A novel care model for dementia: Improving caregiver burden and depression

Background In the United States, people with dementia are cared for by 16,000,000 unpaid caregivers (Alz. Association, 2019). Dementia caregivers have increased morbidity and poorer health than non‐caregivers. Negative biopsychosocial impacts related to caregiving undermine the capacity to provide care, and lead to increased institutional placement, increasing burden on public systems (de Vugt, Verhey, 2013). Method This study investigated the efficacy of a novel care model in which participants were assigned care coordinators who provided education, support, guidance and access to existing resources. Participants were 105 people with dementia (54.3% women) and their caregivers (67.3% women). Depression (CES‐D), caregiver burden (Zarit), and healthcare utilization were measured at baseline and twelve months. We used Linear Effects Modeling and the Actor‐Partner Interdependence Model (APIM; Kashy & Kenny, 2000) to examine the extent to which patient/caregiver’s depression at 12 months was affected by their own and partner’s depression at baseline. Result Care coordination satisfaction was high. There were significant decreases in caregiver burden and depression over time (both p’s < 0.001). Regarding health care utilization, there was a decrease in the number of nights in the hospital with care coordination relative to before study onset. Most people had no change in the number of doctor visits relative to prior to the study, but of those who had a change, most had fewer visits with care coordination. APIM results showed patients’ and caregivers’ depression at baseline were positively correlated ( p < .001). Patients’ depression at baseline predicted their depression at 12‐months ( p < .01), taking into account the correlation of depression between patients and caregivers, and the effect of caregivers’ depression at baseline. Caregivers’ depression at 12‐months was not affected by their own nor patients’ depression at baseline. Conclusion Patients and caregivers participating in a novel caregiving model involving care coordination showed decreased caregiver burden, depression and hospitalization. Caregiver depression at twelve months was unrelated to caregiver and patient baseline depression, controlling for correlations between caregiver and patient depression at baseline. Care coordination may help alleviate negative impacts related to caregiving, suggesting that this model may improve important elements of dementia care.