Effectiveness of thai integrated care program for older adults with dementia in the community: A quasi-experimental study

Abstract

As the number of older adults with dementia is growing worldwide, a variety of services are required to maintain their independent living in the community. The purpose of this quasi-experimental study was to examine the effectiveness of the Thai Integrated Care Program for Dementia. Two health promoting hospitals in the North East region of Thailand were purposively selected, and then randomly assigned into the experiment or comparison group. A total of 20 older adults with dementia from outpatients’ clinics in each hospital and their caregivers were recruited. The intervention group received a 3-month program in addition to usual care, but the comparison group received only usual care. Instruments used to collect the data were the Mini Mental State Examination-Thai version 2002, Basic Activities of Daily Living, Chula Activity of Daily Living Index, Quality of Life-Alzheimer’s Disease, Neuropsychiatric Inventory Questionnaire, and the Zarit Burden Interview. Data was analyzed with paired t-test and Wilcoxon signed rank test. Results revealed that at post-intervention the quality of life of those in the intervention group remained, but in the comparison group this was less than before the intervention. Caregiver burden from the intervention group was significantly lesser than before the intervention and the comparison group. However, there were no significant differences in cognitive and physical functions, and the behavioral and psychological symptoms of dementia between the two groups. We conclude that this program has good potential to maintain quality of life and reduce caregiver burden. Nurse administrators in Thailand need to develop a system to have a nurse case manager or an advanced practice nurse manage the integrative care collaboration with other health professionals to improve the outcomes of dementia management.