Karen I. Connor

Caring for patients with dementia: how good is the quality of care? Results from three health systems.

OBJECTIVES: To describe the quality of dementia care within one U.S. metropolitan area and to investigate associations between variations in quality and patient, caregiver, and health system characteristics.

Effect of a dementia care management intervention on primary care provider knowledge, attitudes, and perceptions of quality of care.

OBJECTIVES: To evaluate the effect of a multicomponent dementia care management program on primary care provider knowledge, attitudes, and perceptions of quality of dementia care.

Determining Care Management Activities Associated with Mastery and Relationship Strain for Dementia Caregivers

OBJECTIVES: To identify specific care management activities within a dementia care management intervention that are associated with 18‐month change in caregiver mastery and relationship strain.

Collaborative Care Management Reduces Disparities in Dementia Care Quality for Caregivers with Less Education

To examine educational gradients in dementia care and whether the effect of a dementia collaborative care management intervention varied according to the educational attainment of the informal caregiver.

Dementia Care Management in an Underserved Community The Comparative Effectiveness of Two Different Approaches

Objectives: To compare the effectiveness and costs of telephone-only approach to in-person plus telephone for delivering an evidence-based, coordinated care management program for dementia. Methods: We randomized 151 patient–caregiver dyads from an underserved predominantly Latino community to two arms that shared a care management protocol but implemented in different formats: in-person visits at home and/or in the community plus telephone and mail, versus telephone and mail only. We compared between-arm caregiver burden and care-recipient problem behaviors (primary outcomes) and patient–caregiver dyad retention, care quality, health care utilization, and costs (secondary outcomes) at 6- and 12-months follow-up. Results: Care quality improved substantially over time in both arms. Caregiver burden, care-recipient problem behaviors, retention, and health care utilization did not differ across arms but the in-person program cost more to deliver. Discussion: Dementia care quality improved regardless of how care management was delivered; large differences in effectiveness or cost offsets were not detected.

Predictors of acceptance of offered care management intervention services in a quality improvement trial for dementia

Care management approaches have been proven to improve outcomes for patients with dementia and their family caregivers (dyads). However, acceptance of services in these programs is incomplete, impacting effectiveness. Acceptance may be related to dyad as well as healthcare system characteristics, but knowledge about factors associated with program acceptance is lacking. This study investigates patient, caregiver, and healthcare system characteristics associated with acceptance of offered care management services.

Person-Centered Approaches to Caregiving

Caregiving can be personally fulfilling, but it is typically labor intensive, time consuming, and stressful. Informal family caregivers provide care in the context of the families in which they are often performing other caregiving roles as mothers, fathers, wives, husbands, or siblings. Additionally, caregiving roles often lead to interrupted employment and limited time for self-care for families who provide such help. A common caregiving situation involves an elderly individual (usually a woman) caring for a spouse with Alzheimer’s disease or related dementia. Caring for someone with a devastating neurodegenerative condition such as Alzheimer’s is difficult for the care recipient, family and friends, caregivers, and healthcare providers. While scientists strive to find cures, the affected person-family dyad struggles, as do providers, in managing a host of signs and symptoms. More recently, efforts to better manage these challenges are drawing upon person-centered approaches, applied not only to the individual with dementia, but to family members as well.