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F3‐03‐04: COMPREHENSIVE, INDIVIDUALIZED, PERSON‐CENTERED MANAGEMENT PROGRAM REDUCES RISK OF HOSPITALIZATION BY 67% AND EMERGENCY ROOM VISITS BY 50% IN COMMUNITY‐RESIDING, ADVANCED AD PERSONS IN A 28‐WEEK RANDOMIZED, CONTROLLED TRIAL
Author(s) -
Kenowsky Sunnie,
Shao Yongzhao,
Sommese Kathryn,
Alshalabi Munther,
Heller Sloane,
Dafflisio Gianna,
Vedvyas Alok,
Reisberg Barry
Publication year - 2018
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2018.06.2751
Subject(s) - medicine , randomized controlled trial , incidence (geometry) , physical therapy , diarrhea , pediatrics , emergency medicine , optics , physics
In addition, twelve speech clinicians blinded to the experimental conditions rated participants’ decisional capabilities. Results: Results showed that participants demonstrated significantly better overall decisional capacity in Understanding (p<.001), Reasoning (p<.001), and Appreciation (p<.001) when supported by visual aids. No significant differences between conditions were found for Expressing a Choice. Participants generated significantly more Rewordings and Exact Statements (p<.001), and significantly fewer Statements Not Mentioned (p<.001), in the visual condition than in the verbal condition. In addition, participants with mild dementia produced more Rewordings (p<.008), while those with moderate dementia offered more Exact Statements (p<.02). Overall, clinicians’ ratings validated participants’ decision-making performance on the experimental tasks, reflecting greater agreement in the visual condition, than in the verbal condition (p<.001 for 6 of 8 ratings). Conclusions:Visual aids were found to enable persons with mild and moderate dementia to make reliable decisions about endof-life care.