Engaging Rural Communities to Identify and Address Gaps and Barriers in Healthcare for Dementia

Alzheimer’s disease and related dementias are currently the sixth leading cause of death in the United States. These diseases contribute significantly to overall healthcare spending due to the costs of long-term care required when family can no longer manage the condition in the home. Families are profoundly affected when a member is diagnosed with Alzheimer’s disease and related dementias. They must navigate management of the disease process in an environment where medical best practice and comprehensive care pathways do not exist. Individuals and families who reside in rural communities in eastern Montana, northern Wyoming, and the western Dakotas are disproportionately impacted by a lack of access to primary care, lack of community services, and vast distance to specialty care. Specialized care is often needed for disease diagnosis, understanding the disease process, treatment, and caregiver assistance.

The objectives of the program focus on providing improved education for patients, caregivers, and healthcare providers while creating an energized system of community engagement around the topic of comprehensive care for Alzheimer’s disease and related dementias. By using a statewide and patient-centered approach, patient partners and other stakeholders will be involved in all aspects of this project from the ground up. The objectives will be met through specific methods and activities that drive and support change. Educational materials will be developed and disseminated in collaboration with the Montana Alzheimer’s Disease and Related Dementias (ADRD) Work Group and Stratis Health, an independent nonprofit organization with expertise in facilitating collaboration in rural communities. Rural town-hall-style gatherings will be held, and champions will be identified in each of the three participating communities. These communities are Lewistown (central Montana), Glendive (eastern Montana), and Lovell (northern Wyoming).

Educational programs to be held in each community will be customized based on early information collection, and expected outcomes include:

• Stakeholders will become more knowledgeable about dementia care and dementia-related Medicare benefits.
• Stakeholders will have a better understanding of PCOR goals and methods and their potential to create healthcare change.
• Stakeholders will have participated in collaborative analysis and agenda setting. They will evaluate key gaps and barriers to dementia care and adoption of ADRD Medicare benefits in their local healthcare facility and identify a set of practical, potential healthcare practice change resolutions that meet all their needs.
• Stakeholders will develop a sustainable, collaborative partnership to implement practice change in their rural community.