Background: The rate of falls in community dwelling older people with cognitive impairment (CI) is twice that of a cognitively intact population, with almost two thirds of people with CI falling annually. Studies indicate that exercise involving balance and/or a home hazard reduction program are effective in preventing falls in cognitively intact older people. However […]
Objectives: To test the effects of an intervention that helps families manage distressing behaviors in family members with dementia.; Design: Two-group randomized trial.; Setting: In home.; Participants: Two hundred seventy-two caregivers and people with dementia.; Intervention: Up to 11 home and telephone contacts over 16 weeks by health professionals who identified potential triggers of patient […]
Objectives: To evaluate cost-effectiveness of the Tailored Activity Program (TAP) for individuals with dementia and family caregivers.; Design: Cost-effectiveness study of a two-group randomized controlled trial involving 60 patients-caregiver dyads randomized to intervention or wait-list control.; Setting: Participants’ homes in Philadelphia region.; Participants: Caregivers were aged ≥ 21 years, lived with patients, and provided ≥ […]
Purpose: The Tailored Activity Program (TAP) is a home-based occupational therapy intervention shown to reduce behavioral symptoms and caregiver burden in a randomized trial. This article describes TAP, its assessments, acceptability, and replication potential.; Design and Methods: TAP involves 8 sessions for a period of 4 months. Interventionists identify preserved capabilities, previous roles, habits, and […]
Purpose: families of dementia patients receiving skilled homecare do not receive supportive services. We evaluated whether a proven intervention, Environmental Skill-building Program (ESP), which reduces caregiver burden and enhances skills managing patient functioning, can be integrated into homecare practices of occupational therapists (OTs) and reimbursed through Medicare Part B.; Design and Methods: a 2-year translational […]
Objectives: To assess whether a dementia care coordination intervention delays time to transition from home and reduces unmet needs in elders with memory disorders.; Design: 18-month randomized controlled trial of 303 community-living elders.; Setting: 28 postal code areas of Baltimore, MD.; Participants: Age 70+ years, with a cognitive disorder, community-living, English-speaking, and having a study […]
Context: Optimal treatment to postpone functional decline in patients with dementia is not established.; Objective: To test a nonpharmacologic intervention realigning environmental demands with patient capabilities.; Design, Setting, and Participants: Prospective 2-group randomized trial (Care of Persons with Dementia in their Environments [COPE]) involving patients with dementia and family caregivers (community-living dyads) recruited from March […]
Background: Behavioral symptoms accompanying dementia are associated with increased health care costs, reduced quality of life and daily functioning, heightened family caregiver burden, and nursing home placement. Standard care typically involves pharmacologic agents, but these are, at best, modestly effective, carry serious risks, including mortality, and do not address behavioral symptoms families consider most distressful […]