North Dakota Assistance Program For Dementia Caregivers Lowered Utilization, Produced Savings, And Increased Empowerment

Abstract

North Dakota's state-funded Dementia Care Services Program provides individualized assistance to caregivers of persons with dementia. Caregivers can contact program representatives at any time and may continue to contact them throughout the years they are caring for the person with dementia. During the program's first forty-two months of operation (January 2010 to June 2013), care consultants assisted 1,750 caregivers, primarily family members, of 951 persons with dementia. In survey responses and other self-reported data, the unpaid caregivers credited the assistance program with helping them feel more empowered, consider their charges less likely to be placed in long-term care, and use less potentially avoidable medical services such as hospitalizations and 911 calls. The program's estimated potential savings were $39.2 million from delayed long-term care placement and $0.8 million from reduced use of medical services, and its two-year costs were $1.2 million. The program's success with its rural service population, for which travel tends to be difficult and resources limited, provides a model for others to adapt. It also encourages further research on impacts of individualized support programs on persons with dementia and their caregivers.

An integrative review of measures of transitions and care coordination for persons living with dementia and their caregivers

“…Among the 71 reports, 60 included 16 measures of transitional care and care coordination outcomes related to the person living with dementia and caregivers (see Table 1). Care transitions and care coordination outcomes measures primarily focus on health‐care use ( n = 48; e.g., acute care, post‐acute care, ambulatory care, long‐term care) 15,16,24,25,27,28,30,31,34,40–80 and cost outcomes ( n = 12) 43,44,48,50,53,56,70,81–85 . Mortality was also a common outcome measure in care transitions and care coordination studies ( n = 14) 26,27,34,40,42,46,49,60,64,65,67,68,85,86 .…”

Caregiver outcomes of a dementia care program

“…In North Dakota, the Dementia Care Services program employs social workers to provide services to PWD and their caregivers, with the goal of caregiver empowerment, reducing premature nursing home placement and decreasing acute health service use (Klug, Halaas, & Peterson, 2014 (Jennings et al, 2018).…”

“…Over a period of 42 months, the program worked with 1,750 caregivers: 55% needed in-person care consultations and the remaining 45% used the telephone information line. Using caregivers' selfhave been saved in lower utilization of medical services Klug et al (2014). did not have a control group to compare the intervention to and the results were all selfreported at the convenience of the individual caregivers.…”

Caregiver Outcomes of a Dementia Care Program

“…In North Dakota, the Dementia Care Services program employs social workers to provide services to PWD and their caregivers, with the goal of caregiver empowerment, reducing premature nursing home placement and decreasing acute health service use (Klug, Halaas, & Peterson, 2014). The care consultants are available by phone and can provide didactic in-person presentations and care consultations.…”

“…Using caregivers' selfreported data, researchers estimated that $39.2 million could have potentially been saved in delayed nursing home placement and an additional $0.8 million may have been saved in lower utilization of medical services. Klug et al (2014) did not have a control group to compare the intervention to and the results were all selfreported at the convenience of the individual caregivers.…”