Dementia care delivered at home by trained nurses improved caregiver burden and behavioral and psychological symptoms of dementia among individuals living at home, according to recent findings.
“People with dementia need comprehensive medical, nursing, psychological and social support to delay the progression of disease and sustain autonomy and social inclusion,” Jochen René Thyrian, PhD, of the German Center for Neurodegenerative Diseases, Greifswald, Germany, and colleagues wrote. “Primary care has been identified as the first point of contact for people with dementia and is thus a promising setting for identification, comprehensive needs assessment and initiating dementia-specific treatment and care. However, primary care systems worldwide are insufficiently prepared for these tasks.”
To assess efficacy and safety of dementia care management in individuals with dementia living at home and caregiver burden, researchers conducted a randomized clinical trial among 407 adults aged 70 years and older living at home. Study participants were randomly assigned to receive dementia care management at home for 6 months or treatment as usual. Dementia care management follows a collaborative care model in which treatment is provided to patients with dementia and support provided to caregivers based on a computer-assisted assessment of needs. Dementia care management was conducted by six study nurses with dementia-specific qualifications.
Overall, 60.9% of the cohort was female and 50.1% lived alone. The mean age of participants was 80 years.
Dementia care management decreased behavioral and psychological symptoms of dementia (P < .001) and caregiver burden (P = .045), compared with usual treatment.
Participants who received dementia care management were more likely to receive anti-dementia drug treatment after 12 months, compared with those who received treatment as usual (39.2% vs. 26.7%; OR = 1.97; 95% CI, 0.99-3.94; P = .03).
Dementia care management was associated with a significant improvement in quality of life for participants not living alone (P = .03), but not with overall quality of life.
Researchers did not find any effect on potentially inappropriate medication.
“Dementia care management provided by specially trained nurses and supported by a computer-based [intervention management system] is an effective and safe collaborative care model that has clinically relevant patient-and caregiver-related effects on treatment and care. Therefore, implementation in routine care could be beneficial for people with dementia and their relative caregivers,” the researchers concluded. – by Amanda Oldt
Disclosure: The researchers report no relevant financial disclosures.