Although the results from a few of the programs appear promising, the evidence on the efficacy of care coordination for persons with Alzheimer's disease and their caregivers is still equivocal. The programs reporting the most success shared a few common characteristics. They coordinated both medical care and LTSS, and participants were in an integ
Below, we highlight the effects of care coordination on psychosocial outcomes. Table 3 provides further details on each study's findings for caregivers and care recipients.
Three studies in this review evaluated costs. The MADDE demonstration resulted in reduced Medicare expenditures of $500 on average, which did not offset the costs of the program (Fox et al., 2000). Participants had a 20 percent copayment, but there were no substantial cost containment incentives to encourage more efficient use of LTSS. The VA/Alzh
Table 3 summarizes the effects of the interventions on medical and LTSS utilization. For most of the studies we reviewed, there were no significant changes in medical utilization (noted as NS). One study found a significant effect of care coordination on medical utilization: Callahan et al. (2006) reported fewer office visits in the interven
Care Coordination for People With Alzheimer's Disease and Related Dementias. Coordinating Medical Services and Long-Term Services and Supports
All of the remaining ten programs coordinated both medical services and LTSS. LTSS arranged by the care coordinators typically included day care, home care, social centers, and respite care. The involvement of health care professionals ranged from direct care coordination responsibilities to consultations as needed. United States Studies
Care Coordination for People With Alzheimer's Disease and Related Dementias. Coordinating Medical Services
One RCT focused on coordinating medical services for persons with dementia. Callahan et al. (2006) described a 12-month collaborative care coordination program in Indiana for persons with dementia which based care recommendations on published Alzheimer's disease treatment guidelines in the United States. Guidelines referenced included those from t
Care Coordination for People With Alzheimer's Disease and Related Dementias. Coordinating Long-Term Services and Supports
Two studies focused on coordinating LTSS. Influenced by the National Long-Term Care Channeling Demonstration of the early 1980s, the Medicare Alzheimer Disease Demonstration and Evaluation (MADDE) was an RCT that was designed to increase access to formal LTSS through care coordination and access to additional LTSS for people with Alzheimer's disea
Care Coordination for People With Alzheimer's Disease and Related Dementias. Models of CARE Coordination
Approaches to care coordination were similar in most of the reviewed studies ( Table 2 ) . Briefly, a care coordinator was assigned to the care receiver/caregiver dyad to conduct a structured assessment, develop a care plan, provide ongoing support, and monitor their progress. For example, in the intervention described by Callahan et al.
Care Coordination for People With Alzheimer's Disease and Related Dementias. Literature Review Methods
We conducted literature searches in PubMed, Web of Science, Scopus, Cochrane, and Ageline using the keywords "Care Coordination" and "Case Management," focusing on health care or long-term services and supports (LTSS) settings, and limited to persons with dementia or Alzheimer's disease. Searches in PubMed combined the MeSH term "Alzheimer disease
Care Coordination for People With Alzheimer's Disease and Related Dementias. Summary of Previous Review Articles
This review builds on previous examinations of the research literature on the effect of care coordination on people with Alzheimer's disease and their caregivers. Pimouguet et al. (2010) recently published a systematic review of eight randomized controlled trials (RCTs) of case management for people with dementia and their caregivers, concluding t
Alzheimer's disease is an irreversible, progressive form of dementia that affects more than 5 million Americans (HHS, 2012). It slowly destroys memory, thinking skills, and eventually the ability to perform activities of daily living (ADLs). People with Alzheimer's disease are often reliant on others for their daily care and are heavy users of med
Care Coordination for People With Alzheimer's Disease and Related Dementias. ACKNOWLEDGMENT/DISCLAIMER
This paper was supported by the Office of the Assistant Secretary for Planning and Evaluation through Contract #HHSP23320100021WI. The authors gratefully acknowledge the useful comments of Helen Lamont, PhD, of the Office of Disability, Aging and Long-Term Care Program within the Office of the Assistant Secretary for Planning and Evaluation, U.S.
This report summarizes the research literature on care coordination for people with Alzheimer's disease, with a particular focus on programs that coordinate both medical care and long-term services and supports. Overall, there is limited evidence of the effectiveness of these programs in improving patient outcomes or reducing health care utilizati
Alzheimer's Association. (2011). "2010 Alzheimer's Disease Facts and Figures." Retrieved May 11, 2012, from http://www.alz.org/documents_custom/report_alzfactsfigures2010.pdf . Alzheimer's Association. (2012). "2011 Alzheimer's Disease Facts and Figures." Retrieved May 11, 2012, from http://www.alz.org/downloads/facts_figures_2011.pdf .
This paper reviews the research literature on ethnic and racial disparities as it relates to Alzheimer's disease. The literature shows consistent and adverse disparities among Blacks and Hispanics compared to non-Hispanic Whites in the prevalence and incidence of Alzheimer's disease, mortality, participation in clinical trials, use of medications
Racial and Ethnic Disparities in Alzheimer's Disease: A Literature Review. Outreach to Minority Communities
Another approach to addressing disparities involves targeting programs and outreach to minority populations. For example, the Alzheimer's Disease Demonstration Grants to States program provided demonstration grants to Florida, Kentucky, and the District of Columbia, that focused on African Americans (Wiener & Mitchell, 2007). For example, in t
Cultural competency is especially important in the health care setting, where barriers to communication and access to quality care can result in delayed diagnosis, inappropriate treatment, or worse. Cultural competence involves both awareness and knowledge about other cultures and skill in relating to people of other cultures. Cultural competence
Racial and Ethnic Disparities in Alzheimer's Disease: A Literature Review. Interventions to Reduce Racial and Ethnic Disparities
Although there is extensive evidence documenting disparities among different racial and ethnic groups with Alzheimer's disease, there are few studies evaluating interventions to address disparities in this population. Almost all interventions designed to explicitly address racial and ethnic disparities focus on cultural competency on the part of t
Racial and Ethnic Disparities in Alzheimer's Disease: A Literature Review. Racial and Ethnic Discrimination
Although discrimination by providers against racial and ethnic minorities in the United States is commonly asserted as the cause of racial and ethnic disparities, we were unable to find any empirical studies on this topic that focused on people with Alzheimer's disease. Indeed, there appear to be few empirical studies on this topic in health care.