Behavioral and psychological symptoms of dementia (BPSD) represent non-cognitive symptoms occurring in almost all people living with dementia. These symptoms are considered the most distressing, as they are associated with worsening cognition, increased risk for secondary complications such as falls and fractures, emergency room admissions, institutionalization, and increased cost of care. These symptoms also increase caregivers’ burden and depression, resulting in poor quality of life. In Ethiopia, patients with BPSD are treated at regular psychiatric clinics, primarily with medications, without accounting for the contribution of the caregivers to the management. Several studies have shown that medications are modestly effective in controlling the symptoms and are associated with serious side effects including increased mortality. Several approaches for non-pharmacological intervention, that involve caregivers, have been used in the treatment of BPSD which were found effective in improving quality of life of patients, decreasing emergency department visits and admission, decreasing caregiver depression, burden, and cost of care. Because the experience is unique for each patient, flexible strategies that can be customized and address the specific needs of the patients and caregivers are needed to ensure the best chance of successful management.
This project will test the utility of a supplemental care model focusing on a non-pharmacologic approach, for patients with BPSD who are getting treatment at psychiatry clinics in Addis Ababa, Ethiopia, that involves caregivers in the management. The management will be through care navigation, which is an approach to personalized care that is based on a care navigator working closely with a patient and caregiver to identify their specific problems, resources, and customized solutions, including patient and caregiver education. The care navigators will be nurses trained to provide psychosocial support, training and education for the patients and caregivers, and share information on resources available, guided by written care protocols. Treatment outcomes for the group receiving the supplemental care model will be compared with those receiving only the usual care. Demonstrating effectiveness of the model in improving treatment outcomes, will provide evidence that this type of approach can be effective in diverse populations and support expansion of this type of model in different hospitals in Ethiopia.