Implementation of a Primary Care Toolkit to Improve Dementia Diagnosis and Management in a Rural Setting

• Main Author: George-Wieland, Meredith
• Format: Text
• Language: unknown
• Published: ScholarWorks at UMass Boston 2022
• Subjects: dementia; early diagnosis; memory impairments; cognitive impairments; rural health; rural health dementia care; dementia care; remote healthcare; dementia toolkit; primary care toolkit; Family Practice Nursing; Geriatric Nursing; Psychiatric and Mental Health Nursing; Kodiak; Alaska
• Online Access: https://scholarworks.umb.edu/nursing_dnp_capstone/22; https://scholarworks.umb.edu/cgi/viewcontent.cgi?article=1022&context=nursing_dnp_capstone

BACKGROUND: There are six million people with dementia living in the United States and this number is expected to rise exponentially due to the aging population. In the United States, it is estimated that only two thirds of dementia cases are recorded during primary care visits and an estimated, one third of cases have been either missed or disregarded. LOCAL PROBLEM: In a remote primary care clinic on Kodiak Island, off the southeastern coast of Alaska, there is a lack of dementia and related cognitive diagnoses in the primary care setting due to patients’ and families lack access to the healthcare system and information related to the disease process. Primary care clinicians, healthcare entities, caregivers and patients are presented with unique challenges due to geographical location. In this setting, as with many other rural settings across the country, there are significant numbers of delayed or under detected diagnosis of dementias and cognitive concerns due to lack of resources and provider confidence in managing dementia centered care. PURPOSE: The purpose of this project is to help community entities, patients and caregivers, and providers within this community become more familiar with early diagnosis and treatment of dementias/cognitive concerns to improve quality of life for patients and caregivers. METHODS: The Chronic Care Model was used to guide this quality improvement project which implemented an abbreviated locally tailored KAER Model Toolkit. The Toolkit was designed to aid in the early diagnosis and management of cognitive concerns/dementias in a primary care setting. The PDSA cycle was used to guide the development, implementation, and evaluation of the project. INTERVENTIONS: After feedback from local entities, a locally-tailored toolkit included the locally tailored KAER Model as well as resources within the KAER Model, which was discussed with local healthcare entities, patients and caregivers to assess for cultural appropriateness and feasibility in a rural island community setting. ...