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The Roger C. Lipitz Center for Integrated Health Care

Keyword: cognitive impairment

Cost-Effective Care Coordination for People With Dementia at Home

A study led by Amber Willink and Quincy Samus, and co-authors Karen Davis, Deirdre Johnston, Betty Black, Melissa Reuland, Ian Stockwell, Halima Amjad, and Constantine Lyketsos published in Innovation in Aging suggests that hospitalization risk reduction strategies may benefit from understanding and addressing caregiving circumstances. Managed-care plans with the flexibility to engage community health workers could benefit from a low-cost, high-touch intervention to meet the needs of enrollees with dementia. Read more

SHARING Choices: A Pilot Study to Engage Family in Advance Care Planning of Older Adults With and Without Cognitive Impairment in the Primary Care Context

A study led by center director Jennifer Wolff and co-authors Danny Scerpella, Kimberly Cockey, Naaz Hussain, Tara Funkhouser, Diane Echavarria, Jennifer Aufill, Amy Guo, Danetta Sloan, Sydney Dy, Kelly Smith, and SHARING Choices Investigators in the American Journal of Hospice and Palliative Care found that SHARING Choices, an advance care planning intervention, was acceptable among older adults with and without cognitive impairment and may increase advance directive completion. The study engaged family in advance care planning of older adults with and without cognitive impairment in the primary care context. Patients remarked that SHARING Choices clarified communication and preferences while family reported a better understanding of their role in advance care planning and communication. SHARING Choices is now being tested in a pragmatic trial at 55 primary care clinics in the Baltimore-Washington area. Read more.

Discussion of Memory During Primary Care Visits of Older Adults with Cognitive Impairment and Accompanying Family

Study by Jennifer Aufill, Halima Amjad, Debra Roter, and Jennifer Wolff in International Journal of Geriatric Psychiatry examines factors associated with memory-related discussion in routine primary care visits of older adults. The study finds discussion of memory appears largely driven by the clinician's, but not the family's, ratings of patient cognition and presence of an established diagnosis, suggesting potential benefit of engaging family to improve cognitive impairment detection in primary care. ...Read More

Does Caregiving Strain Increase as Patients with and without Dementia Approach the End of Life?

Family caregivers are critically important in dementia care. However, when demands exceed capacity, caregiving can impose role-related strain. A study finds that dementia caregivers report significantly higher strain than non-dementia caregivers, and this is even more pronounced for the caregiver near the end of the patient’s life....Read More

Pragmatic trial to Improve Communication for Primary Care Patients with ADRD: R61AG061882

Advance care planning (ACP) is a communication process that supports adults at any age or stage of health in understanding and sharing their personal values, life goals, and preferences regarding future medical care. A new study will refine and test an ACP intervention for older adults with Alzheimer’s Disease and Related Dementias through engagement of family....Read More

Declines in Dementia Prevalence

A study co-authored by Vicki Freedman, Brenda Spillman, Brenda Plassman, and Principal Investigator of the National Health and Aging Trends Study (NHATS) Judith Kasper in the Journal of Gerontology, Series B, finds that the United States is expected to experience short-term declines in dementia prevalence due to age and educational factors, but long-run demographic trends may reverse this course....Read More

Risk of Nursing Home Placement and Medicaid

Improving Benefits and Integrating Care for Older Medicare Beneficiaries with Physical and Cognitive Impairment

Amber Willink, Karen Davis, Cathy Schoen

More than half of Medicare beneficiaries will experience physical and/or cognitive impairment (PCI), limiting their ability to perform daily self-care tasks and requiring long-term care services and supports....Read More