Prof. Tina Sadarangani receives two grants to support research on integrating care in adult day service centers with primary care

Tina Sadarangani, PhD, RN, ANP-C, GNP-BC, assistant professor at NYU Meyers, has been awarded two grants from the National Institute on Aging to study how to improve communication between adult day service centers (ADCs) and primary care providers caring for people with Alzheimer’s disease and other dementias. The goal is to reduce preventable emergency department use and hospitalizations.

ADCs provide health and social services for older adults living in the community—including many with dementia—and are staffed by interdisciplinary teams of nurses, social workers, and other health professionals. People with dementia living at home are susceptible to emergency department visits and hospitalizations, many of which may be avoidable.

ADC staff see their clients regularly and know them intimately. As a result, staff at ADCs can detect changes in older adults’ health status through daily assessment and observations. When staff notify primary care providers in a timely fashion, it can prevent minor health issues from escalating into medical emergencies. However, Sadarangani previously found that ADC staff rely on slow methods like faxes or voicemails to communicate abnormal blood pressures or acute changes in older adults’ behavior, resulting in delayed or no responses from primary care providers. Most ADCs lack the resources to implement electronic health records, and when they do they are rarely interoperable with primary care providers’ systems.

“As the number of people with Alzheimer’s disease and related dementias is expected to triple by 2050 and most remain in the community, there is a critical need to strengthen communication of clinical information between adult day service centers and primary care providers in order to reduce costly and avoidable healthcare utilization,” said Sadarangani.

To address these communication barriers, Sadarangani will capitalize on the ubiquity of mobile devices and tablets, and lay the groundwork for and develop a low-cost mobile health (mHealth) technology to improve communication between ADC staff and primary care providers. After gaining a deeper understanding of risk factors that increase hospitalization among people with dementia, and exploring the barriers and facilitators for communication between ADC staff and primary care providers, she will design an app-based intervention to bridge this communication gap.

Sadarangani received two grants to support this work: a two-year R21 grant (R21AG069801) from the National Institute on Aging totaling nearly $800,000, and a two-year, $200,000 Career Development Award from the National Institute on Aging IMPACT Collaboratory.

“This research aims to reduce fragmentation in healthcare delivery, support early clinical intervention, improve standards of care, thwart costly adverse outcomes, and expand support for people with Alzheimer’s disease and dementia and their families,” said Sadarangani.