With care coordination, problem solving, and an array of services, a model program helps dually eligible Medicare and Medicaid patients and their caregivers cope with dementia challenges.

Among the challenges of being diagnosed with dementia and caring for someone diagnosed with dementia is navigating the complicated health, legal, and social systems designed to help and protect people living with dementia. Recognizing the need for a holistic and coordinated approach to dementia care, comprehensive dementia care programs address both the needs of people living with dementia and their caregivers through several core elements including, for example, care planning, medication management, psychosocial intervention, and care coordination. These programs have been developed over decades of rigorous research including through randomized controlled trials. Despite the obvious need for these programs and mounting evidence of their effectiveness, they have not been widely adopted in the US, largely because there has not been an adequate payment mechanism to support implementation. Until now.

The University of California, Los Angeles Alzheimer’s and Dementia Care (ADC) program enrolls persons living with dementia (PLWD) and their family caregivers as dyads to work with nurse practitioner dementia care specialists to provide coordinated dementia care. At one year, despite disease progression, overall the PLWDs’ behavioral and depressive symptoms improved

As the complexity of medical treatments and patient care systems have increased, the concept of patient navigation is growing in both popularity and breadth of application. Patient navigators are trained personnel whose role is not to provide clinical care, but to partner with patients to help them identify their needs and goals and then overcome modifiable patient‐, provider‐, and systems‐level barriers. Due to its high incidence, duration, and medical–social complexity, dementia is an ideal candidate for a patient‐centric health care delivery model such as care navigation.

Dementia represents a growing healthcare challenge in the United States. The Care Ecosystem, an effective collaborative care model, bridges medical and social care needs for individuals with dementia. The purpose of this study was to describe how the Care Ecosystem has been disseminated and the lessons learned from this experience.

Numerous non-pharmacological programs for family caregivers and persons with dementia (PWDs) have been found efficacious in randomized controlled trials. Few programs have been tested in translation studies that assess feasibility and outcomes in less-controlled, real-world implementations. This translation study tested the impact of the partnership version of BRI Care Consultation, “Partners in Dementia Care (PDC),” on outcomes for PWDs and their family/friend caregivers.

Importance: The effectiveness of different approaches to dementia care is unknown.

Collaborative dementia care models with care navigation, including the Care Ecosystem, improve outcomes for persons living with dementia (PLWDs) and their caregivers. The effects of continuous care over long periods have not been studied.

The purpose of this longitudinal cohort study was to explore the outcomes of persons living with dementia (PLWD) and their caregivers during their first 9 months at the Integrated Memory Care Clinic (IMCC). IMCC advanced practice registered nurses provide dementia care and primary care simultaneously and continuously to PLWD until institutionalization.

This qualitative study evaluates primary care pracitioner perspectives on their role in dementia diagnosis and care.

Objectives: Persons living with dementia (PLWD), particularly those with higher levels of functional impairment, are at increased risk of hospitalization and higher hospital-associated health care costs. Our objective was to provide a nuanced description of reasons for hospitalizations over a 12-month period among community-living persons with dementia taking part in a dementia care coordination study using caregiver-reported data and to describe how reasons varied by disease stage.

The benefits and harms of screening of Alzheimer disease and related dementias (ADRDs) are unknown. This study addressed the question of whether the benefits outweigh the harms of screening for ADRDs among older adults in primary care.

With the aging of the baby boomers, the numbers of Americans
living with or affected by dementia will rise dramatically. By 2025, an
estimated 7.2 million Americans are expected to have Alzheimer’s
disease, which is the most common cause of dementia, accounting
for 60-80% of cases.

We examine care partners' experience of the Maximizing Independence at Home (MIND) intervention, a multicomponent, home-based dementia care coordination program designed to provide high quality, wholistic care coordination for people and families living with dementia.

Objective: To assess whether MIND at Home, a community-based, multicomponent, care coordination intervention, reduces unmet caregiving needs and burden in informal caregivers of persons with memory disorders.

Objective: We conducted an intervention development study to adapt an efficacious ACP intervention, SPIRIT (sharing patient's illness representations to increase trust), for PWDs in early stages (recent Montreal Cognitive Assessment [MoCA] score ≥13) and their surrogates and assess whether SPIRIT could help PWDs engage in ACP.

Background and objectives: Psychoeducation interventions using distance learning modalities to engage caregivers in active learning environments have demonstrated benefits in enhancing caregiving mastery. However, few of these programs have been specifically adapted to develop mastery in Black caregivers.

Understanding experiences and challenges faced by persons living with Early-Onset Dementia (EOD) compared to individuals diagnosed with Late-Onset Dementia (LOD) is important for the development of targeted interventions.

Individuals with dementia may receive high-intensity care at the end of life (EOL) that does not align with their preferences and is costly. Medicare Accountable Care Organizations (ACOs) are an alternative payment model that aims to incentivize high-quality care and lower spending.

People living with dementia (PLWD) are among the highest-need and highest-cost individuals because of the complexity, duration, and range of medical, behavioral, environmental, and social needs. There is a growing evidence base showing that family-centered active management approaches that include activation and empowerment of care partners are well suited to improve care quality, health-related outcomes, and healthcare costs.

