Caregiver Training to Manage Inappropriate Behaviors in Individuals with Alzheime

护理人员培训以管理阿尔茨海默病患者的不当行为

基本信息

批准号：
7672183
负责人：
John V Hobday
金额：
$ 39.91万
依托单位：
HEALTHCARE INTERACTIVE, INC.
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-06-15 至 2011-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7672183
关键词：
Acting Out Acute Address Administrator Affect Age Age Reporting Aggressive behavior Aging Alzheimer&apos s Disease American Americas Antipsychotic Agents Area Attention Attitude Behavior Behavior Therapy Behavioral Burn injury Businesses Caregiver Burden Caregivers Caring Cessation of life Church Cognitive Community Health Education Couples Cues Data Data Analyses Dementia Diagnosis Direct Costs Discipline of Nursing Disease Economics Education Educational Background Educational Curriculum Educational Intervention Elderly Exhibits Facilities and Administrative Costs Family member Feedback Film Future Geographic Locations Grant Healthcare Healthcare Systems Hearing Home environment Hour Human Impaired cognition Individual Internet Intervention Interview Knowledge Length Lifestyle-related condition Literature Long-Term Care Long-Term Care Insurance Measurable Mediating Mediation Medical Medicare/Medicaid Methods Military Personnel Modeling Morals National Institute of Neurological Disorders and Stroke Nature Needs Assessment Newspapers North Carolina Nurses Nursing Homes PPP3CA gene Pamphlets Participant Patients Persons Phase Physician Executives Population Positioning Attribute Preparation Prevalence Price Problem behavior Production Protocols documentation Psychological reinforcement Public Health Quality of life Randomized Controlled Trials Relative (related person)Reporting Research Research Personnel Research Project Grants Resources Risk Risk Factors Rosa Savings Series Services Sex Behavior Sex Education Sexuality Small Business Innovation Research Grant Specialist Staging Stream Stress Surveys Symptoms Testing Therapeutic Time TimeLine Touch sensation Training Translating United States National Institutes of Health Universities Veterans Veterans Hospitals Videotape Visual Washington Work Workplace affection aging population authority base behavior change caregiver education caregiving clinical practice cognitive reserve commercialization coping cost economic cost experience follow-up help-seeking behavior improved innovation interest intimate behavior knowledge base loved ones meetings member older patient outreach program prevent programs prototype psychosocial public health relevance response routine care sex skills skills training successful intervention symposium

项目摘要

DESCRIPTION (provided by applicant): Alzheimer's Disease and related dementias (ADRD) combine to form an urgent healthcare challenge facing the aging population of 21st Century America. In the U.S. during 2008, one person receives an ADRD diagnosis every 71 seconds; by 2050, that number will be one every 33 seconds. Authorities cited in the body of this proposal report ADRD are the third most costly disease sets in the U.S. In spite of ongoing research efforts, at present there is no way to prevent onset of ADRD, and death is the only certain cure. Caregiving options are complicated because the cognitive and physical declines of those with ADRD differ for each person, and no single care routine or protocol is predictably effective. Further, inappropriate behaviors are seen in more than 80% of individuals with ADRD, causing immense stress and increased burden to Certified Nursing Assistants (CNAs). Although behavior management strategies have dominated the ADRD literature since the 1980s, many medical directors and other ADRD facility professionals often lack either the preparation or the time to respond to CNAs' requests for help in managing problematic behaviors. Various authorities experienced in ADRD care, however, suggest measurable positive effects result when CNAs receive ongoing education and skill training in this area. This Phase I effort aims therefore to educate CNAs in the knowledge and skills they need to effectively mediate problematic behaviors of those afflicted with ADRD and to do so through an innovative, Internet based prototype presenting a challenging, informative, application- based curriculum. This product exceeds traditional passive methods of CNA education and in-service training and provides instead multi-media features such as interviews, care models, streaming videos, and online interaction. Through this prototype, CNA testers gain convenient, 24/7, private access to a whole team of intervention consultants and therapeutic support specialists experienced in managing ADRD-related problem behaviors. The dispersed effects of improved practice resulting from this prototype may also facilitate a multi-level intervention with power to affect in many positive ways the care recipients themselves as well as their loved ones. In addition to its strong commercial potential, the proposed Phase I training product has the capacity to benefit public health in venues as diverse as community education, military and veterans' hospitals and services, medical offices, healthcare agencies, church-based outreach programs, and workplace settings. During Phase II, a randomized control trial will test the completed product, and commercialization will be undertaken during Phase III. One of the parallel benefits of all phases of this effort may well be the reduction of both direct and indirect costs of ADRD to U.S. health care systems. PUBLIC HEALTH RELEVANCE: The proposed effort is relevant to the nation's public health because during 2008, 5.2 million Americans of all ages have Alzheimer's Disease and Related Dementias (ADRD), which translates to one ADRD diagnosis every 71 seconds (Alzheimer's Disease Facts and Figures, 2008, p. 8). The economic cost of ADRD includes $148 billion in direct costs to Medicare and Medicaid (not including the costs paid for by the Department of Veterans' Affairs, private health care, and long-term care insurance), and an estimated $267 billion savings to the national healthcare system because 9.8 million family members deliver at least 70% of the care for those with ADRD at home without reimbursement instead of in nursing homes. Further, ADRD care is strongly associated with psychosocial costs to caregivers, who must respond directly to the inappropriate behaviors exhibited by those in the cognitive declines of ADRD (Alzheimer's Disease Facts and Figures, 2008).

