CCAs can lower person-centered dementia care costs
Mary Guerriero Austrom, Ph.D.
Care coordinator assistants, or CCAs, can be a low-cost way to facilitate person-centered care for those with dementia and their caregivers, according to a new study from the Indiana University School of Medicine and the Regenstrief Institute, both in Indianapolis.
“With good management, supervision and support, CCAs can be effective primary care extenders, enabling many tasks important to providing best practice care for older adults to be ‘shifted' down,” said social psychologist and Alzheimer's disease educator Mary Guerriero Austrom, Ph.D., who led the study. “The key is screening to select the right people — people who are comfortable with older adults with cognitive issues — and then teaching and training them and giving them the resources and support they need to do the job.”
CCAs usually have two years of post-high school education, at most. After being screened, hired and trained, and working under the close supervision of nurses, social workers or other professionals, they can complete tasks focused on engagement of the person with dementia and on caregiver support, because such tasks require less training and expertise than that of nurses or social workers, according to the researchers.
“If something happens, the CCAs handle it or, when appropriate, bring it to the team's attention,” Austrom said. “This is a bare-bones model that others can adopt and replicate.”
During the study, CCAs working for Eskenazi Health's Aging Brain Care Medical Home mobile memory care clinic provided expertise on accessing Meals on Wheels, identifying transportation options and procuring durable medical equipment and other services. More than 1,200 people received an average of about 16 residence and phone visits from CCAs during the year.
In addition to extending the reach of the clinic, task-shifting to CCAs provided the medical team with a population health overview of all of the older adults with dementia and their caregivers in the study. The electronic tracking system in place at the ABC Medical Home supplied information on individuals with dementia whose conditions did not appear to be stable or on caregivers who were experiencing stress or depression. This insight allowed the medical team to provide care and gave the team a better perspective of which actions were effective across the entire population and which ones were not, according to the researchers.
The research was supported by the National Institutes of Health and the Centers for Medicare & Medicaid Services.