| Translation of a dementia caregiver intervention for delivery in homecare as a reimbursable Medicare service: outcomes and lessons learned. | |
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MedLine Citation:
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PMID: 20660473 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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 project with a homecare practice was conducted. Five translational activities included refining ESP, site preparation, therapist training, establishing referral mechanisms, and evaluating outcomes using Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM). RESULTS: of 30 OTs approached for participation, 23 (77%) agreed, 22 (96%) completed training, and 21 (95.5%) used ESP and intended to continue use. Of 69 eligible caregivers, 41 (59%) agreed to participate averaging 4.7 sessions. Of 20 returned caregiver surveys, enhancements were reported in all targeted areas of knowledge and skills. Fidelity monitoring revealed inconsistency in therapists use of problem solving, yet caregiver enactment of ESP strategies was high. ESP sessions integrated within patient-directed therapy were reimbursed by Medicare Part B. IMPLICATIONS: RE-AIM indicators suggest moderate translational success. As ESP was reimbursed through Medicare B, its delivery may be sustainable and meet the needs of family caregivers of dementia patients receiving therapies at home. |
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Authors:
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Laura N Gitlin; Mimi Jacobs; Tracey Vause Earland |
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Publication Detail:
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Type: Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2010-07-26 |
Journal Detail:
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Title: The Gerontologist Volume: 50 ISSN: 1758-5341 ISO Abbreviation: Gerontologist Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-18 Completed Date: 2011-01-31 Revised Date: 2011-12-21 |
Medline Journal Info:
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Nlm Unique ID: 0375327 Medline TA: Gerontologist Country: United States |
Other Details:
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Languages: eng Pagination: 847-54 Citation Subset: IM |
Affiliation:
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Jefferson Center for Applied Research on Aging and Health, Thomas Jefferson University, 130 S.9th Street, Suite 513, Philadelphia, PA 19107, USA. laura.gitlin@jefferson.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Activities of Daily Living Adaptation, Psychological Caregivers / education*, psychology Dementia / nursing*, psychology Evidence-Based Medicine Home Nursing / education* Humans Intervention Studies Medicare Part B / economics* Occupational Therapy / education* Outcome Assessment (Health Care) Program Evaluation Quality of Life Reimbursement Mechanisms Social Environment United States |
| Grant Support | |
ID/Acronym/Agency:
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R01 AG022254-01/AG/NIA NIH HHS; R01 AG22254/AG/NIA NIH HHS; R01-AG10947/AG/NIA NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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