Continuity of Care for Older Adults with ADRD Sample Clauses

Continuity of Care for Older Adults with ADRD. Health care for older adults with ADRD is often complicated by their co-occurring chronic conditions, preventing a better level of COC. Evidence suggests that there is a higher prevalence and a greater burden of comorbidities (such as diabetes or stroke) among older adults with ADRD than among those without these conditions.[28–30] The majority of older patients with ADRD receive health care for ADRD and their co-occurring conditions in the ambulatory setting, which is often fragmented.[16,31,32] An average Medicare beneficiary is estimated to see seven physicians in four different practices annually, and the communication among physicians and between patients and physicians is generally poor.[12–15] The presence of ADRD complicates the quality of health care they receive. In the moderate stage of ADRD, a patient can start having behavioral and personality change such as suspiciousness, agitation, and aggressive behaviors. Ultimately, older patients with severe stage of ADRD will have limited functional status and constantly present behavioral disturbance.[5] If the behavioral symptoms associated with ADRD are more dominant than their medical comorbidities, it has been shown to contribute to lower quality of care through detracting the clinicians/physicians from managing co-occurring conditions.[28] Although barriers exist to achieving a better level of COC among older patients with ADRD, previous research found a beneficial impact of COC on alleviating these barriers for higher quality of care in ADRD and other dementias through several mechanisms.[16] First, while the distrust between a patient with ADRD and their physician is one of the barriers towards achieving better quality of care, a patient’s trust in their physicians contributes to the effectiveness of medical care.[33] Xxxxxxx et al. (2001) conducted a cross-sectional survey of adult patients in outpatient primary care setting in the US and the UK.[33] They measured COC as the length of time for a patient’s relationship with their physicians and found that COC is associated with a higher level of trust between the patient and the physician.[33] Second, a collaborative and beneficial patient-provider relationship requires good communication, which serves as a key determinant for better quality of care.[34] Xxxx et al. (2014) found that reduced COC with a PCP can significantly decrease the quality of communication between patients and their physicians in the Veterans Administration (VA) outpatient...