Alzheimer’s and dementia are complex health conditions, and new treatments and health care system barriers add to this complexity. Coordinated care for individuals living with Alzheimer’s is fragmented or absent in most settings, particularly in primary care.
To encourage and improve coordinated care, several dementia care navigation programs have been developed. These programs have shown to improve health outcomes, reduce emergency room visits, lower hospital readmissions, shorten hospital stays, and reduce delays in long-term care placement. In addition, effective care coordination has improved the quality of life for the person living with Alzheimer's or other dementia and their care partners.
Programs to improve patient care
Dementia care navigators play a central and critical role in these care coordination efforts. These navigators may sometimes provide clinical care, but they partner with patients to help them navigate the complex health care system and treatment landscape.
To encourage and implement more coordinated care models across the country for people living with Alzheimer’s and other dementia, the Alzheimer’s Association formed an expert workgroup of researchers to create a definition of consistent dementia care navigation and to identify evidence-based principles to provide framework and standards for dementia care navigation.
Published in Alzheimers & Dementia: Translational Research and Clinical Interventions (TRCI), the expert workgroup outlined seven essential principles for dementia care navigation, which emphasize person-centered care. According to the workgroup, dementia care navigation should:
- Be person- and family-centered to ensure collaboration and enhance engagement.
- Be culturally responsive and address disparities in access to health care and support services.
- Include well-defined roles and responsibilities for all members of the dementia care navigation team.
- Address barriers relating to medical, legal, financial,emotional and other domains facing the person living with dementia and their care partners.
- Provide coaching, education, and coordination in a manner that is empowering, solution-focused, and strengths-based.
- Focus on the family unit as defined by the person living with dementia.
- Ensure processes and protocols are evidence-based.
Dementia Care Navigation Roundtable
With this framework and standards in place, the Alzheimer’s Association is forming a Roundtable of health systems, payers and dementia experts to establish consistent processes and protocols for dementia care navigation.
The Dementia Care Navigation Roundtable will build off the established principles and gather more evidence to provide guidelines to align patient navigation programs. This workgroup will define the need for dementia care navigators and provide best practices for how to implement this framework in all care settings.
Participants and their evidence-based programs include:
David Bass, Ph.D.
Partners in Dementia Care; Benjamin Rose Care Consultation
Chris Callahan, M.D.
Collaborative Care for Older Adults in Primary Care
Sarah Dulaney, RN, MS, CNS
Leslie Evertson, DNP, RN
The Alzheimer’s and Dementia Care Program
Katherine Judge, Ph.D.
Partners in Dementia Care
Quincy Samus, Ph.D.
MIND at Home
For more information
To learn about participating in the Dementia Care Navigation Roundtable or the workgroup, as well as for more information about the Dementia Care Navigation Guidelines, please email firstname.lastname@example.org