By Laurel White
As shortages in home health care workers continue across the country, a UW–Madison School of Education assistant professor is working to help family and other non-professional care partners safely and successfully care for people living with dementia at home.
According to the Alzheimer’s Association, the number of Americans living with dementia is expected to triple by 2050. At the same time, a shortage of medical professionals who can provide specialized care at home isn’t expected to improve.
In response, Beth Fields, an assistant professor in the School of Education’s Department of Kinesiology, is developing a screening tool that will help care partners of people living with dementia let hospital staff know what support and training they need to succeed before their loved one is discharged from the hospital.
Fields says there are no guidelines in place right now to help hospital staff understand what care partners know and don’t know about tasks like giving injections and safely transferring someone from a bed to a wheelchair.
“Care partners’ needs might be getting met if they get a home health consult, but that doesn’t always happen,” Fields says. “There’s just no guarantee right now.”
Fields’ solution is a quick, simple screening tool that care partners complete while their loved one is still being cared for in a hospital setting. The Care Partner Hospital Assessment Tool (CHAT) asks questions like: “Do you need information or training on the patient’s medications?” and “Do you need information or training on how to help the patient with personal care, such as dressing, bathing, or feeding?”
With the answers in hand, CHAT helps hospital staff provide training and make necessary referrals to specialists.
Fields published a paper on the initial development and validity of CHAT in the journal Nursing Reports in 2021. Follow-up papers in the International Journal of Environmental Research and Public Health and Innovation in Aging outlined the tool’s feasibility and appropriateness, as well as its acceptability among care partners of hospitalized older adults. And, last year, Fields received a career development award from the National Institutes of Health’s National Institute on Aging (NIA) to tailor the tool specifically to the needs of care partners for people living with dementia.
The NIA funding will support five years of additional work on CHAT, which will include collaboration with clinical staff at UW Health. Fields’ primary mentors on the project include Manish Shah, chair of the BerbeeWalsh Department of Emergency Medicine at the School of Medicine and Public Health and co-lead of the care research core at the Wisconsin Alzheimer’s Disease Research Center, and Dorothy Farrar-Edwards, professor in the Department of Kinesiology and faculty director of the UW Collaborative Center for Health Equity.
Fields says she doesn’t take UW Health’s crucial collaboration on the effort for granted.
“UW Health has been an incredible partner,” she says.
Fields and her team will work with people living with dementia, their care partners, and clinical staff as co-designers on the new version of CHAT. She says working with the tool’s prospective end users from the outset of the design process is very exciting.
Fields says she hopes to implement and conduct a randomized controlled trial of the new, dementia care-focused version of CHAT next year, aiming to get data on whether the tool improves caregiving preparedness and patient and family satisfaction of hospital care. If that data is promising, further study could be on the horizon. Ultimately, Fields would love to see an evidence-based version of the tool in use at hospitals across the country, bringing support and assurance to hundreds of thousands of care partners — and those they love.
Fields’ team is currently recruiting for virtual co-design sessions. If you provide support to a person living with dementia, or work in the hospital setting and are interested in participating, contact the team at ghsrl@education.wisc.edu or 608-263-7295.