Patient navigation for people with dementia, their caregivers, and the care team: A needs assessment.

Introduction: Among diseases, dementia is the seventh leading cause of death internationally. Dementia is a collection of diagnoses characterized by cognitive deterioration, memory loss, and problems of thinking and reasoning. It is a major cause of disability among seniors around the world. Frequently, people with dementia and their caregivers face fragmented, uncoordinated, and often difficult to navigate systems, which can lower quality of life and contribute to caregiver burden. Patient navigation (PN) is one potential model of integrated care that can effectively improve care coordination and help guide this population through the healthcare system, matching their unmet needs to appropriate resources, services, and programs. Aims, Objectives, Theory or Methods: PN is a person-centred and barrier-focused care model. As PN is a partnership between navigator and client, it can empower them to access resources, services, and programs and support them while navigating the health and social care systems. This project's objectives included: 1) a scoping review to map the literature on the characteristics of patient navigation programs for people with dementia, their caregivers, and/or members of the care team; 2) an environmental scan to identify successful characteristics of current navigation programs in Canada for people with dementia and their caregivers; and 3) semi-structured interviews with key stakeholders in New Brunswick to inform the development and implementation of a PN program for people with dementia, their caregivers, and members of the care team. Highlights or Results or Key Findings: The national environmental scan found 11 programs across 6 provinces with variation in modes of delivery, hours of operation, team compositions, service languages, and services provided. Navigator titles, qualifications, role, and method of counting caseload vary. All were paid positions. The scoping review found 45 articles describing 24 distinct programs, the majority of which were published in the United States between 2015 and 2020. All programs provided some form of referral and/or linkage to other services and most teams were interdisciplinary. There was no consistent patient navigator title or universal delivery method. Twenty-seven interviews were conducted with stakeholders (people with dementia, caregivers, health and social care providers, and decisions makers) for the needs assessment. It found a need for a patient navigator to act as a liaison between services and programs, facilitate care coordination, and improve knowledge of dementia care in a community setting. Navigation challenges include a lack of knowledge and education and siloed systems. Conclusions: Patient navigation can reduce fragmentation and improve the integration and coordination of care. It is one way to engage, support, and inform people with dementia, their caregivers, and care team members. Implications for applicability/transferability, sustainability, and limitations: The results will support the development of a patient navigation pilot program in New Brunswick, Canada. Such a program can play a vital role in ensuring people with dementia, their caregivers, and care providers are connected to each other and to the appropriate services and resources as well as act as partners in the delivery of integrated care. [ABSTRACT FROM AUTHOR]