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Impact of a Comprehensive Dementia Care Pilot Program on Patient, Caregiver, and Health System Outcomes
Lozito, Shannon Cahill-Griffin, Teresa Palumbo, Mary Val
Lozito, Shannon
Cahill-Griffin, Teresa
Palumbo, Mary Val
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Abstract
Dementia is a major driver of caregiver burden, acute care utilization, and health care costs in the United States. Comprehensive dementia care models, such as the University of California, Los Angeles Alzheimer’s and Dementia Care (ADC) Program, have demonstrated benefits for patient-caregiver dyads and health systems. Vermont piloted this model within an academic medical center’s memory program. The purpose of this quality improvement (QI) project was to develop and implement an evidence-based protocol to evaluate the program’s return on investment (ROI) and impact on dyad health outcomes. A mixed-methods evaluation was conducted among dyads eligible for one-year evaluation between June and December 2025. Measures included patient behaviors, depression, acute care utilization, and advance care planning (ACP); caregiver depression, strain, burden, satisfaction, and self-efficacy; and ROI. Data were obtained through caregiver questionnaires and retrospective chart review. Analyses included descriptive statistics, pre–post comparisons, qualitative thematic analysis, and ROI calculation. Caregivers reported high satisfaction and moderate to high self-efficacy; however, pre–post analyses did not show improvement in clinical outcomes for patients or caregivers. Behavioral symptoms and caregiver depression increased significantly, while changes in patient depression, caregiver strain, and burden were not significant. ACP documentation improved, and inpatient days remained below national benchmarks. The pilot program achieved an ROI of 0.56, offsetting more than half of operational costs and aligning with expected early-phase implementation trajectories. The ADC pilot demonstrated meaningful perceived benefit, improved health system outcomes, and promising early financial performance. Findings highlight a discrepancy between perceived benefit and measurable symptom-based clinical outcomes, underscoring the importance of mixed-methods evaluation in dementia care. To strengthen clinical outcomes and long‑term sustainability, enhancements in caregiver support, follow‑up processes, and billing practices are recommended.
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2026-04-30
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Lozito_Final DNP Project Manuscript_2026.04.30.pdf
Adobe PDF, 3.83 MB
- Embargoed until 2028-04-30
Lozito_Final DNP Project Poster Presentation_2026.04.30.pdf
Adobe PDF, 797.22 KB
- Embargoed until 2028-04-30