Translation of the Care of Persons with Dementia in their Environments (COPE) intervention in a publicly-funded home care context: Rationale and research design
Translation of the Care of Persons with Dementia in their Environments (COPE) intervention in a publicly-funded home care context: Rationale and research design
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DOI：
10.1016/j.cct.2016.07.006
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发表时间：
2016-07-01
影响因子：
2.2
通讯作者：
Molony, Sheila
中科院分区：
文献类型：
--
作者：
Fortinsky, Richard H.;Gitlin, Laura N.;Molony, Sheila
背景：痴呆症是全球老年人丧失独立性的主要原因。在美国，大约有1 500万家庭成员为患有痴呆症的亲属提供护理。本文介绍了一项转化研究的基本原理和设计，在这项研究中，将针对老年痴呆症患者和家庭护理人员（CG）的循证非药物干预纳入一项公共资助的家庭护理计划，该计划针对有入住养老院风险的老年人。为期4个月的痴呆症患者在其环境中的护理（科普）干预旨在优化老年人的功能独立性，并改善CG痴呆症管理技能和健康相关结果。科普的特点是10次家庭职业治疗访问，1次家庭访问和1次高级执业护士的电话联系。在一项已发表的随机临床试验中，认为科普有效。在本研究中，老年痴呆症参加康涅狄格州家庭护理计划的老年人（CHCPE）和他们的CG随机分配到接受科普加上他们正在进行的CHCPE服务，或继续接受CHCPE servicesonly.Outcomes：老年痴呆症的主要结果是功能独立性;次要结果是活动参与，生活质量，预防或减轻神经精神症状。CG结果包括感知幸福感和使用活动管理痴呆症状的信心。转化结果包括科普的净财务效益，以及将科普实施到CHCPE的可行性和可接受性。科普有可能改善健康相关的结果，同时节省医疗补助豁免和国家收入资助的家庭护理计划的成本全国。(C)2016 Elsevier Inc.版权所有
Background: Dementia is the leading cause of loss of independence in older adults worldwide. In the U.S., approximately 15 million family members provide care to relatives with dementia. This paper presents the rationale and design for a translational study in which an evidence-based, non-pharmacologic intervention for older adults with dementia and family caregivers (CGs) is incorporated into a publicly-funded home care program for older adults at risk for nursing home admission.Methods: The 4-month Care of Persons with Dementia in their Environments (COPE) intervention is designed to optimize older adults' functional independence, and to improve CG dementia management skills and health-related outcomes. COPE features 10 in-home occupational therapy visits, and 1 in-home visit and 1 telephone contact by an advanced practice nurse. COPE was deemed efficacious in a published randomized clinical trial. In the present study, older adults with dementia enrolled in the Connecticut Home Care Program for Elders (CHCPE) and their CGs are randomly assigned to receive COPE plus their ongoing CHCPE services, or to continue receiving CHCPE services only.Outcomes: The primary outcome for older adults with dementia is functional independence; secondary outcomes are activity engagement, quality of life, and prevention or alleviation of neuropsychiatric symptoms. CG outcomes include perceived well-being and confidence in using activities to manage dementia symptoms. Translational outcomes include net financial benefit of COPE, and feasibility and acceptability of COPE implementation into the CHCPE. COPE has the potential to improve health-related outcomes while saving Medicaid waiver and state revenue-funded home care program costs nationwide. (C) 2016 Elsevier Inc. All rights reserved