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      The Role of Care Navigators Working with People with Dementia and their Caregivers

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          Abstract

          Background:

          Care navigation is an approach to personalized care management and care coordination that can help overcome barriers to care. Care navigation has not been extensively studied in dementia, where health care workforce innovations are needed as a result of increasing disease prevalence and resulting costs to the health care system.

          Objective:

          To identify facilitators and barriers to care navigation in dementia and to assess dementia caregiver satisfaction with care navigation.

          Methods:

          Methods include qualitative research (interviews, focus groups, observations) with “Care Team Navigators” (CTNs) who were part of a dementia care navigation program, the Care Ecosystem, and a quantitative survey with caregivers about their experiences with CTNs. Transcripts were analyzed to identify themes within the data.

          Results:

          CTNs identified the following facilitators to care navigation in dementia: working closely with caregivers; providing emotional support; tailoring education and resources; and coordinating with a clinical team around issues ranging from clinical questions to financial and legal decision-making. The barriers CTNS identified included burn-out, the progressive nature of the disease; coordinating with primary care providers; and identifying resources for dyads who are low-income, do not speak English, or live in rural areas. Caregivers across both sites highly rated CTNs, though satisfaction was higher among those in Nebraska and Iowa.

          Conclusions:

          Innovative approaches to care delivery in dementia are crucial. Care navigation offers a feasible model to train unlicensed people to deliver care as a way to deliver larger-scale support for the growing population of adults living with dementia and their caregivers.

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          Author and article information

          Journal
          9814863
          21942
          J Alzheimers Dis
          J. Alzheimers Dis.
          Journal of Alzheimer's disease : JAD
          1387-2877
          1875-8908
          6 January 2020
          2019
          06 February 2020
          : 71
          : 1
          : 45-55
          Affiliations
          [1 ]Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, 3333 California St., San Francisco, CA 94143
          [2 ]Global Brain Health Institute, University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158
          [3 ]Division of Geriatrics, University of California, San Francisco
          [4 ]Department of Neurology, Memory and Aging Center, University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158
          [5 ]Division of Geriatrics, Department of Internal Medicine, Home Instead Center for Successful Aging, 730 S 38th Ave., Omaha, NE 68105
          [6 ]Department of Medicine and Clinical Pharmacy, University of California, San Francisco, 3333 California St., San Francisco, CA 94143
          Author notes

          Author Contributions

          Study concept and design: AB, SD, JM, DD, SJB, BLM, KLP

          Acquisition of subjects and/or data: AB, SD, JM, WC, PO, JH, JC, AC, AB, TB, SJB, JF, KLP

          Analysis and interpretation of data: AB, KLH, JM, PO, DD, CR, KLP

          Preparation of manuscript: AB, KLH, SD, JM, DD, WC, PO, JEF, JH, JC, RW, KL, SJB, CR, KLP

          Sponsor’s Role: none

          Corresponding Author Alissa Bernstein, 3333 California Street Suite 265, Box 0936, San Francisco, CA 94118, (415) 279-7963, alissa.bernstein@ 123456ucsf.edu ,
          Alternate Corresponding Author katherine.possin@ 123456ucsf.edu
          Article
          PMC7004209 PMC7004209 7004209 nihpa1064097
          10.3233/JAD-180957
          7004209
          31322558
          767be38c-5baa-4869-aa04-a99ff8db6705
          History
          Categories
          Article

          dementia,health care workforce,care navigation,caregivers

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