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

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.

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.

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.

The ABC community program might be a scalable collaborative dementia care model targeting socially vulnerable people living with dementia.