Identifying health priorities early helps persons living with dementia

As their disease progresses, persons living with dementia and multiple chronic conditions (MCC) increasingly rely on care partners to help them make health care decisions for themselves. A new pilot study published in the Journal of the American Geriatrics Society examined perspectives of persons living with dementia and their care partners as they completed a guided, health priorities identification process (HPIP). The HPIP is an evidence-based tool that can be used to support cognitively intact older adults with MCCs to identify and communicate their health priorities.

Led by Joan K. Monin, Ph.D., associate professor of public health (social & behavioral sciences, Yale School of Public Health), and Mary E. Tinetti, MD, Gladys Phillips Crofoot Professor of Medicine (Geriatrics), researchers found persons living with dementia and MCC enjoyed the HPIP and appreciated having their care partner present and actively listening. This approach was chosen to keep the voice of the person living with dementia centered while allowing the care partner to hear and understand their health priorities.

The study finds that making care partners aware of the health priorities of the persons living with dementia early in the dementia course may better prepare them to be care proxies by ensuring care is aligned with what matters to the person living with dementia. While needing to be replicated in larger numbers, the study suggests the feasibility, value, and acceptability of a guided priorities identification process. Future research should examine whether this process leads to better medical, psychological, and behavioral outcomes for these care dyads.