University of North Carolina, Chapel Hill
This study is a parallel arm, cluster randomized trial (CRT) to test the efficacy of Connect-Home ADRD, a transitional care intervention focusing on Skilled Nursing Facility (SNF) patients with Alzheimer's disease and dementias and their caregivers during transitions from SNFs to home, assisted, living, and long-term care. The primary hypothesis is that the intervention will reduce caregiver strain (Aim 1) and patient neuropsychiatric symptoms (Aim 2).
Connect-Home ADRD is a Donabedian-guided intervention that introduces new structure and processes to support Skilled Nursing Facility (SNF) staff delivery of transitional care for transitions to home, assisted living, or long-term care, and post-discharge transitional care by the Dementia Caregiving Specialist (DCS). The research objective is to test the efficacy of Connect-Home ADRD, a transitional care intervention, targeting Skilled Nursing Facility (SNF) patients with Alzheimer's disease and related dementias (ADRD) and their primary caregivers who discharge home and other settings of car…
Inclusion Criteria: Patients: * Ability to speak English * Goal of discharge to home, assisted living, or long-term care * Diagnosis of dementia * Having a caregiver willing to participate Caregivers: * Ability to speak English * Legally authorized representative (LAR) who also provides support for the person with ADRD Inclusion criteria for SNFs: * Location within 120 miles of UNC-Chapel Hill * Admission of at least 75 SNF patients per year Exclusion Criteria: Patients: * Planned hospital readmission for procedures or treatments within 30 days post enrollment. Caregivers: * LAR is…
Connect-Home ADRD will introduce new structure and processes to support SNF staff delivery of transitional care for transitions to home, assisted living, or long-term care, and post-discharge transitional care by the Dementia Caregiving Specialist.
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