Cost-Effective Model For Alzheimer’s Care
As states eye strategies to control the costs of caring for Alzheimer’s disease patients, a New York model is drawing interest, and findings from a study of Minnesota’s effort to replicate it shows it could lead to significant savings and improved services.
The New York University Caregiver Intervention (NYUCI) program offers caregivers six sessions of individual and family counseling within four months of enrollment, the opportunity to participate in a weekly support group and telephone counseling when needed. Minnesota mimicked that effort with a five-year pilot program offered to 228 participating caregivers in urban and rural areas.
The study, published in the April Health Affairs, found the Minnesota program could save $966 million by 2025 if it were implemented state-wide. Cost savings were mainly achieved by keeping Alzheimer’s patients in the community and at home. The authors found that 5 percent more people would stay in these settings if the project was expanded, and 19.3 percent fewer people with dementia would die in an institution.
“These findings suggest that broader access to enhanced caregiver supports could produce a positive return on investment or be cost-effective—assuming widespread implementation, reasonable program costs and substantial caregiver participation,” study authors write.
Mary Mittelman, a research professor in the Department of Psychiatry at the NYU School of Medicine, said at a briefing Wednesday on the study that NYUCI reduced caregiver depression and postponed nursing home placement for a year and a half. Although the Minnesota pilot demonstrated savings, it was costly to train counselors, she said, but added that program architects are planning to use web-based training format going forward.
Gail Hunt, president and CEO of the National Alliance for Caregiving, suggested at the briefing that such a model should look at using workers without degrees, who are recruited for humanistic qualities and can act as a patient and caregiver supporter.
“The role is to deal with the family, part of it is listening and being an ombudsman, they’re a navigator, and can use medical records to enter assessments,” she said, adding that the person could be an immediate contact during off-hours when the family has to make a decision about going to the emergency room or a doctor’s office.