Effectiveness of a Telephonic Aging Brain Care Model for Medicaid Home and Community Services for Dementia Patients and Their Caregivers

Abstract

Objectives: The primary purpose of the present study was the implementation and evaluation of the ABC Community program, a community-based and telephonically administered version of the Aging Brain Care model delivered by Area Agencies on Aging (AAAs) staff. Design: This study employed a prospective pre-post implementation design with pre-specified effectiveness and fidelity goals, with the main outcome measure being the total score of the Health Aging Brain Care (HABC) Monitor at 3- and 6-month follow-up. The HABC Monitor has demonstrated excellent reliability and validity in monitoring and measuring the burden of dementia symptoms and the quality of life and stress of the informal caregivers. Results: The program served 422 Medicaid Home and Community-Based Services participants living with dementia and their caregivers. Participants' mean age was 78 years, with 67% identifying as female and 30% as belonging to minority groups, including 6% Hispanic or Latino and 28% Black or African American. In comparison to baseline, the total score of the HABC Monitor decreased from 24.6 to 15.4 at 6 months, representing a 37% reduction with an effect size of 0.64 standard deviation (p value < 0.001). Approximately 46% of informal caregivers who had at least mild burden at baseline had no such burden at 6 months, and 92% of those who had no stress at baseline remained burden-free at 6 months. Conclusion: The ABC community program might be a scalable collaborative dementia care model targeting socially vulnerable people living with dementia.