Research from Howard University Yields New Findings on Dementia (Safe, Social, and Engaged: Clinician perspectives on good institution-free days for people with dementia): Neurodegenerative Diseases and Conditions – Dementia

2024 JAN 10 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Research findings on dementia are discussed in a new report. According to news reporting out of Howard University by NewsRx editors, research stated, “Composite measures of survival and residence, such as institution-free days (IFDs), encompass many patient and family priorities and are readily measured using payer claims or electronic health record data. However, knowledge gaps limit their application to studies of people with dementia (PWD). First, PWD, family care partners, and clinician perspectives on survival-residence composite outcomes are unknown.”

Our news correspondents obtained a quote from the research from Howard University: “Second, approaches to measuring IFDs consider all institution days equally poor and all home days equally well, which may be inconsistent with stakeholder assessments. We conducted a qualitative study to explore stakeholders’ perspectives on what makes a “good day” for a PWD. This included semi-structured interviews with clinicians who provide care to PWD. Clinicians were also asked for their opinions regarding the use of survival-residence composite outcomes in dementia research. Interviews were audio-recorded and professionally transcribed. De-identified transcripts were reviewed by the research team independently and during weekly consensus meetings to identify relevant themes. Thematic saturation was reached after 24 interviews. Nearly half of clinicians also had personal experience as a care partner of a PWD. Participant characteristics are summarized in Table 1. Salient themes were identified and grouped into 2 major categories: (1) attributes of quality of days for PWD, and (2) impressions of survival-residence composite outcomes (Table 2). Key attributes of quality of days were safety, socialization and engagement, and neuropsychiatric distress. These qualities were more important in defining “home” than type of residence (Figure). Clinicians appreciated that a survival-residence composite outcome, such as IFDs, could capture the important aspects of “aging in place” and avoiding burdensome hospitalizations. They also noted a desire for such a measure to capture the quality of those days. Concerns were raised over how differential access to home-based services due to socioeconomic factors would influence patient accrual of IFDs and whether such a measure might also increase existing stigma around institutions.”

According to the news reporters, the research concluded: “Future work will integrate these findings with the perspectives of PWD and their family care partners as well as further explore the relative values of these attributes of a survival-residence composite outcome for studies of patients with ADRD.”

For more information on this research see: Safe, Social, and Engaged: Clinician perspectives on good institution-free days for people with dementia. Alzheimer’s & Dementia, 2023,19(S19). The publisher for Alzheimer’s & Dementia is Wiley.

A free version of this journal article is available at https://doi.org/10.1002/alz.075077.

Our news editors report that more information may be obtained by contacting Dania Turner, Howard University, Washington, D.C., DC, United States. Additional authors for this research include Catherine L Auriemma, Jasmine Silvestri, Maayra Butt, Julia McMillan, Tamar Klaiman, Kristin Harkins, Jason Karlawish, Scott D Halpern.

(Our reports deliver fact-based news of research and discoveries from around the world.)