Clinical Services

Panel Presentation

(CS4-01) Technology Interventions for Caregivers of Veterans: Design, Outcomes, and Lessons Learned

Sunday, April 23
3:00 PM - 4:00 PM
Location: W224 AB

Objectives
After attending this session, participants will be able to:
1) Describe different technology-enabled interventions that may help caregivers.
2) Describe how different technology-enabled interventions can be used to improve quality of life and outcomes of caregivers of older veterans.
3) Enumerate factors that impact acceptance and adoption of technologies in the home environment.
4) Reiterate potential logistical issues in the implementation and evaluation of technology based interventions for caregiving dyads.
5) Discuss lessons learned and the research, policy, and clinical implications of using technology-enabled interventions in caring for older adults.

Methods
The CCHT program for Dementia Caregivers was implemented in 2009 and available nationally to all Veterans Health Affairs facilities. The Dementia Disease Management Protocol or (DMP) is a set of algorithmic questions delivered to patients via Home Telehealth technology that assess the symptoms, educational needs and self-management status of the patients and caregivers. The Dementia DMP questions are sent to the caregivers daily and the questions elicit responses that enable the Care Coordinator to assess patients’ health status trends and triage any concerns regarding caregiver burden and depression. The patient responses to these questionnaires determine the type of care coordination interventions and education the patients and caregivers receive.

Results
We will assess the use of the CCHT Dementia DMP for the last 5 years in the Veterans Health Affairs using the national VA data, patterns and trends in use, and patient and caregiver outcomes, including caregiver burden, depression, and patient outcomes including ADL and IADL status. We will identify the challenges with the use of home telehealth technology in this group of caregivers and future directions.

Conclusion
The four presentations in this panel will highlight the interventions designs, challenges faces in implementing the caregiving interventions, focusing on the role of technology and its impact on improving patient and caregiver outcome. The symposium will conclude by synthesizing the lessons learned and discussing the research, policy, and clinical implications of the technology-enabled projects. The lessons learned can guide future studies.

Learning Objectives:

Stuti Dang

Physician
Miami VA Healthcare System

Dr. Dang is Physician, a Researcher, and the Assocoate Director for Implementation and Outcomes Research in the Miami VA Geriatrics Research Education and CLinical Ceneter (GRECC). She is also an Associate Professor of Clinical Medicine in the Division of Geriatrics and Palliative Medicine in the Miller School of Medicine’s Department of Medicine, at the University of Miami. Dr. Dang earned an M.B.B.S degree from the University of Delhi, India, completed her residency in Internal Medicine from Rochester, NY, and her fellowship in Geriatrics from Little Rock, AR. She also has an MPH degree from Tulane University. Dr. Dang is a geriatrician with an interest in models of care for patients with chronic diseases, specifically using telehealth and care coordination. She has been involved with telehealth since its inception in the VA. She has extensive experience in the design and implementation of telehealth programs for elderly patients with chronic diseases such as diabetes, heart failure, dementia, and hypertension. She has led and supported various grants to develop and study home telehealth, web, cellular phone, or patient health record based interventions for supporting patients and their caregivers. Her grants attempt to establish usability and utility of technology, and evaluate impact on care, efficacy, and disease specific outcomes.

Presentation(s):

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Constance Uphold

Associate Director for Implementation and Outcome Research in the Geriatric Research Education and Clinical Centers
North Florida/South Georgia Veterans Health System

Dr. Uphold is a Health Services Researcher and the Associate Director for Implementation and Outcome Research in the Geriatric Research Education and Clinical Centers at the Gainesville Veterans Administration Medical Center. Dr. Uphold has a broad background in health communications, family education, informatics, rehabilitation science, and implementation science methods and theories. She is a well-funded VA researcher who is committed to improving the quality of life of Veterans and their family caregivers. In addition, Dr. Uphold is an experienced family nurse practitioner and community health nurse.

Presentation(s):

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Patricia C. Griffiths

Health Research Scientist
Atlanta Department of Veterans Affairs Medical Center/GRECC/CVNR

Patricia Griffiths is a research scientist, life-span developmental psychologist and gerontologist. She holds joint appointments at GA Tech, Emory University School of Medicine and the Department of Veterans Affairs Rehabilitation Research and Development Center for Visual and Neurocognitive Rehabilitation (CVNR). She is Principal Investigator of the CVNR Veteran Caregiving Support Studies Research Group where the focus of the program is on translational and applied research dedicated to helping older adults and their caregivers age in place safely (or with choice). The mission of the group is to design, implement and evaluate multi-component, integrative medicine and technology based rehabilitative interventions to improve function and care for older adults while optimizing quality of life, dignity and respect for both members of the care-partner dyad.

Presentation(s):

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Randall Rupper

Associate Director, Clinical, Salt Lake VA GRECC
Salt Lake VA Geriatric Research Education and Clinical Center

Rand Rupper is a geriatric physician and health services researcher at the Salt Lake VAMC and an Associate Professor at the University of Utah. He has been a GRECC investigator since 2003. Dr. Rupper’s work focuses on improving care delivery and access for older, rural patients, and improving resources for their family caregivers. He has led large, randomized clinical trials that included providing cancer navigation services to Native American Populations across the Intermountain West, and providing telehealth based dementia care-management to caregivers of Veterans with dementia. Currently, he is working with the VA Offices of Rural HeaIth and Geriatrics and Extended Care to lead the national dissemination of COVER to COVER, a program that creates partnerships with community agencies to connect rural Veterans and their families to community and VA benefits and resources. Dr. Rupper was raised in rural Utah and attended college at Brigham Young University. He completed medical school at Stanford, and Internal Medicine Residency at the University of Washington. He was a Robert Wood Johnson Clinical Scholar at the University of North Carolina, where he earned an MPH. He completed Geriatric Fellowship at the University of Utah.

Presentation(s):

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(CS4-01) Technology Interventions for Caregivers of Veterans: Design, Outcomes, and Lessons Learned



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