Background and Objective
Hospitalized persons living with dementia are at risk for functional decline, behavioral symptoms of distress, and delirium, all persisting in the post-acute period. In turn, family care partners (FCPs) experience increased anxiety and lack of preparedness for caregiving, compounding existing strain and burden. Family-centered Function-focused Care (Fam-FFC) purposefully engages FCPs in assessment, decision-making, care delivery, and evaluation of function-focused care during and after hospitalization (within 48 hours of discharge, weekly telephone calls for a total of 7 additional weeks, then monthly for 4 months). The objective of this study was to test the efficacy of Fam-FFC.

Research Design and Methods
A cluster randomized controlled trial included 455 dyads of persons living with dementia and FCPs in six medical units in three hospitals. Patient outcomes included return to baseline physical function, behavioral symptoms of distress, depressive symptoms, and delirium severity. FCP measures included preparedness for caregiving, anxiety, strain, and burden.

Results
Multilevel level modeling demonstrated that the likelihood of returning to baseline function across time for Fam-FFC participants was twice that of the control group by the end of 6 months (OR = 2.4, p =0.01, 95% CI 1.2-4.7). Fam-FFC was also associated with fewer symptoms of distress (b = -1.1, SE = 0.56, p = 0.05) but no differences in the amount of moderate physical activity, depressive symptoms, and delirium severity. Preparedness for caregiving increased significantly only from 2 months to 6 months (b=0.89, SE=0.45, d=0.21, overall p =0.02) in the intervention group, with no group differences in anxiety, strain, and burden.

Discussion and Implications
Fam-FFC may help prevent some of the post-acute functional decline and behavioral symptoms in hospitalized persons living with dementia. Further research is needed to promote sustained improvements in these symptoms with more attention to the post-acute needs of the care partner.

Direct Link: https://doi.org/10.1093/geroni/igad083

Journal: Innovation in Aging. 2023 Aug 16:igad083

Keywords: acute care, ADRD, Dementia, functional recovery, older adults, Physical Activity, randomised controlled trial,

Applications: Physical Activity,

CamNtech Reference: M23052

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