title: Caregiver outcomes of partners in dementia care: effect of a care coordination program for veterans with dementia and their family members and friends.
abstract: The objective is to test the effectiveness of Partners in Dementia Care (PDC), a care-coordination program that integrates and improves access to medical and nonmedical services, while strengthening the informal care network and providing information, coaching, and emotional support. PDC was delivered via a partnership between Veterans Affairs (VA) Medical Centers (VAMCs) and Alzheimer's Association chapters, for caregivers of veterans with dementia living in the community and receiving primary care from the VA. The initial sample was 486 caregivers of 508 veterans with diagnosed dementia. Outcomes were evaluated for 394 and 324 caregivers who completed 6- and 12- month follow-up, respectively. PDC had a standardized protocol that included assessment and reassessment, action planning, and ongoing monitoring. It was delivered by telephone and e-mail for cost efficiency and the ability to handle caseloads of 100 to 125. Care coordinators from VAMCs and Alzheimer's Association chapters worked as a team using a shared computerized record. A variety of caregiver outcomes was measured after 6 and 12 months. Intervention group caregivers had significant improvements in outcomes representing unmet needs, three types of caregiver strains, depression, and two support resources. Most improvements were evident after 6 months, with more-limited improvements from Months 6 to 12. Some outcomes improved for all caregivers, whereas some improved for caregivers experiencing more initial difficulties or caring for veterans with more-severe impairments. PDC is a promising model that improves linkages between healthcare services and community services, which is a goal of several new national initiatives such as the National Plan to Address Alzheimer's Disease and a proposed amendment to the Older Americans Act.
authors.affiliation: Benjamin Rose Institute on Aging, Cleveland, Ohio 44120, USA. dbass@benrose.org
authors.forename: David M
authors.initials: DM
authors.lastname: Bass
authors.forename: Katherine S
authors.initials: KS
authors.lastname: Judge
authors.forename: A Lynn
authors.initials: AL
authors.lastname: Snow
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Wilson
authors.forename: Robert
authors.initials: R
authors.lastname: Morgan
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Looman
authors.forename: Catherine A
authors.initials: CA
authors.lastname: McCarthy
authors.forename: Katie
authors.initials: K
authors.lastname: Maslow
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Moye
authors.forename: Ronda
authors.initials: R
authors.lastname: Randazzo
authors.forename: Maurilio
authors.initials: M
authors.lastname: Garcia-Maldonado
authors.forename: Richard
authors.initials: R
authors.lastname: Elbein
authors.forename: Germaine
authors.initials: G
authors.lastname: Odenheimer
authors.forename: Mark E
authors.initials: ME
authors.lastname: Kunik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology* / Q000628:therapy*; D017028:Caregivers / Q000523:psychology*; D003153:Community Health Services; D003299:Cooperative Behavior; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D033062:Friends / Q000523:psychology*; D006301:Health Services Needs and Demand / Q000458:organization & administration; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D010347:Patient Care Planning / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration; D012944:Social Support; D016896:Treatment Outcome; D014481:United States; D014728:Veterans / Q000523:psychology*
keywords: care coordination; caregiver support; dementia caregiving