The Role of Care Navigators Working with People with Dementia and Their Caregivers.

Adult Aged Caregivers / psychology Consumer Behavior Dementia / therapy Female Focus Groups Health Services Accessibility / organization & administration Humans Interviews as Topic Male Patient Navigation / methods Surveys and Questionnaires
Care navigation caregivers dementia health care workforce

Journal

Journal of Alzheimer's disease : JAD
ISSN: 1875-8908
Titre abrégé: J Alzheimers Dis
Pays: Netherlands
ID NLM: 9814863

Informations de publication

Date de publication:
2019
Historique:
pubmed: 20 7 2019
medline: 21 10 2020
entrez: 20 7 2019
Statut: ppublish

Résumé

Care navigation is an approach to personalized care management and care coordination that can help overcome barriers to care. Care navigation has not been extensively studied in dementia, where health care workforce innovations are needed as a result of increasing disease prevalence and resulting costs to the health care system. To identify facilitators and barriers to care navigation in dementia and to assess dementia caregiver satisfaction with care navigation. Methods include qualitative research (interviews, focus groups, observations) with "Care Team Navigators" (CTNs) who were part of a dementia care navigation program, the Care Ecosystem, and a quantitative survey with caregivers about their experiences with CTNs. Transcripts were analyzed to identify themes within the data. CTNs identified the following facilitators to care navigation in dementia: working closely with caregivers; providing emotional support; tailoring education and resources; and coordinating with a clinical team around issues ranging from clinical questions to financial and legal decision-making. The barriers CTNS identified included burn-out, the progressive nature of the disease; coordinating with primary care providers; and identifying resources for dyads who are low-income, do not speak English, or live in rural areas. Caregivers across both sites highly rated CTNs, though satisfaction was higher among those in Nebraska and Iowa. Innovative approaches to care delivery in dementia are crucial. Care navigation offers a feasible model to train unlicensed people to deliver care as a way to deliver larger-scale support for the growing population of adults living with dementia and their caregivers.

Sections du résumé

BACKGROUND
Care navigation is an approach to personalized care management and care coordination that can help overcome barriers to care. Care navigation has not been extensively studied in dementia, where health care workforce innovations are needed as a result of increasing disease prevalence and resulting costs to the health care system.
OBJECTIVE
To identify facilitators and barriers to care navigation in dementia and to assess dementia caregiver satisfaction with care navigation.
METHODS
Methods include qualitative research (interviews, focus groups, observations) with "Care Team Navigators" (CTNs) who were part of a dementia care navigation program, the Care Ecosystem, and a quantitative survey with caregivers about their experiences with CTNs. Transcripts were analyzed to identify themes within the data.
RESULTS
CTNs identified the following facilitators to care navigation in dementia: working closely with caregivers; providing emotional support; tailoring education and resources; and coordinating with a clinical team around issues ranging from clinical questions to financial and legal decision-making. The barriers CTNS identified included burn-out, the progressive nature of the disease; coordinating with primary care providers; and identifying resources for dyads who are low-income, do not speak English, or live in rural areas. Caregivers across both sites highly rated CTNs, though satisfaction was higher among those in Nebraska and Iowa.
CONCLUSIONS
Innovative approaches to care delivery in dementia are crucial. Care navigation offers a feasible model to train unlicensed people to deliver care as a way to deliver larger-scale support for the growing population of adults living with dementia and their caregivers.

Identifiants

DOI: 10.3233/JAD-180957 PMID: 31322558 PMC: PMC7004209
pubmed: 31322558
pii: JAD180957
doi: 10.3233/JAD-180957
pmc: PMC7004209
mid: NIHMS1064097
doi:

Types de publication

Journal Article Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

45-55

Subventions

Organisme : NCATS NIH HHS
ID : KL2 TR001870
Pays : United States
Organisme : NIA NIH HHS
ID : L30 AG060590
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG056715
Pays : United States

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Auteurs

Alissa Bernstein (A)

Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USA.
Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.

Krista L Harrison (KL)

Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.
Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA.

Sarah Dulaney (S)

Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.

Jennifer Merrilees (J)

Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.

Angela Bowhay (A)

Department of Internal Medicine, Division of Geriatrics, Home Instead Center for Successful Aging, Omaha, NE, USA.

Julia Heunis (J)

Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.

Jeff Choi (J)

Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.

Julie E Feuer (JE)

Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.

Amy M Clark (AM)

Department of Internal Medicine, Division of Geriatrics, Home Instead Center for Successful Aging, Omaha, NE, USA.

Winston Chiong (W)

Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.

Kirby Lee (K)

Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.

Tamara L Braley (TL)

Department of Internal Medicine, Division of Geriatrics, Home Instead Center for Successful Aging, Omaha, NE, USA.

Stephen J Bonasera (SJ)

Department of Internal Medicine, Division of Geriatrics, Home Instead Center for Successful Aging, Omaha, NE, USA.

Christine S Ritchie (CS)

Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.
Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA.

Dan Dohan (D)

Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USA.

Bruce L Miller (BL)

Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.

Katherine L Possin (KL)

Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.
Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › The Role of Care Navigators Working with...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › The Role of Care Navigators Working with...
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questionsmedicales.fr › Troubles mentaux › Troubles neurocognitifs › Démence › The Role of Care Navigators Working with...
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