title: Treatment outcomes of a crisis intervention program for dementia with severe psychiatric complications: the Kansas bridge project.
abstract: OBJECTIVE
  Although declines in memory and attention are hallmark symptoms of Alzheimer's disease (AD), noncognitive symptoms are prevalent. Over 80% of individuals will experience neuropsychiatric symptoms, which complicates symptom profiles. Research indicates a community-integrated response to dementia crisis can reduce negative consequences attributed to crisis including increased caregiver burden, increased health care costs, and premature institutionalizations.
  
  
  METHODS
  The Kansas Dementia Crisis Bridge Project is a multidisciplinary collaboration to provide direct support in critical situations to reduce psychiatric rehospitalizations. Coordinators provided counsel and dementia education to families throughout critical period of acute neuropsychiatric symptoms, facilitated professional involvement, and provided crisis prevention planning through crisis review. The Neuropsychiatric Inventory Questionnaire and Geriatric Depression Scale were used to measure the impact of neuropsychiatric symptoms and Bridge interventions on patient and caregivers.
  
  
  RESULTS
  The Bridge project significantly reduced patient anxiety, depression, resistance to care, impulsive behavior, verbal outbursts, and wandering. Caregivers reported significantly reduced anxiety, apathy, resistance to care, and less distress over patient neuropsychiatric symptoms. Caregivers also reported increased confidence in managing difficult behaviors, and the project effectively reduced or resolved neuropsychiatric crisis. The project delayed nursing home placement for community-dwelling patients.
  
  
  CONCLUSIONS
  Crisis support models like the Bridge project reduce strain on care-delivery systems by incorporating nonpharmacological interventions, assisting families with communication, and reducing family distress during symptom crises. Although much of AD research focuses on disease-modifying medical interventions, aging and care systems in the state must simultaneously move towards dependency-modifying care interventions.
authors.affiliation: Department of Psychology, University of Kansas, Lawrence, KS, USA. dkj@ku.edu
authors.forename: David Kevin
authors.initials: DK
authors.lastname: Johnson
authors.forename: Michelle
authors.initials: M
authors.lastname: Niedens
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Wilson
authors.forename: Lora
authors.initials: L
authors.lastname: Swartzendruber
authors.forename: Amy
authors.initials: A
authors.lastname: Yeager
authors.forename: Kelly
authors.initials: K
authors.lastname: Jones
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001521:Behavior Therapy; D017028:Caregivers / Q000523:psychology*; D015897:Comorbidity; D003419:Crisis Intervention / Q000379:methods*; D003704:Dementia / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007615:Kansas / Q000453:epidemiology; D008297:Male; D009483:Neuropsychological Tests; D010359:Patient Readmission / Q000706:statistics & numerical data; D010865:Pilot Projects; D016730:Program Development; D015397:Program Evaluation; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome