VOICE: VITAL OUTCOMES INSPIRED BY CAREGIVER ENGAGEMENT
An evidence-based platform of training programs focused in key clinical areas to support, educate, and engage family caregivers and improve outcomes for consumers.
A competency-based training program for care teams, intended to support caregivers of people diagnosed with dementia.
A comprehensive approach to assess fall risk and provide caregivers with appropriate coaching and tools.
Dementia and Alzheimer’s Today
The rate of Alzheimer’s disease and other dementias in the U.S. is rising rapidly. In fact, many experts now refer to the conditions as a public health crisis. And unfortunately, the burden of dementia care often falls primarily on untrained family members.
$259 billion for dementia care in 2017 will rise to an estimated $1.1 trillion by 2050
16 million unpaid family caregivers
18 billion hours of care per year provided by caregivers
$230 billion estimated value in unpaid care
75% of caregivers report being frustrated and overwhelmed by dementia care
Despite their essential role, the vast majority of family caregivers do not receive any formal training. And very few of the training programs that are available are based on evidence or have documented results.
VOICE - Dementia Care Program
VOICE - Dementia Care is an evidence-based training program designed to improve knowledge, confidence, and self-efficacy of caregivers who provide care to those living with dementia. The goal is to improve outcomes and minimize negative events, such as hospitalizations, ER visits, injuries, and falls.
The caregiver training program consists of in-home sessions followed by ongoing consultation with the care team and support through Vela, Seniorlink’s care collaboration platform.
Content is divided into four modules:
Management of behavioral symptoms
While each case is unique, the VOICE - Dementia Care training sessions follow an established coaching framework that reinforces consistent messaging and structure.
Results of the VOICE - Dementia Care Pilot
The program began with a pilot that was carried out to determine the effectiveness of the interventions. The results of this pilot guided the creation of the broader VOICE - Dementia Care program.
Pilot results for family caregivers:
Additional focus on dementia care was impactful in reducing caregiver burden.
Increased confidence in their ability to manage loved one’s dementia symptoms.
Pilot results for consumers with dementia:
47% decrease in incident events (falls, emergency department visits and hospitalizations) during and after training.
71% decrease in hospitalizations and a 50% reduction in emergency department visits in the 6 months after the program, compared to the 6 months before the program.
The VOICE – Dementia Care program profoundly impacts the ability of caregivers to manage care for a loved one with dementia. The improved capacity and capability in turn impacts both costs and quality of care. By reducing adverse events and hospitalizations, populations using VOICE observed reductions in overall costs of care for years following the initial intervention. Meanwhile, as caregivers experienced increased confidence and lower levels of stress related to their caregiving duties, they were able to provide care for longer periods of time and make less use of respite care services.
The Impact of Falls Today
Falls are the leading cause of fatal and non-fatal injuries for older Americans. Millions of people over the age of 65 are treated for falls-related injuries. (1) Falls threaten seniors’ safety and independence and lead to significant economic and personal costs.
Every 11 seconds an older adult is treated in the emergency room for a fall in the U.S. (1)
Every 19 minutes an older adult dies from a fall (1)
$31 billion in costs to Medicare alone in 2015 (1)
Top 20 most costly conditions (2,3)
$67 billion expected cost by the year 2020 as the population ages (4)
Despite the prevalence and danger of falls, many family caregivers are not trained or prepared to manage the fall risks inherent in the home setting.
Voice – Falls Prevention Program
VOICE – Falls Prevention is a comprehensive assessment of fall risk and a personalized training program in fall prevention to provide caregivers with safety coaching and tools, with the goal of reducing the rate of falls.
This program follows an established framework with several steps of evaluation, training, and support.
The proprietary Falls Quick Screen (FQS) helps evaluate all consumers for fall risk by assessing fall history, gait, balance, and other factors.
The FQS assigns each consumer to a risk category that predicts both risk of falling and risk of injurious fall, enabling varying levels of intervention with caregivers.
The existing care plan is reassessed and revised, including additional coaching, referral to external skilled services like physical therapy, collaboration with pharmacists to review and revise medication plans, and more.
All actions are recipient-centered, dynamic, and sensitive to changes in health status. Ongoing, daily interactions between caregivers and care teams are conducted via Seniorlink’s care collaboration platform, Vela, which provides insight into changes in status within the home.
Results of the VOICE – Falls Prevention Pilot
The VOICE – Falls Prevention program began as a pilot created to manage the rate of falls within Seniorlink’s Caregiver Homes program. Historically, about 25-30% of medical incidents for consumers receiving support from Caregiver Homes have been falls. Nearly one-third of all reported falls resulted in some level of injury, half of which resulted in an emergency room visit or hospitalization.
During the pilot, over 39% of assessed consumers were identified as being both at high risk of falling and at high risk of injurious falls. Any fall that occurred was considered an event, no matter the injury status, and was verified by nurses or care managers.
Results for family caregivers and consumers:
Caregivers were more aware of potential triggers for falls.
50% reduction in falls rate, from a peak of 1.46 falls per 1000/days in 2013 to 0.73 by the end of 2016 (this compares with a range of 1.3 to 8.9 in skilled nursing facilities and hospitals).
Despite the growth of the overall consumer population during the pilot period, the addition of new team members and rapid program growth, the pilot was still a success.
Results for care teams:
Caregiver Homes’ field teams (RNs and CMs) had better insight on which consumers in their caseload required more coaching on falls management and prevention.
Field teams were better equipped with strategies and education to help prevent future falls.
The ability to obtain daily insights from caregivers helped care teams reinforce key learnings on fall management.
With the VOICE – Falls Prevention program, care teams and caregivers work together to actively adapt care plans to the consumer. This can significantly impact the most common cause of injury among older adults, thereby creating aggregate savings at scale through reduced use of expensive care in emergency rooms and hospitals. Plus, reducing falls can also help caregivers avoid the stress and burden that comes from more intensive caregiving duties during recovery from injury.
LEARN MORE ABOUT LEVERAGING TECHNOLOGY TO ENGAGE FAMILY CAREGIVERS AND IMPROVE OUTCOMES
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based injury statistics query and reporting system (WISQARS) [online]. https://www.cdc.gov/injury/wisqars. Accessed March 2017.
Burns ER, Stevens JA, Lee RL. The direct costs of fatal and non-fatal falls among older adults – United States. J SafetyRes. 2016;58.
Carroll NV, Slatum PW, Cos FM. The cost of falls among the community-dwelling elderly. J Manag Care Pharm. 2005;11(4):307-316.