Forming an Alzheimer's Care Dream Team
May 9, 2006 -- If everyone with Alzheimer's disease had a "case manager" for their Alzheimer's care, it might help Alzheimer's patients and their caregivers, a new study shows.
The study, published in The Journal of the American Medical Association, included 153 older adults with Alzheimer's disease and their caregivers.
All of the patients and caregivers live in Indianapolis. That's where researcher Christopher Callahan, MD, works at Indiana University's Center for Aging Research.
Callahan and colleagues make the case for "collaborative care," a team of specialists led by a nurse to help patients and their families navigate Alzheimer's care. But even without such a team, there are steps caregivers can take to take care of themselves while tending to Alzheimer's patients.
Alzheimer's disease is the most common form of dementia among older adults. But it's not a normal part of the aging process.
The Alzheimer's Association estimates that 4.5 million Americans have Alzheimer's disease, with that number set to grow as the U.S. population ages.
The Alzheimer's patients in Callahan's study were almost 78 years old, on average. Most were financially disadvantaged and had other health problems. About half were black.
Patients had "moderate" dementia at the study's start, the researchers write, based on scores from a mental skills test.
Doctors randomly assigned 84 patients to get a year of collaborative care. Advanced practice nurses were at the heart of collaborative care.
The nurses coordinated weekly meetings by a team of geriatricians, geriatric psychiatrists, and psychologists. The nurses also tracked the details of the patients' cases, including depression, medication use, and patient-caregiver attendance at group therapy sessions.
The other 69 patients got standard Alzheimer's treatment, plus information on Alzheimer's, communication skills, caregiver coping skills, and legal and financial advice. They also received patient exercise guidelines and a caregiver guide.
The researchers compared the two groups after a year (when the collaborative care program ended) and again six months later.
The collaborative care group had some different results from the other participants:
The study, published in The Journal of the American Medical Association, included 153 older adults with Alzheimer's disease and their caregivers.
All of the patients and caregivers live in Indianapolis. That's where researcher Christopher Callahan, MD, works at Indiana University's Center for Aging Research.
Callahan and colleagues make the case for "collaborative care," a team of specialists led by a nurse to help patients and their families navigate Alzheimer's care. But even without such a team, there are steps caregivers can take to take care of themselves while tending to Alzheimer's patients.
Alzheimer's Study
Alzheimer's disease is the most common form of dementia among older adults. But it's not a normal part of the aging process.
The Alzheimer's Association estimates that 4.5 million Americans have Alzheimer's disease, with that number set to grow as the U.S. population ages.
The Alzheimer's patients in Callahan's study were almost 78 years old, on average. Most were financially disadvantaged and had other health problems. About half were black.
Patients had "moderate" dementia at the study's start, the researchers write, based on scores from a mental skills test.
Collaborative Care
Doctors randomly assigned 84 patients to get a year of collaborative care. Advanced practice nurses were at the heart of collaborative care.
The nurses coordinated weekly meetings by a team of geriatricians, geriatric psychiatrists, and psychologists. The nurses also tracked the details of the patients' cases, including depression, medication use, and patient-caregiver attendance at group therapy sessions.
The other 69 patients got standard Alzheimer's treatment, plus information on Alzheimer's, communication skills, caregiver coping skills, and legal and financial advice. They also received patient exercise guidelines and a caregiver guide.
The researchers compared the two groups after a year (when the collaborative care program ended) and again six months later.
Study's Results
The collaborative care group had some different results from the other participants:
- Fewer behavioral and psychological dementia symptoms at 12 and 18 months.
- More likely to take antidepressants and Alzheimer's drugs called cholinesterase inhibitors.
- Less distress and depression in caregivers as the study progressed.
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