Memory Care in Assisted Living: Does it Improve Quality Outcomes?

辅助生活中的记忆护理：它能提高质量结果吗？

• 批准号: 10807400
• 负责人: Eric Jutkowitz
• 金额: $ 218.31万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2026-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10807400
• 关键词: Address; Affect; Alzheimer' s Disease; Alzheimer' s disease diagnosis; Alzheimer' s disease related dementia; Assisted Living Facilities; Bathing; Caring; Communities; Complex; Data; Databases; Dementia; Elderly; Employee; Family; Goals; Health Policy; Impaired cognition; Interview; Link; Literature; Long-Term Care; Marketing; Medicare; Methods; Organizational Policy; Outcome; Persons; Policies; Policy Maker; Policy Making; Process; Quality of Care; Recording of previous events; Research; Services; Site; Sterile coverings; Structure; Surveys; Testing; Training; Variant; Work; beneficiary; community living; cost; dementia care; design; evidence base; experience; health care disparity; health care service utilization; improved; insight; memory care; response; satisfaction; supportive environment; therapy development

PROJECT ABSTRACT Of the nearly one million people who reside in assisted living (AL), up to 70% have some form of cognitive impairment and 40% have a diagnosis of Alzheimer's Disease and Alzheimer's Disease-Related Dementias (AD/ADRD). AL staff provide services including help with dressing and meals, and nearly 25% of ALs provide specialized care for people living with AD/ADRD (also known as “memory care”). Very little is known about the quality of memory care. To improve AD/ADRD care, consumers must understand whether the quality provided in memory care settings, at a surcharge of almost 36% compared to a room in general AL, is worth the cost. The objective of this application is to examine variation in the quality of care for AL residents with AD/ADRD. It is hypothesized that residents with AD/ADRD in ALs that provide memory care receive higher quality care than their counterparts in ALs that do not provide memory care (“between” AL effects). Also, it is hypothesized that residents with AD/ADRD in ALs without memory care experience poorer quality of care than residents without AD/ADRD (“within” AL effects). Conversely, residents with AD/ADRD in ALs with memory care experience similar quality of care compared to residents without AD/ADRD. To test these hypotheses, the research team will leverage the data and methods that they have developed to 1) identify Medicare beneficiaries residing in ALs; 2) connect policy data to specific AL communities; and 3) combine more than 2,000 AL communities’ employee and resident/family satisfaction surveys with national, administrative data. In response to NOT-AG-21-046, the project has the following specific aims: 1. Compare quality outcomes (i.e., worker satisfaction, resident/family satisfaction, healthcare utilization) between ALs that do and do not provide memory care. Working hypothesis: ALs that provide memory care will have better quality outcomes than ALs that do not provide memory care. This aim looks at how quality varies between ALs. 2. Compare the difference in quality outcomes of residents with and without AD/ADRD within ALs that do and do not provide memory care. Working hypotheses: 2a) within general ALs, residents with AD/ADRD will have poorer outcomes than residents without AD/ADRD; 2b) within memory care ALs, there will not be a significant difference in quality outcomes between residents with and without AD/ADRD. This aim looks at how quality varies within ALs. 3. Understand the processes of care that contribute to quality outcomes for residents with AD/ADRD among ALs that do and do not provide memory care. Semi-structured interviews and on- site observations in ALs that do and do not provide memory care will identify the processes of care that are associated with satisfaction and experience of care for residents with AD/ADRD. The project is significant because it will provide national data about AL care for people living with AD/ADRD.

项目摘要 在近 100 万人生活辅助生活 (AL) 中，高达 70% 的人患有某种形式的认知障碍 损伤，40% 被诊断患有阿尔茨海默病和阿尔茨海默病相关痴呆 (AD/ADRD) AL 员工提供的服务包括穿衣和膳食帮助，近 25% 的 AL 提供服务。 对于 AD/ADRD 患者的专门护理（也称为“记忆护理”），人们知之甚少。 为了改善 AD/ADRD 护理，消费者必须了解所提供的质量是否良好。 在记忆护理机构中，与一般 AL 的房间相比，附加费近 36%，是值得的。 此应用程序的目的是检查患有 AD/ADRD 的 AL 居民护理质量的变化。 迫切希望提供记忆护理的 AL 中患有 AD/ADRD 的居民能够获得更高质量的护理 比他们在 AL 中的天赋不提供记忆护理（“在”AL 效果之间）。 没有记忆护理的 AL 中患有 AD/ADRD 的居民所获得的护理质量比居民差 没有 AD/ADRD（离线“AL 效应内”），患有 AD/ADRD 的 AL 患者接受记忆护理。 与没有 AD/ADRD 的居民相比，他们获得的护理质量相似。 研究团队将利用他们开发的数据和方法 1) 确定医疗保险 居住在 AL 的受益人；2) 将保单数据连接到特定的 AL 社区；以及 3) 合并多个社区； 使用国家行政数据对 2,000 个 AL 社区的员工和居民/家庭满意度进行调查。 根据对 NOT-AG-21-046 的回应，该项目有以下具体目标： 1. 比较质量结果（即 提供和不提供服务的 AL 之间的员工满意度、居民/家庭满意度、医疗保健利用率） 记忆护理工作假设：提供记忆护理的 AL 会比 AL 获得更好的质量结果。 2. 比较 AL 之间的质量差异。 在提供和不提供服务的 AL 内，患有 AD/ADRD 的居民与未患有 AD/ADRD 的居民的质量结果存在差异 工作假设：2a) 在一般 AL 中，患有 AD/ADRD 的居民的情况会较差。 与没有 AD/ADRD 的居民相比，2b) 在记忆护理 AL 中，不会有显着的结果 患有 AD/ADRD 的居民与未患有 AD/ADRD 的居民之间质量结果的差异。 3. 了解有助于为患有以下疾病的居民提供优质结果的护理流程 提供和不提供记忆护理的 AL 中的 AD/ADRD 半结构化访谈和现场。 对提供和不提供记忆护理的 AL 进行观察，将确定以下护理过程： 与 AD/ADRD 居民的护理满意度和体验相关 该项目意义重大。 因为它将提供有关 AD/ADRD 患者的 AL 护理的全国数据。