Utilizing Senior Companions to Enhance Dementia Care Services and Supports

Project Summary/Abstract Public health efforts to address Alzheimer's disease or related dementias (ADRD) are limited. The inability of formal healthcare systems to effectively identify ADRD and the lack of suitable care or case management often result in families remaining unaware of important community-based, long-term services and supports (LTSS) that could help to mitigate the negative effects of cognitive impairment. Approaches that: a) identify community-residing older persons with dementia; b) assist their families in navigating the healthcare system; and c) facilitate the identification of appropriate community-based LTSS could result in more effective management of ADRD. The proposed R61-R33 project will feature a collaboration between Lutheran Social Service of Minnesota (LSS-MN) and the University of Minnesota to evaluate a novel adaption of the Senior Companion Program (SCP), an initiative that matches lay/volunteer older adults with community-based clients in need (often of lower socioeconomic status) in order to provide respite and instrumental activity daily living support. This adaptation of the SCP (i.e., the SCP-Dementia/SCP-D) will assist families better manage ADRD, identify and facilitate use of community-based LTSS, and improve engagement with primary care providers. The aims of this project are as follows, identified by study Phase (R61/R33): R61 1): Implement SCP-D for 25 persons with ADRD or memory concerns in one urban and rural region of Minnesota; R61 2): Refine SCP-D delivery and implementation for efficacy evaluation; and R33 1) Evaluate the efficacy and implementation of SCP-D throughout Minnesota and randomly assign 250 persons with ADRD and/or memory concerns by region to one of 2 groups: one that receives the SCP-D over a 6-month period and a usual care control condition that receives standard SCP services. Six-month outcomes that we hypothesize the SCP-D will influence include: a) increases in caregiver self-efficacy and competence; b) improved interaction with the person with ADRD's primary care provider; c) decreases in caregiver distress; d) increases in the person with ADRD's quality of life; e) increases in LTSS service utilization; and f) overall cost-effectiveness from societal and health payer perspectives. The SCP-D offers a potentially efficient, wide-ranging service model for states and communities to implement. Moreover, enhancing interactions with healthcare providers and creating effective linkages to community-based LTSS addresses several goals of the National Plan to Address Alzheimer's Disease 2017 Update.