Collaborative Transdisciplinary Team Approach for Dementia Care

Galvin, James E.; Valois, Licet; Zweig, Yael

doi:10.2217/nmt.14.47

Cited by 100 publications

(112 citation statements)

References 35 publications

(54 reference statements)

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“…Interprofessional team‐based care is considered a key element in person‐centred care for older adults (American Geriatrics Society Expert Panel on Person‐Centred Care, ). Though many examples of team‐based approaches to dementia care in the literature tend to focus on collaborative care between various combinations of physicians, nurse practitioners, social workers and health educators (Callahan et al, ; Counsell et al, ; Galvin, Valois, & Zweig, ; Vickrey et al, ), all have demonstrated some level of improved dementia care. Expanding team composition to include a variety of community‐based services has the potential to better integrate and coordinate care across services and sectors (Lee, Hillier, Heckman, et al, ).…”

Section: Discussionmentioning

confidence: 99%

Partnerships for improving dementia care in primary care: Extending access to primary care‐based memory clinics in Ontario, Canada

Lee

Hillier

Gregg

2019

Health Soc Care Community

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In Ontario, Canada, the Primary Care Collaborative Memory Clinic (PCCMC) model of dementia care provides a team‐based assessment and management service that has demonstrated increased capacity for dementia care at the primary care level. PCCMCs are established following completion of a multi‐faceted memory clinic training programme. Evidence of the success of this care model has been demonstrated primarily in practice settings with integrated interprofessional healthcare providers (HCPs). Desire to implement PCCMCs in less‐resourced family practice settings without integrated interprofessional HCPs has resulted in partnerships with community agencies and services to create the multifaceted teams needed for this care model. The purpose of this study was to describe the key lessons learned in the development and implementation of 18 PCCMCs in primary care practice models without integrated interprofessional HCPs. Mixed methods included tracking of clinic referrals, pre‐ (N = 122) and post‐ (N = 71) training surveys to assess practice changes and factors facilitating and challenging clinic implementation. Interviews were conducted with 40 team members to identify key lessons learned. Key enablers were access to training, organisational/ management and care provider support, availability of infrastructure supports and clinic coordination. Data were collected between January 2012 and January 2017. PCCMCs were challenged by a lack of sustainable funding, inadequate infrastructure support, competing priorities, maintaining adequate communication among team members, and coordinating multiple schedules. Suggestions to support longer term sustainability were identified, many addressing identified challenges such as securing sustainable funding, and ensuring partners understand the importance of their role and succession planning. This study demonstrated that by establishing community partnerships and leveraging existing community resources, the PCCMC model is generalisable to multiple family practice settings including those without integrated interprofessional staff. Lessons learned can inform the development of interventions for complex chronic conditions requiring interprofessional support in primary care.

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Section: Discussionmentioning

confidence: 99%

Partnerships for improving dementia care in primary care: Extending access to primary care‐based memory clinics in Ontario, Canada

Lee

Hillier

Gregg

2019

Health Soc Care Community

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“…When various psychosocial interventions are offered, they can effectively improve caregiver outcomes [16,17] and patient outcomes, such as decreased rates of institutionalization [18]. A comprehensive review of the literature on multidisciplinary models of care is beyond the scope of this article (though see Galvin et al recent work in this journal [19]). However, most models rely on the primary care physician or one specialist physician and an array of allied health professionals to care for patients.…”

Section: Dementia Care Models and Caregiver Stressmentioning

confidence: 99%

Dementia and Caregiver Stress

Zwerling

Cohen

Verghese

2016

Neurodegener. Dis. Manag.

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Keywords• care coordination • caregiver burden • dementia care models • stress According to the Alzheimer's Association, in 2014, caregivers of people with dementia provided an estimated 17.9 billion hours of informal (unpaid) assistance valued at more than US$217.7 billion [1]. The US Census Bureau expects the number of people age 65 years and older to double between 2010 and 2050 [2], and this is expected to dramatically increase the need for caregiving in coming decades. More than one in three caregivers of dementia patients are over age 65 years [1]. Caregiver stress is an under-recognized and undertreated health risk that can lead to poor outcomes for both caregivers and patients with dementia, including higher rates of morbidity and mortality. As we plan for the needs of an aging population with high prevalence of dementia, models of care must include caregivers. We describe our center's approach to this issue in the context of the health risks assumed by caregivers. Health effects of caregiver stressStress leads to a variety of physiological and psychological responses. Depending on the nature of the stressor [3], the degree of stress [4] and other factors related to the person experiencing the stress, the stressor and the environment, the effects of stress can vary greatly. Acute stress may promote increased vigilance and other appropriate behavioral changes. With chronic exposure to an unresolved stressor or repeat exposure to stressors of sufficient magnitude, responses and adaptations to stress fail and individuals suffer negative resultant consequences [5]. Compared with caregivers of people with nondementing illnesses, caregivers of people with dementia may be less able to cope with increased stressors as they have twice the rates of substantial financial, emotional and physical difficulties associated with caregiving [6].Many studies have shown widespread, direct, deleterious health consequences of caregiver stress. For instance, caregivers have compromised immune function compared with noncaregivers [7]. They have elevated markers of cardiovascular disease and impaired kidney function [8,9].

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“…Such models are inherently transdisciplinary -they require the participation of more than one discipline for their success. Early randomized trials have shown that care management by nurses or social workers [40,41] can improve outcomes for patients and family caregivers, and collaborative care models for AD have strong potential to improve patient outcomes while providing overall cost savings [42].…”

Section: Adopt a Systematic Multidomain And Team-based Approach To Patmentioning

confidence: 99%

“…Patients at risk must have assistance with medication management at home, and family caregivers must be offered explicit education and support, which is often lacking [72]. Multiple ways of providing caregiver education and support are available and can reduce caregiver burden and improve patients' well-being [42,70], but are not generally built in to the provision of healthcare. Moreover, guidelines for healthcare of patients with dementia are outdated, as they poorly address comorbidities [73].…”

Section: Adopt a Systematic Multidomain And Team-based Approach To Patmentioning

confidence: 99%

Are we Providing the Best Possible Care for Dementia Patients?

Borisovskaya

Chen

Borson

2015

Neurodegener. Dis. Manag.

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Healthcare for patients with dementia is often reactive, poorly organized and fragmented. We discuss opportunities for improvements in the care of individuals living with dementia at home that can be implemented by physicians in their practices today. In particular, we argue that systematic identification and diagnosis of cognitive impairment and dementia in their early stages, coupled with a coherent, evidence-informed management framework, would benefit patients with dementia substantially and ease the burden of their caregivers. We emphasize that dementia influences all aspects of patient care, and each medical decision must be passed through the filter of knowledge that patients with dementia have special needs that can be identified and addressed.

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Collaborative Transdisciplinary Team Approach for Dementia Care

Cited by 100 publications

References 35 publications

Partnerships for improving dementia care in primary care: Extending access to primary care‐based memory clinics in Ontario, Canada

Partnerships for improving dementia care in primary care: Extending access to primary care‐based memory clinics in Ontario, Canada

Dementia and Caregiver Stress

Are we Providing the Best Possible Care for Dementia Patients?

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