The Integrated Memory Care Clinic (IMCC) is a patient-centered medical home as defined by the National Committee for Quality Assurance directed by advanced practice registered nurses (APRNs) caring for persons living with dementia (PLWD); physicians provide specialty consultation but do not direct care or care planning.

Dementia is associated with high health care costs, premature long-term care (LTC) placement, medical complications, reduced quality of life, and caregiver burden. Most health care providers and systems are not yet organized or equipped to provide comprehensive long-term care management for dementia, although a range of effective symptoms and supportive care approaches exist. The Maximizing Independence at Home-Streamlined (MIND-S) is a promising model of home-based dementia care coordination designed to efficiently improve person-centered outcomes, while reducing care costs.

The Alzheimer’s Association estimates that Medicare spent $146 billion on Alzheimer’s disease in 2022—meaning that more than one in every six Medicare dollars will have been spent on someone with ADRD. Medicaid spent another $60.8 billion caring for these individuals.

A substantial number of evidence-based dementia caregiving support programs positively impact family and friend caregivers. Researchers and service organizations have successfully translated and delivered a subset of these programs to caregivers and are included in Best Programs for Caregiving (BPC).

Access to comprehensive dementia care is limited. Recent changes in billing for professional services, including new physician fee schedule codes, encourage clinicians to provide new services; however, current reimbursement does not cover costs for all needed elements of dementia care.

Despite scientific progress over the last 25 years, dementia remains one of the toughest health-care challenges. Alzheimer’s disease is the sixth-leading cause of death in the United States, and the number of deaths from all related dementias may be twice as high.

These are momentous times for Alzheimer disease
(AD) and Alzheimer disease and related dementias
(ADRDs). For the first time, the US Food and Drug Ad-
ministration has approved disease-modifying drugs that
bring some hope for long-term clinical benefit for per-
sons affected by mild cognitive impairment or early to
mild dementia.

The current US system of reimbursement for dementia care does not support the complex biospychosocial needs of families living with Alzheimer disease and related dementias. We propose an alternative payment system for dementia care that would provide insurance coverage for evidence-based, collaborative dementia care models. This payment model involves a per member per month payment for care management services that would target community-dwelling beneficiaries living with dementia and evidence-based education and support programs for unpaid caregivers. This payment model has the potential to align the incentives of payers and providers and create market demand for the implementation of collaborative dementia care models across the nation.

Objectives: To examine a 12-month dementia care management program's effect on health care cost, utilization, and overall return on investment in a Medicare managed care population.

Background and objectives: Psychoeducation interventions using distance learning modalities to engage caregivers in active learning environments have demonstrated benefits in enhancing caregiving mastery. However, few of these programs have been specifically adapted to develop mastery in Black caregivers.

Evidence-based models for providing effective and comprehensive care for Alzheimer’s disease and related dementias exist but have yet to be successfully implemented at scale. The Alzheimer’s and Dementia Care Program (ADC Program) is an effective comprehensive dementia care model that is being disseminated across the United States. This qualitative study examines barriers and facilitators to implementing the model among early adopting sites.

Older adults have been uniquely and adversely affected by COVID-19 compared to younger populations. Beyond increased vulnerabilities from age alone, COVID-19 also disproportionately affects persons with dementia (PWD). Approximately 11% of U.S. older adults aged 65 and older have Alzheimer’s disease and related dementias, with 6.5 million Americans currently living with the disease.

Objective: To investigate effects of a novel dementia care coordination program on health services utilization.

​

The emergency department evaluates many patients with undiagnosed cognitive impairment and presents an opportune setting to facilitate early detection and referral to memory care specialists. We evaluated a novel care navigation pathway that facilitated referrals of ethnoculturally diverse individuals with suspected cognitive impairment from geriatric professionals embedded in the emergency department to dementia specialist care.

Latinos in the US are 1.5 times more likely to develop Alzheimer’s Disease and Related Dementias (ADRD) than non-Latino Whites. This systematic review aims to summarize current understanding of the perceptions, knowledge, beliefs, and attitudes about ADRD and brain health of Latinos to inform public health efforts addressing disparities.

Multiple studies have shown that quality of care for dementia in primary care is poor, with physician adherence to dementia quality indicators (QIs) ranging from 18% to 42%. In response, the University of California at Los Angeles (UCLA) Health System created the UCLA Alzheimer's and Dementia Care (ADC) Program, a quality improvement program that uses a comanagement model with nurse practitioner dementia care managers (DCM) working with primary care physicians and community-based organizations to provide comprehensive dementia care.

Cognitive impairment (CI) is one of several factors known to influence hospitalization, hospital length of stay, and rehospitalization among older adults. Redesigning care delivery systems sensitive to the influence of CI may reduce acute care utilization while improving care quality.

The workforce available to care for older adults has not kept pace with the need. In response to workforce limitations and the growing complexity of healthcare, scientists have tested new models of care that redesign clinical practice. This article describes why new models of care in aging, dementia, and mental health diffuse inadequately into the healthcare systems and communities where they might benefit older adults.

Dementia is a chronic disease that requires medical and social services to provide high-quality care and prevent complications. As a result of time constraints in practice, lack of systems-based approaches, and poor integration of community-based organizations (CBOs), the quality of care for dementia is poorer than that for other diseases that affect older persons.