Research Executive Summary
New Quality of Life Measures to Improve Dementia Care in Nursing Homes
The goal of this project, funded by the national Alzheimer’s Association, is to provide participating nursing homes with access to dementia-specific quality measures and benchmarks which can highlight for nursing home staff a problem otherwise masked in the aggregate facility QM/QI rates provided by CMS. Early identification of these problem areas will lead to better assessment and management of adverse outcomes and improved quality of life for dementia residents.
For example, our research shows that dementia residents are 4-5 times more likely to experience behavioral symptoms, depression, and mobility decline, and are 2.5 times less likely to have diagnosed and reported pain even though they have the same prevalence of pain-related conditions as cognitively intact residents. One of the new measures is specifically designed to identify probable undetected pain in dementia residents and identify resident-specific risk factors for pain. Untreated pain can result in serious quality of life issues common to this population that require increased staff resources, such as excessive behavior symptoms, depression, and faster than expected functional decline.
To meet our research goal, we will:
- Provide 100 nursing homes with ongoing access to dementia-specific quality of life measures and benchmarks via a web-based application, EQUIP for Quality®. These quality of life measures will include risk adjusted measures for undetected pain, functional decline, worsening urinary incontinence, and prevalence of depression.
- Provide patient-centered risk profiles for the new dementia-specific quality of life outcomes to support and improve clinical decision-making and guide effective care plan interventions to prevent the adverse outcomes.
- Compare changes in rates of adverse outcomes in participating nursing homes to a matched control group to evaluate whether access to targeted quality of life data/measures results in quality of life improvements.
- Disseminate information on programs/interventions identified through new measures as resulting in superior outcomes in residents with Alzheimer’s disease/dementia.