描述（由申请人提供）：阿尔茨海默氏病和相关痴呆症 (ADRD) 共同构成 21 世纪美国人口老龄化面临的紧迫医疗保健挑战。 2008 年在美国，每 71 秒就有一个人收到 ADRD 诊断；到 2050 年，这个数字将是每 33 秒就有一个。本提案报告正文中引用的权威机构指出，ADRD 是美国第三大最昂贵的疾病。尽管正在进行研究工作，但目前还没有办法预防 ADRD 的发作，死亡是唯一确定的治疗方法。护理选择很复杂，因为 ADRD 患者的认知和身体衰退程度因人而异，并且没有任何单一的护理常规或方案可以预见有效。此外，超过 80% 的 ADRD 患者存在不当行为，给认证护理助理 (CNA) 带来巨大的压力和负担。尽管行为管理策略自 20 世纪 80 年代以来一直在 ADRD 文献中占据主导地位，但许多医疗主任和其他 ADRD 机构专业人员往往缺乏准备或时间来响应 CNA 在管理问题行为方面的帮助请求。然而，在 ADRD 护理方面经验丰富的各种权威机构表示，当 CNA 接受该领域的持续教育和技能培训时，会产生可衡量的积极效果。因此，第一阶段的工作旨在教育 CNA 所需的知识和技能，以有效调解 ADRD 患者的问题行为，并通过创新的、基于互联网的原型来实现这一目标，该原型提供具有挑战性的、信息丰富的、基于应用的课程。该产品超越了传统CNA教育和在职培训的被动方式，提供了访谈、护理模型、流媒体视频、在线互动等多媒体功能。通过这个原型，CNA 测试人员可以方便地、24/7、私人地接触整个团队的干预顾问和治疗支持专家，他们在管理 ADRD 相关问题行为方面经验丰富。这种原型所带来的改进实践的分散效应也可能促进多层次的干预，并以许多积极的方式影响护理对象本身及其亲人。除了其强大的商业潜力外，拟议的第一阶段培训产品还能够在社区教育、军事和退伍军人医院和服务、医疗办公室、医疗保健机构、基于教会的外展计划等多种场所造福公共卫生。工作场所设置。在第二阶段，随机对照试验将测试完成的产品，并在第三阶段进行商业化。这项工作所有阶段的并行好处之一很可能是减少 ADRD 对美国医疗保健系统的直接和间接成本。公共健康相关性：拟议的工作与国家公共健康相关，因为 2008 年期间，所有年龄段的 520 万美国人患有阿尔茨海默病和相关痴呆症 (ADRD)，这意味着每 71 秒就会诊断出一名 ADRD（阿尔茨海默病事实和数据， 2008 年，第 8 页）。 ADRD 的经济成本包括 Medicare 和 Medicaid 的 1,480 亿美元直接成本（不包括退伍军人事务部、私人医疗保健和长期护理保险支付的费用），以及估计为医疗保险节省 2,670 亿美元。国家医疗保健系统，因为 980 万家庭成员为患有 ADRD 的患者提供至少 70% 的护理，而无需报销，而不是在疗养院。此外，ADRD 护理与护理人员的社会心理成本密切相关，护理人员必须直接对 ADRD 认知能力下降患者表现出的不当行为做出反应（阿尔茨海默病事实和数据，2008）。