GAPcareAD: A Brief Emergency Department Intervention to Address Post-Fall Care Needs of Persons Living With Dementia and Care Partners

This multi-site randomized controlled trial will evaluate the efficacy of GAPcareAD compared to usual care among 350 PLWD and their caregivers (dyads) presenting to one of the three EDs after a fall. The intervention includes pharmacist- and physical therapist-led assessments, targeted modification of fall risk factors, and coordinated communication of fall prevention plans with caregivers and care teams. Outcomes include fall-related ED visits, injuries, hospitalizations, quality of life, caregiver burden, and adherence to recommendations over 6 months. GAPcareAD aims to determine whether a pragmatic, ED-based intervention can reduce fall-related healthcare utilization and improve patient and caregiver outcomes, while informing future large-scale implementation.

Inclusion criteria

• Community-dwelling adult (living at home or assisted living) 65 years-old or older presenting to ED after a fall within the last seven days
• Fall not due to syncope or external force (i.e., struck by car,assault, intoxication)
• Fall not due to serious illness (i.e., stroke, acute myocardial infarction)
• Patients have an identified caregiver
• Patient must have known ADRD or score ≥2 on the AD8 Dementia Interview.
• Anticipated to be discharged to home/assisted living/rehabilitation at the time of consent (i.e. not admitted)
• The patient and/or caregiver have a reliable phone number where they can be reached throughout the intervention

Exclusion criteria

• Living in a nursing home
• Patients are admitted to the hospital
• Patients who have advanced cancer and/or are in hospice
• Patients have presence of injuries that prevent mobilization (i.e. pelvic or lower extremity fractures)