PB #27 ... Articles About GEAR Program Now Available to Everyone ... 8/31/22

Readers familiar with this site will note that I have already posted several Personal Blog columns about the GEAR program … Blogs # 18, 24, and 26 … a federally funded program designed to improve care for people with Alzheimer’s disease (AD) and other forms of dementia in hospital Emergency Departments (EDs).  Published manuscripts about the research reviews conducted by the GEAR task force in four focus areas … communication, detection, best practices, and transitions … are now available to read.  These articles, as well as additional information about this project, may be accessed in the “Manuscripts and Publications” section of the main GEAR website at https://gearnetwork.org.

In the words of Dr. Chris Carpenter, one of the leaders of this project, “We would like to generate some media interest in this effort so that persons living with dementia and their care partners are aware of this work.  The more folks know the more they can pressure their Congressional leaders to ensure funding for this research. These citizens can also pressure their local emergency departments to begin adapting for more dementia-friendly care.”

If any reader has access to major mass media, it would be wonderful to alert such media to the availability of these manuscripts to generate more interest in improving emergency care for dementia patients and increase general awareness of what must be done.  Following are the verbatim “Conclusions and Implications” sections of the manuscripts dealing with our four areas of focus.  It is hoped that these articles will lead to future research to develop the most effective strategies in each area and eventually lead to substantial improvement in how dementia patients are treated in hospital EDs.

  

Communication … Conclusions and Implications

This scoping review identified sparse published research to guide evidence-based communication strategies in the ED for PLWD and their care partners. Although general themes appear to emerge around rushed communication and inadequate engagement of care partners, these findings are neither quantified nor directly linked to ineffective communication. Strategies to improve ED communication for PLWD do not exist, although educational interventions outside the ED suggest limited effectiveness. GEAR 2.0-ADC stakeholders prioritized the identification of barriers and facilitators to effective ED communication for PLWD.

 

Detection … Conclusion and Implications

We report the results of 2 systematic scoping reviews evaluating diagnostic accuracy and feasibility to detect cognitive impairment and dementia in the ED setting. The GEAR 2.0 Advancing Dementia Care task force, using these results, developed consensus research priorities practice gaps to advance the detection of cognitive impairment and dementia in the ED setting. They include the need for more effective and efficient approaches to recognize persons at risk for cognitive impairment and dementia. These approaches should balance the importance of equitable screening and the goal and the consequences identifying cognitive impairment. These research priorities will be the basis of future GEAR 2.0 research funding opportunities.

 

Best Practices … Conclusions and Implications

The results of this scoping review reveal a wide range of components of both ED care practices and ED care needs for PLWDs. Although many structural and process interventions show positive results, the lack of depth and reproducible results prevent specific recommendations on best practices in ED care for PLWDs. Future research should work to identify improvements in ED care for PLWDs, address gaps in training, identify priority outcomes, address community and identity-based factors, and incorporate economic viability and implementation science

Transitions … Conclusions and Implications

This systematic scoping review found few ED-to-community care transition interventions targeting cognitively impaired older adults and their care partners. Further, there was little data identifying care transition outcomes of importance to these groups. Personalizing care transitions for these ED patients and measuring what matters most during ED-to-community care transitions were identified as the highest priority areas for future ED research involving cognitively impaired older adults and their care partners. As such, research funding agencies, advocacy groups, and researchers should focus their resources and efforts on these domains, thereby developing the science to improve the health of this vulnerable population.

 

Once again, readers are urged to access https://gearnetwork.org to read the entire articles and learn more about this project.