Integrated memory care clinic: Primary care for people living with dementia

Abstract

AbstractBackgroundThe Integrated Memory Clinic (IMCC) serves individuals with a dementia diagnosis, such as Alzheimer’s disease or a related disorder, and their care partners who reside in a community setting. The IMCC is America’s first and only comprehensive primary and dementia care practice. The IMCC addresses a primary concern for nearly 6 million Americans living with dementia: How to identify a primary care practice that is knowledgeable about, and sensitive to, the complex medical and social issues associated with a dementia diagnosis and also that can manage the co‐morbidities common in aging. The model takes a primary palliative care perspective, emphasizing aggressive symptom management, advance care planning, and holistic care that focuses on improving the quality of life for the person living with dementia and their care partner. The IMCC’s patient‐centered approach allows patients to receive a broad array of health care services in a single visit from an interdisciplinary team. The IMCC team supports families living with dementia by focusing on the care recipient and care partner well‐being and quality of life, by processes designed to avoid inappropriate acute and emergency care utilization, and through stage‐based support and psychoeducational programs. The IMCC launched a Patient Family Advisory Council simultaneously with enrolling its first patient. The Council meets monthly to review and advise health care providers about clinic operations, communications, billing practices, and sustainability. Currently, four nurse practitioners deliver care to approximately 550 patients. The average age of the patient population is 78 years; 65% of patients are female; 42% of patients are non‐white. The ambulatory care sensitive admission rate ranges from 1.56% to 2.87% for the past 12 months. Performance in hypertension and diabetes management outperforms health system benchmark goals for primary care practices. The IMCC nurse practitioners’ overall patient experience scores are at 97th percentile, representing a meaningful and positive caregiver experience. The IMCC has earned national recognition as a patient‐centered medical home from the National Commission on Quality Assurance. The IMCC represents a novel model of care for people living with dementia and their caregivers and may be a more sustainable model for this growing vulnerable population.