Prof. Ab Brody receives $3.8 million from National Institute of Aging to study dementia and home healthcare

Abraham (Ab) Brody, PhD, RN, FAAN, associate professor and associate director at the Hartford Institute for Geriatric Nursing at NYU Rory Meyers College of Nursing, has received a $3.8 million grant from the National Institute of Aging, part of the National Institutes of Health.

The five-year project (R01AG056610-01), which started in August 2017, will examine an evidence-based intervention developed by Brody’s team for home healthcare clinicians to improve the quality of life and reduce unnecessary healthcare utilization for people living with dementia and their caregivers.

As the population ages, the rate of dementia, including Alzheimer’s disease, is expected to triple. Many people with dementia are cared for through home healthcare, but few agencies or home health clinicians are appropriately prepared to provide palliative, symptom-based, patient and family-centered care for this vulnerable population.

“Most home healthcare clinicians are inadequately trained to care for persons living with dementia, are frustrated by their lack of training, and have difficulty assisting patients and caregivers in maintaining quality of life. This leads to adverse patient outcomes, increased caregiver stress and burnout, worse caregiver health, and unnecessary healthcare utilization,” said Brody. “The most concerning areas in need of improvement are in managing pain and behavioral and psychological disturbances in the people living with dementia, as these can have significant effects on both the person living with dementia and their caregiver.”

To address these issues, Brody created the Dementia Symptom Management at Home Program (DSM-H), an interprofessional, evidence-based intervention developed specifically for home healthcare agencies and clinicians, including registered nurses, occupational therapists, and physical therapists. It includes clinician training, mentorship and evidence-based assessment instruments, care plans, and caregiver education materials.

The DSM-H has shown strong preliminary results; the NIA-funded study will expand on earlier research with a multi-site efficacy trial. The DSM-H will be randomly implemented in care teams at three diverse home healthcare agencies located in different regions of the United States.

The study will include more than 300 pairs of people living with dementia and their caregivers. The researchers will measure the effects of the DSM-H on quality of life and symptom severity in the people with dementia; assess the effects of the DSM-H on quality of life, physical and mental health among caregivers of people living with dementia; and measure whether the DSM-H can reduce unnecessary healthcare utilization, including emergency room visits, among people living with dementia.