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The Healthy Aging Brain Centers Initiative

The Healthy Aging Brain Centers Initiative From Discovery to Delivery The Minimally Standardized Care. IDND Vision IDND Summit Resource center Referral Need MCP RAPID-PC I-ADC PADRE. The Healthy Aging Brain Centers Initiative. The State of Art in Dementia Care. Content. Delivery.

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The Healthy Aging Brain Centers Initiative

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  1. The Healthy Aging Brain Centers InitiativeFrom Discovery to DeliveryThe Minimally Standardized Care www.indydiscoverynetwork.com

  2. IDND Vision IDND Summit Resource center Referral Need MCP RAPID-PC I-ADC PADRE The Healthy Aging Brain Centers Initiative www.indydiscoverynetwork.com

  3. The State of Art in Dementia Care Content Delivery Case Management / coordination: 1- community resources 2- various clinical providers 3- caregivers and family members Within a Health Care System (HCS): - PCP or and MCP Outside of HCS: - Alzheimer A or Area On Aging Medical management: 1-Diagnsois 2-pharmacotherapy 3-comorbidity care • Within a HCS: • - PCP with support (mild cases) • MCP for more complex (complex cases) • PCP and MCP ? Caregiver Interventions: 1- Education, 2- Skills to manage recipient BPSD, 3- Social support 4- Cognitive strategies for negative emotional responses 5- Strategies for enhancing -healthy behaviors and -managing stress. Within HCS: - Pharmacotherapy at PCP Outside HCS: - Non-pharmacotherapy at AA www.indydiscoverynetwork.com Callahan et al, JAMA, 2006; Vickrey et al, Annals of IM, 2006; Belle et al, Annals of IM, 2006

  4. Ambulatory Care for Older Adults Pt’s Home Checking –In at the Clinic Pt-Clinician Interaction at the Acute Care Setting Waiting Area Pt-MD Interaction At the Clinic Checking-Out Pt-Clinician Interaction at the Long-term Care Setting Pt’s Home www.indydiscoverynetwork.com

  5. Dementia Care Model 2007 Delivery Dementia Care Package Home Environment Modification and Self Management Dementia Team Caregiver Intervention Dementia Care Coordinator MCP PCP Medical Management AA Chapter Local Area Agency on Aging 24 Hr Crisis Hotline Adult Day Care or Home Health www.indydiscoverynetwork.com

  6. MCP vs II Case finding within The Primary Care System Mild Complexity Primary Care Dementia Clinic (PCP + DCC)/ Focus on the Dyad: - Medical dementia Care - Relevant comorbid care - Secondary Prevention Dementia Care Needs & Coordination Periodic Assessment (DCC) Moderate-Severe Complexity Community Resources: - Pt & CG Self-management - Home & Respite Care Support • Specialty Care Dementia Clinic • (DCP + DCC) / Focus on the Dyad: • Medical dementia Care DCC: Dementia Care Coordinator PCP: Primary Care Provider MCP: Dementia Care Provider Pt: Patient with dementia CG: Caregiver of patient with dementia Boustani, Callahan, Sachs. JGIM in Press www.indydiscoverynetwork.com

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