Designing an Integrated Model of Dementia Care

The Comprehensive Memory Center seeks to improve patient outcomes through interprofessional collaboration

An article authored by researchers affiliated with the Mulva Clinic for the Neurosciences outlines the interprofessional model of dementia care offered at UT Health Austin’s Comprehensive Memory Center (CMC). Published earlier this year in the Journal of Interprofessional Care, the report describes the center’s design and benefits associated with the model.

According to neuropsychologist Robin Hilsabeck, PhD, Director of the Comprehensive Memory Center, this research is part of the center’s efforts to understand the value of a collaborative approach in treating conditions such as Alzheimer’s disease and mild cognitive impairment. “There currently aren’t very many interprofessional care teams working in the dementia space,” says Dr. Hilsabeck. “We hope to determine how a wrap-around, full services approach may affect outcomes and quality of life.”

Teamwork in the clinic

The CMC is comprised of an interprofessional care team that includes neurologists, neuropsychologists, a geriatric psychiatrist, a physician assistant, clinical social workers, a speech-language pathologist, and more. Practitioners from multiple specialties may be present at a single appointment, reducing the time patients and caregivers must devote to clinic visits and allowing them to access multiple services and/or clinicians in one location.

Diagnostic procedures are also performed at this site, after which the entire interprofessional team convenes to decide the best course of action. “We have a consensus diagnosis meeting where we discuss every new case and what the diagnosis and care plan will be,” says Dr. Hilsabeck.

Clinicians continue to operate as a team in implementing this care plan, which can include the patient’s medical treatments as well as support services for both patients and caregivers. The CMC research coordinator informs patients of their eligibility for ongoing clinical research at this time. The center also maintains relationships with other community organizations and resources so that patients can access the most appropriate resources for their individual condition.

The CMC approach was informed by previous research into dementia care models, conversations with experts across the country, and discussion groups featuring patients with Alzheimer’s Disease and related disorders and their caregivers. The center’s model was then continually refined based on patient feedback. For example, more written materials were created to help patients understand what to expect at various steps in the care process.

Promising early outcomes

CMC practitioners found that with their model, the average interval between a patient’s first appointment and their diagnosis was roughly two months. This marks a significant time advantage over a traditional clinical model, where this process can take over a year.

In addition to this quantitative data, patients and caregivers were surveyed about their experiences with the CMC. Respondents praised the clinicians as well as the clarity of the center’s communications.

Study authors cite the lengthy team appointments as a potential drawback of this strategy because they make the care model accessible to fewer patients. The researchers note that further investigation is needed to fully appreciate the benefits and limitations of the CMC’s interprofessional approach to dementia care.

Advancing memory care through research

The ability of CMC clinicians to design and evaluate their patient-centered care model illustrates an important strength of an academic medical system: the tireless pursuit of evidence-based strategies to improve patient outcomes.

This approach has garnered the center recognition at the state and national level. The Texas Health & Human Services Commission named the CMC an Innovator in Aging in 2018 for introducing patient-focused design to dementia care. In 2021, the CMC was designated as an Age-Friendly Health System-Committed to Care Excellence by the Institute for Healthcare Improvement for its efforts to strengthen elder care using the “4 Ms” – (What Matters, Medication, Mentation, and Mobility).

Dr. Hilsabeck notes that in addition to furthering the future standard of care, dementia research also benefits current patients. “As an academic medical practice, we are continuously trying to connect our patients with research opportunities, whether it’s a CMC study or one that a colleague is conducting across the state. If patients want to learn more about the latest in dementia research and how they can participate, they can come to us.”

A list of currently-enrolling Comprehensive Memory Center research studies is available on the center’s clinic page. Information about all research labs, publications, and ongoing clinical trials associated with the Mulva Clinic for the Neurosciences can be viewed on the clinic’s dedicated research page.

Courtesy or UT Health Austin blog, original article here