Home-Based Care System for Dementia Patients Helps Delay Nursing Home Move

Home-based care teams can help dementia patients maximize their independence, improve quality of life, and stay at home longer before transitioning into a nursing home, suggests new research covered in a HealthDay article

The team, consisting of a nurse, a psychiatrist, and a care coordinator, can determine each person’s needs, whether it’s fall-proofing a bathroom or medication administration. The care coordinator serves as team leader and stays in contact with patients and their families, depending on each person’s needs. 

After testing the program on more than 300 people aged 70 or older who had mental impairments, researchers found that 70% of those who received counseling and follow-up services were still living at home by the end of the 18-month study. 

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In contrast, about 50% of the control group participants, who were receiving standard care, had moved into a nursing home, hospital, or assisted living facility, or had passed away. 

Dr. Quincy Miles Samus, the study author, is an assistant professor of psychiatry and behavioral science at Johns Hopkins. The project is called MIND (Maximizing Independence at Home) and is based on a person-centered, coordinated care model.

Care team visits can include assessing a slew of unmet needs, such as decreasing clutter to reduce risk of falls; managing other chronic conditions like diabetes; completing a will and other legal directives; and participating in meaningful social activities, Samus said, adding that the average program participant had seven unmet needs. 

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While both the intervention group and the control group had reduced their number of unmet needs by the end of the study, the intervention group had a greater reduction and reported a higher quality of life compared to those in the other group. 

“We didn’t want to keep people at home miserable,” Samus said, “so [this] finding was great.”

 It’s also expected to be cost effective, notes the HealthDay article. Researchers aren’t sure how much the program will cost, but estimate it would be about $1,000 to $2,000 a person each year. Nursing homes, in contrast, can cost anywhere between $30,000 and $100,000 a year. 

“It would appear advantageous to Medicare’s expenditures to pay for [an at-home program],” Dr. Gary Kennedy, a director of geriatric psychiatry at Montefiore Medical Center in New York City, is quoted as saying. 

Read the full HealthDay article.

Written by Alyssa Gerace