237985 Ghosts of Home Care: Medicare's Neglect of Alzheimer's Disease Patients and Evidence-based Practice

Sunday, October 30, 2011

William Cabin, PhD, JD, MPH, MSW , Social Work and Gerontology Programs, Richard Stockton College, Pomona, NJ
Public health has devoted limited research and policy action to Alzheimer's disease (AD) (Satariano, 2006). The paper presents results of interviews of 72 home care social workers and nurses' (1) knowledge of evidence-based interventions for persons with Alzheimer's disease and their caregivers (Laura Gitlin & Mary Mittelman's interventions) and (2) strategies used to cope with organizational constraints on providing care for identified needs of these clients. The study results indicate: (1) Only 10% of social workers and 23% of nurses were aware of the interventions, none of which are Medicare-covered and (2) coping strategies were predominantly conformist (i.e., following corporate guideline), with less than 20% innovating or challenging the guidelines. The paper also presents a proposed policy change to create palliative care coverage for the AD population in the Medicare home health benefit.

Learning Areas:
Chronic disease management and prevention
Public health or related nursing
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
1. Explain coverage limitations for Alzheimer’s disease in Medicare home health. 2. Analyze knowledge of evidence-based home and community-based interventions for Alzheimer’s disease persons and their caregivers. 3. Explain the role of organizational constraints on delivering care.

Keywords: Dementia, Home Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I was a home care executive for 26 years and conducted the research being presented.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.