Publication Date

Spring 2023

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Robin L. Whitney

Second Advisor

Denise Dawkins

Third Advisor

Theresa Harvath

Keywords

dementia, family caregivers, care management, nurse practitioners

Abstract

Dementia due to Alzheimer’s and other disease is a growing concern for healthcare providers as the number of individuals in the U.S. population ages. Persons with dementia (PWDs) rely on caregivers, primarily family caregivers (FCGs), for basic and instrumental activities of daily living as the disease progresses. There may be negative outcomes, such as depression, strain, and distress for FCGs of PWDs. Routine assessment and intervention by healthcare providers can address needs of FCGs of PWDs. There are multiple interventions that have demonstrated effectiveness in caring for PWDs and FCGs; one such intervention is care management. The University of California, Davis, Health (UCDH) Alzheimer’s and Dementia Care (ADC) Program is a care management program serving PWDs and FCGs since July 2021. This project evaluates the program’s effect on FCG outcomes, specifically depression, strain, and distress. Despite an increase in the severity of dementia and in the number of basic and instrumental activities of daily living requiring caregiving support, FCGs of PWDs experienced decreased levels of depression, strain, and distress following 12 to 18 months in the UCDH ADC Program. Other notable findings include PWDs experiencing reductions in severity of neuropsychiatric symptoms and remaining at home with FCGs. Encounters in the program were primarily unscheduled, non-billable encounters. Despite limitations, primarily small sample size and lack of sample diversity, this project contributes to literature supporting dementia care management for PWDs and FCGs. Future research should address these limitations to understand the experiences of a diverse population and to make dementia care management programs sustainable.

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