Memory Care in Assisted Living: Does it Improve Quality Outcomes?

辅助生活中的记忆护理：它能提高质量结果吗？

• 批准号: 10807400
• 负责人: Eric Jutkowitz
• 金额: $ 218.31万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2026-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10807400
• 关键词: Address; Affect; Alzheimer' s Disease; Alzheimer' s disease diagnosis; Alzheimer' s disease related dementia; Assisted Living Facilities; Bathing; Caring; Communities; Complex; Data; Databases; Dementia; Elderly; Employee; Family; Goals; Health Policy; Impaired cognition; Interview; Link; Literature; Long-Term Care; Marketing; Medicare; Methods; Organizational Policy; Outcome; Persons; Policies; Policy Maker; Policy Making; Process; Quality of Care; Recording of previous events; Research; Services; Site; Sterile coverings; Structure; Surveys; Testing; Training; Variant; Work; beneficiary; community living; cost; dementia care; design; evidence base; experience; health care disparity; health care service utilization; improved; insight; memory care; response; satisfaction; supportive environment; therapy development

PROJECT ABSTRACT Of the nearly one million people who reside in assisted living (AL), up to 70% have some form of cognitive impairment and 40% have a diagnosis of Alzheimer's Disease and Alzheimer's Disease-Related Dementias (AD/ADRD). AL staff provide services including help with dressing and meals, and nearly 25% of ALs provide specialized care for people living with AD/ADRD (also known as “memory care”). Very little is known about the quality of memory care. To improve AD/ADRD care, consumers must understand whether the quality provided in memory care settings, at a surcharge of almost 36% compared to a room in general AL, is worth the cost. The objective of this application is to examine variation in the quality of care for AL residents with AD/ADRD. It is hypothesized that residents with AD/ADRD in ALs that provide memory care receive higher quality care than their counterparts in ALs that do not provide memory care (“between” AL effects). Also, it is hypothesized that residents with AD/ADRD in ALs without memory care experience poorer quality of care than residents without AD/ADRD (“within” AL effects). Conversely, residents with AD/ADRD in ALs with memory care experience similar quality of care compared to residents without AD/ADRD. To test these hypotheses, the research team will leverage the data and methods that they have developed to 1) identify Medicare beneficiaries residing in ALs; 2) connect policy data to specific AL communities; and 3) combine more than 2,000 AL communities’ employee and resident/family satisfaction surveys with national, administrative data. In response to NOT-AG-21-046, the project has the following specific aims: 1. Compare quality outcomes (i.e., worker satisfaction, resident/family satisfaction, healthcare utilization) between ALs that do and do not provide memory care. Working hypothesis: ALs that provide memory care will have better quality outcomes than ALs that do not provide memory care. This aim looks at how quality varies between ALs. 2. Compare the difference in quality outcomes of residents with and without AD/ADRD within ALs that do and do not provide memory care. Working hypotheses: 2a) within general ALs, residents with AD/ADRD will have poorer outcomes than residents without AD/ADRD; 2b) within memory care ALs, there will not be a significant difference in quality outcomes between residents with and without AD/ADRD. This aim looks at how quality varies within ALs. 3. Understand the processes of care that contribute to quality outcomes for residents with AD/ADRD among ALs that do and do not provide memory care. Semi-structured interviews and on- site observations in ALs that do and do not provide memory care will identify the processes of care that are associated with satisfaction and experience of care for residents with AD/ADRD. The project is significant because it will provide national data about AL care for people living with AD/ADRD.

项目摘要 在居住在辅助生活（AL）的近100万人中，高达70%的人有某种形式的认知障碍。 40%的人被诊断患有阿尔茨海默病和阿尔茨海默病相关痴呆症 (AD/ADRD）。AL工作人员提供的服务包括帮助穿衣和用餐，近25%的AL提供 为AD/ADRD患者提供专门护理（也称为“记忆护理”）。关于这一点，我们知之甚少。 记忆的质量。为了改善AD/ADRD护理，消费者必须了解所提供的质量 在记忆保健设置，在近36%的附加费相比，一个房间一般铝，是值得的成本。 本申请的目的是检查与AD/ADRD AL居民的护理质量的变化。它 假设在提供记忆护理的AL中，AD/ADRD居民接受更高质量的护理 比他们的同行在AL不提供记忆照顾（“之间”AL效应）。另外，假设 在没有记忆护理的AL患者中，AD/ADRD患者的护理质量比患者差。 无AD/ADRD（AL效应”范围内“）。相反，患有记忆障碍的AL患者中的AD/ADRD患者 与没有AD/ADRD的居民相比，经历类似的护理质量。为了验证这些假设， 研究团队将利用他们开发的数据和方法来1）识别医疗保险 2）将政策数据与特定的AL社区连接起来;以及3）将联合收割机 2 000个AL社区的雇员和居民/家庭满意度调查，并附有国家和行政数据。在 根据对NOT-AG-21-046的响应，该项目具有以下具体目标：1.比较质量结果（即， 工人满意度、居民/家庭满意度、医疗保健利用率）之间的差异 记忆护理工作假设：提供记忆护理的人工智能将比人工智能有更好的质量结果 不提供内存维护。这一目标着眼于AL之间的质量差异。2.比较 在提供和不提供AD/ADRD的AL内，有和没有AD/ADRD的居民的质量结局差异 记忆护理工作假设：2a）在一般AL中，AD/ADRD居民的 结果比没有AD/ADRD的居民; 2b）在记忆保健AL中， 有和没有AD/ADRD的居民之间的质量结果差异。这一目标着眼于质量如何 AL内部有所不同。3.了解有助于居民质量结果的护理过程， 在提供和不提供内存管理的AL之间的AD/ADRD。半结构化面试和现场 在提供和不提供记忆护理的人工智能中进行的观察将确定 与AD/ADRD患者的满意度和护理体验相关。这个项目意义重大 因为它将为AD/ADRD患者提供有关AL护理的全国数据。