Dementia Care Quality at Home: A Dementia Care Curriculum for Home-Based Primary Care

Background Dementia is highly prevalent among the 7.5 million homebound older adults in the United States. Despite this high dementia prevalence, dementia care interventions and associated curricula developed to date have focused nearly exclusively on office-based primary care and have not been adapted to the unique care setting, staffing, and workflows of home-based primary care (HBPC). We developed and implemented a pilot study of the Dementia Care Quality at Home (DCQH) curriculum to train HBPC clinicians and staff in person-centered dementia care. The objective of this study is to evaluate the DCQH curriculum. Method The curriculum comprised 8 required and 4 optional asynchronous video modules, two 90-minute synchronous skill-building sessions focused on training for implementation of a standardized assessment, and six core dementia care modules through structured home visits, and monthly case conferences. Learners completed baseline assessments and care modules with patients and caregivers, followed by fidelity reviews and post-intervention focus groups. We assessed learners’ knowledge via training questionnaires, completion rates, fidelity of assessments and modules, and the reported feasibility and acceptability of the curriculum using both quantitative and qualitative methodology. Results Twenty-one HBPC clinician and staff learners completed training and post-curriculum surveys. Fifty assessments and 256 dementia care modules were successfully delivered, with 92% fidelity by audit. Learners qualitatively reported increased confidence in dementia care domains including symptom management, behavior strategies, caregiver support, and interdisciplinary collaboration. Focus groups highlighted improved team cohesion and consistent care delivery. Caregivers valued having structured time outside of traditional medical visits to address dementia-specific concerns. Conclusion The DCQH curriculum improved knowledge, workflow integration, and interdisciplinary collaboration among HBPC teams, while offering caregivers enhanced support. This structured, scalable model shows promise for improving dementia care delivery in home-based settings and may serve as a framework for future training in geriatric care settings.