Implementing innovative models of dementia care: The Healthy Aging Brain Center

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Abstract

Background: Recent randomized controlled trials have demonstrated the effectiveness of the collaborative dementia care model targeting both the patients suffering from dementia and their informal caregivers. Objective: To implement a sustainable collaborative dementia care program in a public health care system in Indianapolis. Methods: We used the framework of Complex Adaptive System and the tool of the Reflective Adaptive Process to translate the results of the dementia care trial into the Healthy Aging Brain Center (HABC). Results: Within its first year of operation, the HABC delivered 528 visits to serve 208 patients and 176 informal caregivers. The mean age of HABC patients was 73.8 (standard deviation, SD 9.5), 40% were African-Americans, 42% had less than high school education, 14% had normal cognitive status, 39% received a diagnosis of mild cognitive impairment, and 46% were diagnosed with dementia. Within 12 months of the initial HABC visit, 28% of patients had at least one visit to an emergency room (ER) and 14% were hospitalized with a mean length of stay of five days. The rate of a one-week ER revisit was 14% and the 30-day rehospitalization rate was 11%. Only 5% of HABC patients received an order for neuroleptics and only 16% had simultaneous orders for both definite anticholinergic and anti-dementia drugs. Conclusion: The tools of 'implementation science' can be utilized to translate a health care delivery model developed in the research laboratory to a practical, operational, health care delivery program.

Original languageEnglish (US)
Pages (from-to)13-22
Number of pages10
JournalAging and Mental Health
Volume15
Issue number1
DOIs
StatePublished - Jan 1 2011

Fingerprint

Dementia
Brain
Delivery of Health Care
Caregivers
Hospital Emergency Service
Cholinergic Antagonists
African Americans
Antipsychotic Agents
Length of Stay
Randomized Controlled Trials
Public Health
Education
Research
Pharmaceutical Preparations

Keywords

  • complex adaptive system
  • dementia care
  • implementation science
  • informal caregiver
  • memory care practice

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Gerontology
  • Phychiatric Mental Health
  • Psychiatry and Mental health
  • Medicine(all)

Cite this

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title = "Implementing innovative models of dementia care: The Healthy Aging Brain Center",
abstract = "Background: Recent randomized controlled trials have demonstrated the effectiveness of the collaborative dementia care model targeting both the patients suffering from dementia and their informal caregivers. Objective: To implement a sustainable collaborative dementia care program in a public health care system in Indianapolis. Methods: We used the framework of Complex Adaptive System and the tool of the Reflective Adaptive Process to translate the results of the dementia care trial into the Healthy Aging Brain Center (HABC). Results: Within its first year of operation, the HABC delivered 528 visits to serve 208 patients and 176 informal caregivers. The mean age of HABC patients was 73.8 (standard deviation, SD 9.5), 40{\%} were African-Americans, 42{\%} had less than high school education, 14{\%} had normal cognitive status, 39{\%} received a diagnosis of mild cognitive impairment, and 46{\%} were diagnosed with dementia. Within 12 months of the initial HABC visit, 28{\%} of patients had at least one visit to an emergency room (ER) and 14{\%} were hospitalized with a mean length of stay of five days. The rate of a one-week ER revisit was 14{\%} and the 30-day rehospitalization rate was 11{\%}. Only 5{\%} of HABC patients received an order for neuroleptics and only 16{\%} had simultaneous orders for both definite anticholinergic and anti-dementia drugs. Conclusion: The tools of 'implementation science' can be utilized to translate a health care delivery model developed in the research laboratory to a practical, operational, health care delivery program.",
keywords = "complex adaptive system, dementia care, implementation science, informal caregiver, memory care practice",
author = "Boustani, {Malaz A.} and Sachs, {Greg A.} and Alder, {Catherine A.} and Stephanie Munger and Schubert, {Cathy C.} and {Guerriero Austrom}, Mary and Hake, {Ann M.} and Unverzagt, {Frederick W.} and Martin Farlow and Matthews, {Brandy R.} and Perkins, {Anthony J.} and Beck, {Robin A.} and Callahan, {Christopher M.}",
year = "2011",
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AU - Boustani, Malaz A.

AU - Sachs, Greg A.

AU - Alder, Catherine A.

AU - Munger, Stephanie

AU - Schubert, Cathy C.

AU - Guerriero Austrom, Mary

AU - Hake, Ann M.

AU - Unverzagt, Frederick W.

AU - Farlow, Martin

AU - Matthews, Brandy R.

AU - Perkins, Anthony J.

AU - Beck, Robin A.

AU - Callahan, Christopher M.

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N2 - Background: Recent randomized controlled trials have demonstrated the effectiveness of the collaborative dementia care model targeting both the patients suffering from dementia and their informal caregivers. Objective: To implement a sustainable collaborative dementia care program in a public health care system in Indianapolis. Methods: We used the framework of Complex Adaptive System and the tool of the Reflective Adaptive Process to translate the results of the dementia care trial into the Healthy Aging Brain Center (HABC). Results: Within its first year of operation, the HABC delivered 528 visits to serve 208 patients and 176 informal caregivers. The mean age of HABC patients was 73.8 (standard deviation, SD 9.5), 40% were African-Americans, 42% had less than high school education, 14% had normal cognitive status, 39% received a diagnosis of mild cognitive impairment, and 46% were diagnosed with dementia. Within 12 months of the initial HABC visit, 28% of patients had at least one visit to an emergency room (ER) and 14% were hospitalized with a mean length of stay of five days. The rate of a one-week ER revisit was 14% and the 30-day rehospitalization rate was 11%. Only 5% of HABC patients received an order for neuroleptics and only 16% had simultaneous orders for both definite anticholinergic and anti-dementia drugs. Conclusion: The tools of 'implementation science' can be utilized to translate a health care delivery model developed in the research laboratory to a practical, operational, health care delivery program.

AB - Background: Recent randomized controlled trials have demonstrated the effectiveness of the collaborative dementia care model targeting both the patients suffering from dementia and their informal caregivers. Objective: To implement a sustainable collaborative dementia care program in a public health care system in Indianapolis. Methods: We used the framework of Complex Adaptive System and the tool of the Reflective Adaptive Process to translate the results of the dementia care trial into the Healthy Aging Brain Center (HABC). Results: Within its first year of operation, the HABC delivered 528 visits to serve 208 patients and 176 informal caregivers. The mean age of HABC patients was 73.8 (standard deviation, SD 9.5), 40% were African-Americans, 42% had less than high school education, 14% had normal cognitive status, 39% received a diagnosis of mild cognitive impairment, and 46% were diagnosed with dementia. Within 12 months of the initial HABC visit, 28% of patients had at least one visit to an emergency room (ER) and 14% were hospitalized with a mean length of stay of five days. The rate of a one-week ER revisit was 14% and the 30-day rehospitalization rate was 11%. Only 5% of HABC patients received an order for neuroleptics and only 16% had simultaneous orders for both definite anticholinergic and anti-dementia drugs. Conclusion: The tools of 'implementation science' can be utilized to translate a health care delivery model developed in the research laboratory to a practical, operational, health care delivery program.

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