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New GEAR Network research identifies ways to improve emergency care for people with dementia

Dr. Manish Shah, a professor of Emergency Medicine at UW and an emergency physician at UW Health

Researchers from the University of Wisconsin School of Medicine and Public Health and collaborating institutions have published a new collection of research papers that identify ways to improve emergency care for people with dementia. 

As a part of a research collaboration funded by the National Institutes of Health (NIH) called the Geriatric Emergency care Applied Research (GEAR) Network, the UW School of Medicine and Public Health led a team of researchers, along with Yale University School of Medicine, Northwestern University Feinberg School of Medicine, and the School of Medicine at Washington University in St. Louis, to further develop research on dementia in emergency care.

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“The population of people living with dementia in the United States is growing rapidly, we have around 6 million adults in the US with dementia, and it’s supposed to double over the next 25 or so years,” says Dr. Manish Shah, a professor of Emergency Medicine at UW and an emergency physician at UW Health, who co-led the research team. “The NIH recognized this was an issue, put out a competitive grant request, and we propose this GEAR Networks or what we call GEAR 2.0- Advancing Dementia Care.” 

This group helped identify specific areas that need to be focused on in future studies to provide the best care for people living with dementia. These areas include better recognition of dementia-related cognitive impairment by emergency care providers and memory care services, improved discharge of patients with cognitive impairment to their homes, improving communication strategies between emergency care providers and patients with dementia, and improving the care provided to this population while in the emergency department. 

“These four areas are important for a number of reasons… The care we deliver to people with dementia is sometimes a little bit different than the care we deliver to people without it, right?” says Dr. Shah. “So we need to think, what do we have to do when we communicate with these people? And what do we have to do such that we give them the care they want?” 

The research team, funded by the NIH and people living with dementia, their families and advocates, first began in 2020 and it focused on examining gaps in care while also assessing previous research efforts in health care settings across the country. The three gaps identified included a limited quantity of dementia care research in emergency department settings, inadequate reporting around diversity, equity and inclusion related to dementia care in emergency departments, and a need to balance inspiration with pragmatism to advance real-world, impactful solutions in emergency departments.

“The question becomes: how is this different in different groups … among Asians, or among Black people, or Hispanics, or among folks in rural communities versus urban communities, folks that have limited health literacy?.These things are really not discussed in most of the papers that we found. But they’re also important to the lived experience of the person living with dementia who comes to the emergency department for care,” Dr. Shah says about the second gap identified in the team’s research. “So that we found across everything, it’s a really important piece that needs to be focused on, such that we can give care for that person that’s culturally relevant. That’s helpful to them.”

According to a press release from UW School of Medicine and Public Health, the research team is committed to addressing and facilitating progress in all four areas and gaps in care. Using its NIH funding, the GEAR network will distribute pilot grants to health systems and academic medical centers across the nation to support research studies that will improve emergency care models for people living with dementia. 

“You’re not going to make massive changes, but if you can start making small changes, teaching people what’s important to people living with dementia, what’s important to our communities, whether they’re communities of color, rural communities, or urban communities, we can start to get where we need to get to just care for these folks in a much, much better way,” explains Dr. Shah.