Association of Participation in the Collaborative Care Team With Behavioral and Psychological Symptoms of Dementia and Caregiver Distress
Yu‐Hsuan Hung, Wen‐Fu Wang, Ming‐Che Chang, Yu‐Chun Tung, Kai‐Ming JhangABSTRACT
Introduction
The management of behavioral and psychological symptoms associated with dementia (BPSD) was challenging for the physicians and their caregivers, which placing a great burden on their caregivers, families, and communities. Our study aimed to explored the factors associated with changes in BPSD severity and caregiver distress.
Methods
This retrospective cohort study examined 738 community‐dwelling individuals who were newly diagnosed with dementia and had BPSD at baseline. Participants were categorized based on a case manager–centered collaborative model that evaluated unmet needs and offered appropriate interventions to patients and caregivers. A generalized linear model with backward selection identified factors linked to changes in total NPI and NPI Distress scores one year after diagnosis.
Results
Participants dismissed during follow‐up (compared with those with continuous follow‐up, β = 3.2, 95% CI = 0.83–5.5, p = 0.008) and participants cared for by a sole informal caregiver (compared with ADL‐independent participants whose caregivers only provide companionship, β = 3.9, 95% CI = 1.2–6.7, p = 0.006) were significantly associated with higher NPI total scores. Male sex ( β = –3.0, 95% CI = –4.9, –1.0, p = 0.003), and using assistive devices and home modifications ( β = –3.0, 95% CI = –6.0, –0.01, p = 0.05) were protective factors. Similar patterns emerged for caregiver distress, with follow‐up discontinuation ( β = 1.7, 95% CI = 0.18, 3.2, p = 0.029), using respite care ( β = 4.4, 95% CI = 0.00, 8.7, p = 0.05), and participants cared by a sole informal caregiver ( β = 2.7, 95% CI = 0.95, 4.4, p = 0.003) increasing distress.
Conclusions
The case manager–centered dementia collaborative care model was associated with reduced short‐term BPSD severity and caregiver distress, with sex, care mode, and social resource use as predictive factors. Integrating collaborative care models in long‐term care healthcare systems is recommended to better support dementia patients and caregivers.