In-home Caregiving Extends Patient's Life

By Jane Farrell

An in-home program that provided elderly people with counseling and resources increased the time they lived successfully at home, even with dementia and other memory disorders.

Most of the participants in the study said they preferred to stay at home.

The pilot program, conducted by researchers from the Johns Hopkins School of Medicine, focused on elderly Baltimore residents over a period of 18 months.

"The project demonstrated that we were able to help such people age in place without sacrificing their quality of life," says study leader Quincy Miles Samus, Ph.D., an assistant professor of psychiatry and behavioral sciences.

The trial, Maximizing Independence (MIND) at Home, studied 303 people 70 years and older with memory disorders, primarily dementia and mild cognitive impairment. One hundred and ten of them received an in-home visit from a memory care coordinator and nurse who assessed the participants’ needs, including diagnosis of memory problems, review of medications, behavior problems, daily activities, and untreated medical problems such as hearing or vision problems, high blood diabetes. The care team then developed a personalized care plan and worked with the participant’s family.

In a report published in The American Journal of Geriatric Psychiatry, the Johns Hopkins investigators say that those who got 18 months of care coordination with home visits were able to safely stay in their homes a median of 288 extra days, or around 9.5 months, over a median follow-up period of about 2 years. "This can make a huge difference in terms of comfort, money and quality of life for those involved," says Samus.

Patients who met  regularly with care coordinators were less likely to leave their homes or die than were those in the control group (30 percent versus 45.6 percent). They also had improved quality of life.

Insurance does not always cover non-medical needs and coordinator services, andSamus says her team's research was designed to begin answering the question of whether care models like MIND can demonstrate the financial savings and value in hopes that more health-care insurers might cover the cost programs like this in the future.