Sara B. Holmes

Ask the consumer: An innovative approach to dementia-related adult day service evaluation

Historically, family caregivers have been considered the “consumers” when evaluating respite programs for persons with dementia offered by adult day service (ADS) centers. The purpose of this article is to describe a unique evaluation of ADS conducted directly with persons with dementia. Seventeen persons who regularly attended the Silver Club, an ADS program associated with the University of Michigan Turner Geriatric Clin ic, were interviewed by an independent, trained interviewer using a single group, one-time, cross-sectional administration of a consumer satisfaction survey. Fifteen persons were able to complete the interview successfully. The implication of this evaluation is that when specially designed procedures are used, persons with dementia are capable of contributing usable data to consumer satisfaction surveys. Including the voice of this vulnerable population improves the quality of an agencys overall evaluation process and supports the basic philosophy of ADS to preserve the self-worth, independence, and dignity of cognitively impaired individuals.

Providing Dementia Outreach Education to Rural Communities: Lessons Learned From a Train-the-Trainer Program

Although several educational outreach programs designed to address the needs of older adults with dementia in rural areas have been reported in the literature, few have been systematically evaluated. The purpose of this article is to describe the Dementia Education Train-the-Trainer Program (DE-TTT-P), designed to disseminate information about dementia in rural areas of Michigan. Twenty-eight health care providers completed the DE-TTT-P and now serve as trainers. Over the course of the 18-month program, 3,276 rural residents attended one of the 223 dementia education sessions offered by the trainers. After summarizing the design, implementation, and evaluation of the program, the discussion offers lessons learned and strategies to maintain the newly formed network of trainers beyond the official project period.

Planning for a statewide network of dementia assessment services: A survey of geriatric assessment services in Michigan:

All 38 geriatric assessment service units identified in Michigan were surveyed and responded as a component of planning a statewide network of diagnostic and assessment services for patients with dementia. Most units were outpatient (71 percent), urban (71 percent), and hospital-based (82 percent). Some provided primarily geropsychiatric services (21 percent), while the rest provided general geriatric services. The staff included physicians (95 percent), nurses (100 percent), social workers (95 percent) and other professionals (SO percent) such as nutritionists, neuro psychologists or clinical pharmacists. Assessments performed by most units included physical (92 percent), psychosocial (95 percent), functional (95 percent), neurological (71 percent) mental (95 percent), and financial (89 percent). Patient referral sources were most frequently self/family, followed by physician, community agencies, and community mental health. Reasons for referral were most often confusion! memory loss, followed by behavior change, caregiver stress, depression, and evaluation for placement. Most patients seen were between 65 and 84 years of age (72 percent), lived within 25 miles of the unit (87 percent), and had dementia (62 percent). Urban sites assessed significantly more persons per month (19 percent) than non-urban sites (4 percent). Community-based services spent significantly more time per month on geriatric assessments (68 hours) than did hospital-based services (26 hours). These survey results will aid the development of a statewide network of dementia diagnostic and assessment services.

Strategies for community-based dementia education and creating sustainable change: Lessons learned from the Community Outreach Education Program

The Community Outreach Education Program (COEP) was established to disseminate information about the diagnosis, assessment, management, and treatment of dementia to health care professionals, service providers, staff of community organizations and voluntary agencies, and family caregivers in communities throughout Michigan. This paper will describe the activities implemented as part of outreach educational interventions in Bay City, Saginaw, Grand Rapids, and Kalamazoo, Michigan. Lessons learned about community-based dementia education and strategies for creating sustainable change are discussed.

Development and evaluation of a statewide autopsy education workshop

The role of autopsy is critical in confirming diagnoses and advancing research in Alzheimers disease. In collaboration with the Alzheimers Association chapters in Michigan, the staff of the Education Core of the Michigan Alzheimers Disease Research Center developed, implemented, and evaluated an educational intervention based on a train-the-trainer model to disseminate information about autopsy to chapter staff and volunteers. Participants at a one-day Autopsy Education Workshop (AEW) developed skills to make presentations about autopsy in their local communities and assist family caregivers with decision-making. Participants reported significant gains in knowledge about autopsy and an increased level of confidence in discussing autopsy withfamily members. The AEW curriculum and evaluation design will be described.