Home health providers have turned to screening for dementia as a standard part of their health assessment, finding meaningful clinical and operational benefits.
Home dementia screening promoted previous diagnosis and personalized care pathways, with industry experts talking to Home Health News and identifying potential candidates for additional home services.
Early detection of dementia may improve clinical outcomes, but according to a national poll on aging, 80% of adults aged 65 to 80 have not been screened for cognitive issues in the past year.
“If you suspect cognitive impairment but have no diagnosis on the file, home screening can connect important points to clinicians,” Neurotrack co-founder and CEO Elli Kaplan told HHCN. “As well as providing a unique opportunity for providers to observe and connect with their families at home, the right digital cognitive screening platform can also take the next step, filter out other causes, referrals, formalize the diagnosis, create the diagnosis, and provide the documentation necessary to provide patients and their loved ones with local resources and support.”
Based in Redwood City, California, Neurotrack is developing tools for providers that can be easily delivered at scale to promote early detection of cognitive impairments and continuous monitoring of cognitive function.
Dosing dementia screening at home can encourage patients to be more open-minded.
A study from the National Institute of Aging suggests that patients are more likely to disclose cognitive concerns in familiar, stress-free environments, such as homes. Research shows that patient-centered cognitive assessments conducted at home can increase motivation to pursue more open discussion and further evaluation. According to a study by the Alzheimer's Disease Association, if 88% of cases of dementia are identified at the earliest stage, the United States can achieve overall $7 trillion in medical and long-term care costs savings.
Staying at home also allows clinicians to identify symptoms of cognitive impairments and other health determinants, such as difficulties and excessive clutter following conversation, sources told HHCN.
Kaplan said that integrating clinically trusted cognitive screening tools into home health visits has the added benefit of identifying candidates for more comprehensive home services, such as dementia-specific care.
Providing dementia-specific services can help some providers differentiate themselves from their peers.
Home dementia screening can be conducted through a variety of ways, including self-controlled zero cognitive tests (SAGE), mini-mental status tests (MMSE), and virtual screenings provided by care organizations such as Johns Hopkins' Mind at Home.
“We've seen this strategy work to expand identification while increasing patient engagement, improving outcomes and promoting well-being,” she said. “As the burden of dementia continues to grow, multi-purpose cognitive screening techniques that work in patients' homes, like clinics, will become a critical component of quality care in aging populations.”
Plans in progress
This means that Health moved in October 2024 to incorporate dementia screening into standard health assessments. The provider manages Neurotrack's Cognitive Health Digital Screener at the patient's home, under the guidance of a clinician during the Intraorganizational Health Assessment (IHES).
The results, including the findings of cognitive impairment, will be shared with the primary care provider (PCP) of patients, whom Heidi Schwarzwald, meaning chief medical officer of health, states that it will allow timely intervention, care planning and coordination.
“Screenings are routinely carried out as part of Signify Health's IHE at no additional cost to members,” Schwarzwald told HHCN. “Health Plans or our clinicians can recommend cognitive screening, including digital cognitive screening, based on member health records or clinician's home assessment. Members can also request cognitive screening.”
Dallas-based Signify Health, CVS Health Company (NYSE: CVS) leverages sophisticated analytics, technology, and a national provider network to create value-based payment programs and leverage a national provider network.
Although screening is self-managed, the clinician, which means health, assists patients throughout the process and explains the purpose and importance of the test. The digital test is less frustrating than traditional pen and paper cognitive health screening tests, Schwarzwald said.
“With new digital screeners, our primary clinicians can objectively capture the cognitive health status of our members, which, together with the symptoms observed, can lead to a diagnosis,” says Paymon Farazi. “By bringing members back into care, they and their families can work with the PCP to develop a care plan and receive the necessary treatment.”
According to Schwarzwald, when a clinician engages as a member of a health plan, they start with a simple conversation. They often ask individual family and hobbies as a starting point. This approach helps to form the basis of relationships and meaningful visits.
Results are combined with other clinical assessments, including the ability and diagnosis and history of drug history of individuals performing device activities in daily life (IADL). Confounders are then excluded to accurately determine whether the member has mild cognitive impairment or dementia. The results of the screening will be shared with the health plan and the individual primary care provider (PCP) for further care planning.
“Supporting older adults at age-specific terms means not only helping individuals manage their existing chronic conditions, but also providing comprehensive preventive testing for both mental and physical health conditions,” Schwarzwald said.
