IDND Developed Clinical Tools

Anticholinergic Cognitive Burden Scale

 

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The ACB Scale was developed by the Aging Brain Program of the Indiana University Center for Aging Research. The scale identifies medications to avoid and also suggest safer alternatives.  It also identifies not only the prescription and over-the-counter medications themselves but classifies them by the severity of their anticholinergic effects on cognition.

To obtain a copy of the ACB scale please contact jim@preferredphm.com.

 

The Healthy Aging Brain Care Monitor

 

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Understanding primary care practices as complex adaptive systems enhances our capacity to implement  research findings and introduce locally acceptable and effective changes. Improving dementia care in this complex adaptive primary care system requires integrating three crucial steps in dementia care:

  • Finding patients with a high probability of having dementia (Screening)
  • Confirming the presence of dementia in these patients (Diagnosis)
  • Monitoring the response to dementia-specific pharmacological and non-pharmacological management plans (Management)

In hypertension care, the “blood pressure cuff” is one tool that is used to complete all three steps. Based on the “blood pressure cuff” concept, the HABC monitor was developed to function similarly in dementia care- one instrument capable of achieving all three processes of screening, diagnosis, and management.

The development of the HABC monitor was based on:

  1.  A review of the literature of previous self-report or caregiver-report based instruments to capture dementia symptoms
  2. The data collection used by the PREVENT study
  3. Our clinical experience in managing patients with cognitive deficits and dementia.

Its face validity was tested using the feedback of an interdisciplinary team of 22 representatives from three disciplines; clinical care, clinical research, and psychometrics, who were involved in dementia care and research.

The current HABC Monitor includes two versions: one for the patient and the caregiver.  The caregiver version of the monitor includes 32 items covering the four clinical relevant domains of dementia symptoms; cognition, functional deficit, behavioral/psychological, and caregiver burden. Each item has four categories of responses that use the frequency of the target problem in the past two weeks and has a similar anchor. The patient self-report version of the HABC monitor contains 30 items related to those on the caregiver version in addition to six demographic questions.

DO NOT reproduce without permission.

For more information or permission to use, please contact jim@preferredephm.com or visit the Healthy Aging Brain Center website to fill out the self-report monitor online.

 

The Healthy Aging Brain Center

 

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What is the Healthy Aging Brain Center?
In 2008, the research lab and the clinic became one entity as older adults with cognitive disorders and their caregivers began receiving care in the new Healthy Aging Brain Center at the IU Center for Senior Health at Wishard Health Services. The Healthy Aging Brain Center (HABC) was developed in collaboration between Indiana University Center for Aging Research, the Regenstrief Institute, Inc., the Indiana University School of Medicine Division of General Internal Medicine and Geriatrics, and the Wishard Health Care System. The HABC has adapted the content and delivery model of the PREVENT study. 
PREVENT is a medical home/collaborative dementia care model that implemented and delivered the national guidelines for diagnosing and managing Alzheimer’s disease and other related dementing disorders with an intergrated health care system that includes both memory care and primary care practices. PREVENT expanded the definition of the patient to include the informal caregiver and removed the walls of memory and primary care clinics by delivering the care in and outside the clinician-patient encounter and facilitating access to the local community resources. 
How does the HABC program work?
The Healthy Aging Brain Center, at Wishard Health Services offers a unique team approach of care by evaluating each patient thoroughly to uncover all possible causes of memory problems and provide a comprehensive management plan to help both the patient and caregiver.

The HABC program has two main phases: the initial assessment phase and the follow-up phase. During the initial assessment, the HABC team summarizes all relevant data and formulates an individualized treatment plan. Within 2-3 days following this initial assessment, the HABC medical assistant communicates the team’s plan of action to the patient’s primary care physician. Within the follow-up phase and using face-to-face, telephone, and/or email interactions with the patient-caregiver dyad, the HABC Dementia Care Coordinator and the HABC physician monitor and modify the implementation of the HABC individualized care plan.