Geriatric models of care for neurodegenerative disorders.

New models of care seek to reorganize healthcare to meet the challenges of a growing number of persons with chronic conditions, to optimize the use of the available workforce, and to improve the quality of care. Increasingly, these models also seek to organize care in a manner that addresses cost and efficiency in addition to quality of care. This chapter first revisits the history of chronic care models and then provides a description of successful and sustainable examples of integrated, multidisciplinary approaches for persons with dementia, persons with Parkinson's disease, and the frail elderly.

House calls for seniors: building and sustaining a model of care for homebound seniors.

Homebound seniors suffer from high levels of functional impairment and are high-cost users of acute medical services. This article describes a 7-year experience in building and sustaining a physician home visit program. The House Calls for Seniors program was established in 1999.

Effectiveness of collaborative care for older adults with Alzheimer disease in primary care: a randomized controlled trial.

Context: Most older adults with dementia will be cared for by primary care physicians, but the primary care practice environment presents important challenges to providing quality care.

Objective: To test the effectiveness of a collaborative care model to improve the quality of care for patients with Alzheimer disease.

Design, Setting, And Patients: Controlled clinical trial of 153 older adults with Alzheimer disease and their caregivers who were randomized by physician to receive collaborative care management (n = 84) or augmented usual care (n = 69) at primary care practices within 2 US university-affiliated health care systems from January 2002 through August 2004.

Implementing a screening and diagnosis program for dementia in primary care.

Background: Primary care physicians are positioned to provide early recognition and treatment of dementia. We evaluated the feasibility and utility of a comprehensive screening and diagnosis program for dementia in primary care.

Methods: We screened individuals aged 65 and older attending 7 urban and racially diverse primary care practices in Indianapolis.

The effectiveness of depression care management on diabetes-related outcomes in older patients.

Background: Depression frequently occurs in combination with diabetes mellitus, adversely affecting the course of illness.

Objective: To determine whether enhancing care for depression improves affective and diabetic outcomes in older adults with diabetes and depression.

Design: Preplanned subgroup analysis of the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) randomized, controlled trial.