PRIOR MIND AT HOME RESEARCH PROJECTS


MIND at Home Phase I was a cross-sectional, community-based study (Johnston et al., 2011).  The study’s purpose was to determine whether a brief cognitive telephone screening method could efficiently identify individuals in the community in need of dementia care.  Additionally, this study was designed to develop a multi-dimensional needs assessment tool to detect the types of unmet dementia-related needs that exist for those with dementia and their family caregivers.  Study recruitment relied on letters sent and phone calls made to participants in an earlier demographic study entitled “Aging in Place in the Baltimore Jewish Community” and background promotions of the study through local newspapers.  A total of 292 individuals age 70 and older in Baltimore, MD were evaluated.  A subsample of 43 participants received a comprehensive in-home assessment for dementia and dementia-related needs using the Johns Hopkins Dementia Care Needs Assessment (JHDCNA) tool.

This study highlighted the challenges of community-based recruitment for dementia research.  While the telephone screening process was time consuming for the research staff, the majority (79%) of those who screened positive for cognitive impairment were determined to have either mild cognitive impairment (MCI) or dementia based on a subsequent in-home evaluation.

Virtually all participants with dementia who received an in-home assessment had at least one unmet need.  The most common unmet needs were for a dementia work-up, general medical care, environmental safety issues, assistance with activities of daily living impairments, and access to meaningful activities.  The most common unmet needs for caregivers were for caregiver education about dementia, knowledge of community resources, and caregiver mental health care.

This study demonstrated that effective and efficient means for identifying community-residing persons with dementia are needed so that dementia care interventions can be provided to address unmet needs of patients and their caregivers.

Figure 2 Distribution of JHDCNA domains by diagnostic status and unmet needs from Johnston et al 2010