Roughly one out of every three patients receiving home health care services has some form of dementia. The numbers are similar, though slightly smaller, for hospice.
Despite this prevalence, many home-based caregivers lack the training and educational expertise to provide care that’s truly effective.
Aliviado Health, a new initiative run out of the Hartford Institute for Geriatric Nursing at New York University’s Rory Meyers College of Nursing, is trying to fill that knowledge gap for home health and hospice agencies across the United States — and slash readmissions rates in the process.
Formally launched in August, Aliviado teams up with home-based providers by offering educational material, training tools, mentorship programs and treatment algorithms focused on dementia care, Ab Brody, associate director of the Hartford Institute and an NYU associate professor, told Home Health Care News. Aliviado — Portuguese for “relief” — also helps home health and hospice agencies through hands-on mentorship programs and by developing specialized patient care plans.
“A lot of what Aliviado does is around understanding how to approach patients and finding out why they might be agitated or resistant to care,” Brody, the initiative’s original developer, said. “That allows us to provide much more effective care and to perform the treatments, personal care services that are needed to help maximize independence for those with dementia.”
Aliviado may have announced its intent to partner with home health and hospice agencies last month, but the initiative has its roots in a decade’s worth of research and real-world observations.
In the early part of his career, Brody spent several years doing house calls as a nurse practitioner, working closely with dementia patients, home health providers and hospice agencies. It was at that point when Brody began to recognize how home-based providers were having difficulty caring for dementia patients, particularly in terms of managing behavioral symptoms.
“I heard from many nurses, physical and occupational therapists, social workers, who felt really frustrated by not understanding how they could better care for their patients, frustrated knowing they likely weren’t doing everything they could,” Brody said. “I spent a lot of time focusing on education, working with clinicians, all to answer the question, ‘Why is it that all these clinicians across multiple agencies, multiple types of home-based care, really do not feel prepared to care for persons with dementia, other than recommending sedating medications?’”
In 2017, Brody received a $3.8 million grant from the National Institute of Aging, part of the National Institutes of Health, to support and evaluate his work.
Aliviado’s rollout came a little more than a month prior to 2018’s World Alzheimer’s Day, recognized on Sept 21. Alzheimer’s disease is the most common cause of dementia.
A growing trend
In recent months, several home-base care providers have either touted the implementation of their own specialized dementia care training or highlighted their participation in new industry-led coalitions.
These moves make sense from a business perspective, as companies are positioning themselves to serve a growing market. Today, roughly 5.7 million Americans are living with Alzheimer’s, according to the Chicago-based Alzheimer’s Association. By 2050, the number is projected to increase to nearly 14 million.
Prioritizing dementia care makes sense from a regulatory perspective as well, as some states have begun to pass legislation meant to ensure adequate service. Illinois, for example, has in place the Alzheimer’s Disease and Related Dementia Training Act.
“If you advertise yourself, put yourself out into the marketplace as having services for Alzheimer’s or dementia clients, then you have to train your workers, you have to have someone who is identified as the trainer, and that trainer has to have a demonstrated competency,” Sheila McMackin, owner of Illinois-based Wellspring Personal Care, previously told HHCN. “There are a bunch of organizations out there that do dementia training.”
Up-and-coming health care startups are likewise eyeing dementia care for business opportunities. They include Los Angeles-based SingFit, a company that uses music to rewire the brain and improve cognitive function.
SingFit’s PRIME product is currently used by more than 400 senior living communities, according to Andy Tubman, its co-founder and chief clinical officer. Moving forward, SingFit plans to expand by working with home health and home care agencies.
“We are working with many [senior living communities] as well as with a half-dozen other home care and home health agencies in the final beta testing of our new SingFit STUDIO product,” Tubman said. “SingFit STUDIO is a one-to-one cognitive health and dementia solution designed to work in home health, home care, skilled nursing and assisted living.”
SingFit has “some exciting arrangements in the works with major home care agencies” and hopes to reveal more details in coming months, according to Tubman.
Aliviado sets sights on expansion
Aliviado is currently working with “several” large, not-for-profit agencies located in different areas of the country, Brody said. The initiative is also currently in talks with health systems about implementing Aliviado across their home health and hospice operations.
In the coming year, Aliviado has its sights set on partnering throughout a group of 27 hospice agencies as part of a future project.
“We’re realty excited to get [Aliviado] into the hands of the people who need it, to really help patients with dementia and their caregivers,” Brody said.
Aliviado is structured as a self-sustaining enterprise that is not-for-profit. Providers that work with Aliviado pay an implementation fee based on agency size and individualized operations. Aliviado users also can choose to pay an ongoing annual subscription fee to allow for updates and consultation services.
Adding further business appeal, Aliviado has been shown to help home health agencies avoid undercoding for many of the cognitive function and cognitive symptom OASIS items, according to Brody. Aliviado has also been shown to more effectively identify and treat patient pain, an ability that could have a positive effect on agency star ratings.
Aliviado has also been shown to reduce hospital readmissions by up to 18% and improve caregiver satisfaction.
“The other big component of Aliviado has to do with the staffing side — there’s a slew of studies from over the years that highlight how maintaining staff is a huge issue in home health and hospice,” Brody said. “There’s a high level of staff burnout and turnover, but these programs can help empower staff and give them a greater sense of understanding within their work.”
Written by Robert Holly