MEMORI Corps: Activity-based Companion Care for Dementia

This project adapts a novel activity-based companion care model (MEMORI Corps) for community-living persons with dementia for a virtual delivery format, and then implements the intervention in a pilot, two-arm, randomized controlled trial to evaluate intervention acceptability, feasibility, and preliminary efficacy versus an augmented waitlist control. The goals of the program are to reduce social isolation and improve health and well-being for PWD, reduce burden and support family CGs, and to provide health benefits and meaningful engagement for older volunteer Companion Guides.

The target group is 60 dyads (persons living with dementia and their informal co-residing caregiver) and 36 companion guides (health volunteer 55 years of age and older). Participants are randomized 1:1 either to the intervention or waitlist control group. Waitlist participants are offered the opportunity for cross-over into active intervention group. PWD/CG outcomes will be assessed at Baseline, 6-, and 12-weeks (PWD/CG participation lasts 12 weeks). Volunteer Companion Guide outcomes will be assessed at baseline, 6-, and 12-months.

This model program could serve as an important new advancement for community-based long term care for PWD that addresses unmet patient- and family-centered needs through civic engagement of seniors. It could also serve as an intervention for dementia risk-reduction and brain health if found to be efficacious.

Specific aims are to:

Aim 1: Adapt and refine the MEMORI Corps intervention for a virtual delivery format using iterative user-centered design principles and multiple stakeholder input.

Aim 2: Conduct a pilot, two-arm, randomized controlled trial to evaluate acceptability, feasibility, safety, and preliminary efficacy of the MEMORI Corps intervention (vs. wait list control group) in 60 community-living person's living with demential (PLWD) and informal caregiver dyads and 36 volunteer companion guides from geographically and demographically diverse regions in Maryland.

Aim 3: Evaluate the feasibility of ascertainment of community-living PLWD, caregiver, and volunteer-level outcomes over time using virtual and telephonic data collection methods.

Inclusion criteria

Persons with dementia and informal caregiver (PWD/CG) must both meet eligibility criteria. These criteria are designed to reduce PWD/CG attrition and ensure safety of PWD, CG, and volunteers.

PWD are eligible if:

• English speaking;
• Have an established physician clinical diagnosis of dementia (any stage) and confirmed with Informant Questionnaire on Cognitive Decline in the. Elderly (IQCODE) cut off >=52 ,
• Are able to participate in at least 4 basic Activities of Daily Living (out of 11),
• Have not received formal (i.e., in-home companion care, or adult day center) activity-focused care services in the past 4 weeks,
• Living at home in all counties in Maryland and Baltimore City,
• Have a co-residing informal caregiver willing to participate as study partner, and 30 years old or older.

CG are eligible if:

• English speaking,
• 21 years of age or older (male or female),
• Deemed to be a reliable informal caregiver (not paid for caregiving of PWD) who knows the PWD well,
• Co-residing with the PWD, and
• Relied on by the PWD for assistance in activities of daily living (instrumental or basic).

Volunteers (i.e. "Companion Guides") are eligible if:

• English-speaking,
• 55 years or older, (3) High School diploma or General Equivalency Diploma (GED) (minimum) (2) ability pass a basic adult literacy screen
• Ability to pass a background check, physical and mental health screening,
• A Montreal Cognitive Assessment (MoCA)-Blind score of 18 or above,
• Ability to commit to 12 months of service (5 hours per week, excluding travel time and continuing education and support), and
• Are reliable during intake and on-boarding process and able to successfully complete training.

Exclusion criteria

PWD are excluded if:

• Deemed to be in a crisis/unsafe situation at baseline,
• Planned transition from home in less than 6 months,
• At end-stage disease (e.g. bed-bound and non-communicative, or hospice),
• Currently enrolled in a dementia related clinical trial, or
• Deemed to have severe behavioral symptoms so severe that participation in this study is unsafe (e.g., are placing self or others at harm).

CGs are excluded if:

• Do not plan to be co-residing with the PWD in the next 6 months, or
• Currently involved in a behavioral/educational clinical trial.

Volunteers are excluded:

• Planning on moving from the area in the next 12 months,
• Unable to provide informed consent, and
• Report having an existing cognitive disorder diagnosis by a health provider (e.g., Mild Cognitive Impairment, Alzheimer's disease or other type of dementia).