Method:Eight databases were searched from their respective inception through to August of 2014. All of the resulting studies conducted in Hong Kong and relevant to EoL care or palliative care were examined. The included studies were assessed with respect to study design, care settings, participants, research themes, and major findings.Results:Some 107 publications published between 1991 and 2014 were identified. These studies were undertaken at a range of places by different professionals. Of the total, 44 were led by physicians, 36 by nurses, 17 by social workers, and 10 by other professionals. Participants included both inpatients and outpatients with different illnesses, nursing home residents, older community-dwelling adults, deceased individuals, care staff, and informal caregivers. A total of 13 research themes were identified: (1) attitudes to or perceptions of death and dying; (2) utilization of healthcare services, (3) physical symptoms or medical problems; (4) death anxiety or mental health issues; (5) quality of life; (6) advance directives or advance care planning; (7) supportive care needs, (8) decision making; (9) spirituality; (10) cost-effectiveness or utility studies; (11) care professionals' education and training; (12) informal caregivers' perceptions and experience; and (13) scale development or validation.Significance of results:While there has been a wide and diverse range of research activities in Hong Kong, EoL care services at primary care settings should be strengthened. Some priority areas for further research are recommended.

scholarly journals LONGITUDINAL CHARACTERISTICS OF INFORMAL CAREGIVERS OF COMMUNITY-DWELLING PERSONS WITH DEMENTIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S450-S450
Author(s):  
Eric Jutkowitz ◽  
Joseph E Gaugler ◽  
Amal Trivedi ◽  
Lauren L Mitchell ◽  
Pedro L Gozalo
Keyword(s):  
Nursing Home ◽  
Adult Children ◽  
Functional Limitations ◽  
Informal Caregivers ◽  
Mixed Effects ◽  
Community Dwelling ◽  
Mixed Effects Models ◽  
Linear Mixed Effects Models ◽  
Linear Mixed Effects ◽  
Retirement Study

Abstract Alzheimer’s disease and related dementias (ADRD) affect >5 million Americans. Persons with ADRD experience functional limitations and often require support from informal caregivers (e.g., help with feeding). Little is known about how caregiving evolves over the full course of the disease. We used data from the Health and Retirement Study to identify incident predicted community-dwelling persons with ADRD (n=565), their informal caregivers, and the total hours of care they received in a month from predicted incidence up to 8-years post incidence. We estimated linear mixed-effects models to determine the characteristics of the person with ADRD that are associated with trajectories of caregiving hours. At predicted incidence, persons with ADRD received 120 hours of care in a month of which spouses provided 30% of care hours, adult children provided 32% of care hours, other relatives provided 12% of care hours, and non-relatives (including paid support) provided 25% of care hours. By 8-years post incidence, persons with ADRD still in the community (n=23) received 303 hours of care in a month of which spouses provided 28% of care hours, adult children provided 41% of care hours, other relatives provided 3% of care hours, and non-relatives provided 28% of care hours. Having great grandchildren and more functional limitations were associated with receiving more hours of informal care. Attrition (mortality and residing in a nursing home) was influenced by hours of care received in the previous interview and resulted in those that remained in the community being persons that required less care.

scholarly journals The Cost-Effectiveness of Two Forms of Case Management Compared to a Control Group for Persons with Dementia and Their Informal Caregivers from a Societal Perspective

PLoS ONE ◽  
2016 ◽  
Vol 11 (9) ◽  
pp. e0160908 ◽  
Author(s):  
Janet MacNeil Vroomen ◽  
Judith E. Bosmans ◽  
Iris Eekhout ◽  
Karlijn J. Joling ◽  
Lisa D. van Mierlo ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Case Management ◽  
Societal Perspective ◽  
Informal Caregivers ◽  
Control Group ◽  
The Cost
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