Day Center Participant and nursing student.
Background & Goals
As the population ages, the number of people diagnosed with Alzheimer’s disease and related dementias (ADRD) rises. The current healthcare system is not equipped to adequately meet the needs of an aging diverse population. In particular, Latino and Haitian communities are often unable to access dementia-specific care. Many dementia-specific programs in place fail to provide support for Latino and Haitian families, who provide the majority of the care.
A literature review shows depression, stress, low self-efficacy, and knowledge deficit about Behavioral and Psychological Symptoms of Dementia to be consequences from prolonged caregiving. The Louis and Anne Green Memory and Wellness Center (MWC) has successfully implemented a nurse-driven, innovative, dementia-specific model to improve health and health equity through community engagement. This model represents a significant step towards achieving health equity among Latinos and Haitians living with ADRD in the United States. Building, cultivating, and sustaining authentic relationships and engaging with individuals as well as their communities are cornerstones of the MWC’s innovative and transformative approach.
The MWC seeks to expand access to care that is grounded in caring and to transform the support available to community-resident older adults as well as their caregivers. Since its inception, the MWC has integrated home-based and in-clinic services to optimize care and developed dementia-specific supportive services for persons living with Intellectual and Developmental Disabilities and ADRD, specifically those with Down Syndrome.
The Louis and Anne Green Memory and Wellness Center (MWC) model embraces a transformative, holistic model of specialized dementia care and supportive services informed by nursing theories, perspectives, and caring science. Caring is a complex and multi-dimensional concept. The MWC model embodies an innovative way of caring science being translated into action. This nurse-led program addresses the complex needs of persons with or at risk for ADRD and their families, guided by what matters most to each person. This model is critical in advancing the health of persons living with ADRD as well as their family caregivers while improving health equity for the community and reducing costs of care.
The uniqueness of integrating mind, body, and spirit to deliver care that is individualized, convenient, cost-effective, and innovative is exemplified, practiced, and lived within this nurse-designed model. Specifics of this model include:
- Nurse-driven program focused on memory and wellness evaluations, accurate diagnosis, risk reduction identification and care planning, delaying cognitive decline, increasing quality of life, and providing continuity of care and support for the person with ADRD and the family caregiver. Care provided collaboratively is led by gerontological nurse practitioners working with an interprofessional clinical team of experts, including psychiatric-mental health nurse practitioners, psychiatrists, neuropsychologists, social workers, and staff, each trained specifically in caring science, geriatrics, and gerontology.
- Guided by a caring-based conceptual nursing perspective framework.
- Transformative delivery of care through a biopsychosocial, and diverse, inclusive lens.
- Scholarly, culturally and linguistically responsive, person-family-community-centered, interprofessional practice and education approach.
- Integration of student clinical experiences and faculty practice in effective delivery of dementia-specific health care, research, advocacy/policy, and community service.
Evidence of Success
The Caring Science Model of Specialized Dementia Care for Transforming Practice and Advancing Health Equity has been successful at increasing access to care among Latino and Haitian individuals with ADRD, and their caregivers, by:
- Using culturally-tailored interventions to reduce depression, anxiety, stress, and social isolation in older adults with ADRD;
- Transforming dementia care through embracing caring and technology during COVID-19 and beyond;
- Maintaining culturally appropriate services, technology, and supports for people living with dementia and caregivers during COVID-19;
- Partnering with faith-based communities to provide dementia-specific care and supportive services;
- Integrating Psychiatry and Mental Health Care within the caring-based model of dementia-specific care and supportive services, in-office, home-based, and virtually;
- Reducing perceived burden while increasing self-perceived competence among family caregivers to best fulfill their caregiver roles, while self-preserving and maintaining their best possible quality of life;
- Healthcare delivery model aligned with clinical outcomes of the MWC practice, where a healthy practice is achieved by integrating and aligning best practices including clinical, financial, and ethical protocols;
- Reduced healthcare costs for individuals and the healthcare system: unplanned hospitalizations, unnecessary re-admissions, and/or premature institutionalizations;
- Reduced overall burden of healthcare expenses of individuals and their families by allowing the caregiver to remain in the workforce longer through reducing stress, depression, anxiety, and other burdens and providing respite care, resources, services, and supports; and
- Increased quality of life experienced by individuals living with ADRD and their caregivers as well as satisfaction with caring-based programs and services.
The model has received more than $10 million in grant funding from state and federal agencies as well as private foundations and corporations. It has also received over $8 million in fee for services since 2014 to build, support, and expand the Louis and Anne Green Memory and Wellness Center Caring Science Model of Care. The model has been replicated by institutions and communities nationally and internationally. It also serves as an interprofessional clinical practicum site.