A home assistance model for dementia: outcome in patients with mild-to-moderate Alzheimer's disease after three months

• Main Authors: Gabriele Carbone, Francesca Barreca, Giovanni Mancini, Giovanni Pauletti, Veronica Salvi, Nicola Vanacore, Carla Salvitti, Fiorella Ubaldi, Luigi Sinibaldi
• Format: Article
• Language: English
• Published: Istituto Superiore di Sanità 2013-03-01
• Series: Annali dell'Istituto Superiore di Sanità
• Subjects: Alzheimer's disease; home assistance; non-pharmacological approach; outcome research; rehabilitation
• Online Access: http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0021-25712013000100007&lng=en&tlng=en

The treatment of dementias, which are currently incurable pathologies, requires an approach to care that involves both the patients and their families. The effect of alternative interventions, besides the pharmacological approach, therefore warrants evaluation. In this paper, we describe one such intervention, which was provided by our home care team for Alzheimer's Disease. Patients were granted a three-month period of home care assistance, which included physical and cognitive rehabilitation as well as interventions on the home environment and the family, such as psychological support for the main caregivers. The assistance was provided in thrice-weekly sessions, each lasting six hours. Twenty-two patients (age 78.4±6.5 yrs), all of whom had received a diagnosis of probable AD, were enrolled. There was a statistically significant improvement in the NPI score (p = 0.004), Barthel index (p = 0.01), Tinetti's scale (p = 0.013) and CBI score (p = 0.016) at the end of the 3-month treatment period. The patients' caregivers also reported a significant improvement in the physical and social burden at the CBI at the end of the period of home care assistance (p = 0.026 and p = 0.006). In a further evaluation performed 3 months after the end of the treatment period, the beneficial effect previously observed in both patients and caregivers was no longer present.