Rural areas tend to have a larger share of older adults, but few dementia-specific services. With most specialists practicing in cities, most of the responsibility for dementia diagnosis and management in rural areas falls to local primary health care (PHC) providers. However, there is a knowledge gap in evidence-based best practices to guide rural dementia care. Given the tremendous diversity across rural settings and PHC teams, a “one size fits all” approach to designing rural best practices is not effective. There is a need for adaptable strategies that can be tailored to individual PHC teams in different contexts.
Currently in its early stages, the Rural Dementia Action Research (RaDAR) Dementia Toolkit will be an important outcome of the Foundation grant program. In partnership with rural PHC providers we will develop an inventory of evidence-based best practices for delivering comprehensive, integrated PHC for dementia that is adaptable, scalable, and sustainable across diverse rural settings and PHC teams.
This research program involves three linked research streams: Stream 1: Interdisciplinary team-based care to support ongoing care management and education/support for patients and caregivers. Stream 2: Remote specialist-to-primary care education and support through technology Stream 3: Decision support tools for PHC providers that are embedded in the electronic medical record (EMR).
We will also create and validate dementia case definitions for EMR and administrative data so that we can examine the effectiveness of the toolkit. The ultimate goal of the research is to improve the quality of rural PHC, and quality of life, among people with dementia and their caregivers living in rural areas.