Adapting the Connect-Home transitional care intervention for the unique needs of people with dementia and their caregivers: A feasibility study.
Mark Toles, Jennifer Leeman, M Heather McKay and 2 others
PMID 36274509WHAT IT FOUND
Adapted skilled nursing facility transitional care for people with dementia and caregivers was delivered with high fidelity and rated helpful.
Two of nineteen patients were readmitted within 30 days, but with no control group this cannot show it works.
Key findings
01Staff delivered most Connect-Home ADRD components: 18 of 19 dyads had a complete transition plan, 19 of 19 had a care plan meeting, and 19 of 19 had records transmitted.
02Caregivers who completed the acceptability survey rated the intervention very helpful (mean 1.3 of 3), not at all difficult to use (mean 1.0), and helpful for preparing them for care at home (mean 1.3).
03Two of 19 patients had hospital readmission within 30 days of nursing home discharge; no patient had emergency department use without hospitalization.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for RNs
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What it does not show
This was a single-arm pilot with no randomization or control group, so it cannot show whether the intervention caused the outcomes. The study was conducted during the COVID-19 pandemic, which reduced the eligible pool and limited in-person interactions. It was conducted in two not-for-profit skilled nursing facilities, so it may not apply to for-profit facilities. The sample was small at 19 dyads, most participants were white, and only English-speaking participants were included. Acceptability data were completed for 12 dyads, with 3 dyads missing because the patient died or was readmitted and 4 because the caregiver was unavailable. Only 4 patients answered the patient survey. The study was not powered to evaluate patient outcomes.
The easy way to misread this
Do not read two readmissions among 19 patients as proof the program prevents hospitalizations. This was a single-arm feasibility pilot with no control group, and the authors state the findings are descriptive and cannot demonstrate efficacy.