Integrating palliative care for dementia into primary care

Greg A. Sachs, M.D., has received an award from the National Palliative Care Research Center to conduct a study aimed at improving quality of life and decreasing suffering for older adults and their family caregivers. The award is one of only two pilot project support grants funded by NPCRC in 2008.

Dr. Sachs will evaluate the feasibility of incorporating an outpatient palliative care program for patients with dementia into the primary care setting. Dr. Sachs's multidisciplinary team will build on a successful model that he previously developed for a geriatrics specialty clinic. That model, the Palliative Excellence in Alzheimer Care Efforts (PEACE) Program, provided improved symptom management, enhanced family support, and assistance with difficult decision making.

The Indiana version (IN-PEACE) will try to extend this approach into primary care practices where most older adults receive their health care.

"I'm most excited about working with other Indiana University clinicians and researchers who have used this collaborative care approach with primary care to improve the care of older adults with depression, dementia or frailty," said Dr. Sachs. "This will allow us to reach out into the community to help more patients and their families and to do so before they’ve experienced needless suffering."

This two-year pilot project has the potential to significantly improve care for community-based individuals with dementia, and to shape future program development and policy for older adults living at home, in assisted living environments, or in nursing homes.

A noted researcher in the fields of geriatrics and medical ethics, Dr. Sachs is an IU professor of medicine and the chief of the Division of General Internal Medicine and Geriatrics, a Regenstrief Institute, Inc. research scientist, and an IU Center for Aging Research center scientist.

"People with dementia are an especially challenging group of patients for most primary care practices," says Dr. Sachs. "Providing excellent care as the illness progresses really takes a team approach and coordination with community-based services and resources ranging all the way from homemakers to hospice. Most physicians do not have the training, time or staff to provide palliative care to this population.

Palliative care focuses on relieving suffering and supporting the best possible quality of life for individuals living with serious illness. Doctors, nurses, social workers and other specialists care for patients with chronic illnesses, functional impairment, and a high burden of family caregiving responsibilities. Palliative care is provided at the same time as all other appropriate medical treatments.

NPCRC promotes evidence-based palliative care research in order to improve the care of patients with serious illness, and their families.