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Tech-enabled caregiver interventions drive outcomes that keep dementia patients out of the ED and hospital
Caring for someone with dementia can be emotionally, physically, and financially challenging. With nearly 1 in 10 older Americans living with dementia [1], the need for effective support for their caregivers has never been greater. Research has found significant benefits when caregivers participate in evidence-based programs. However, many of these programs are not scalable nor sustainable outside of a research context. While technology is a clear enabler of scale, few studies have leveraged technology to address this issue for engaging and intervening with unpaid family caregivers – until now.
Gold Standard Research Establishes Clear Evidence of the Impact of Targeted Caregiver Support
Rippl CTO and Head of AI, Joe Chung, has long recognized the importance of technological advancements in improving dementia care. “No condition is better suited to derive significant benefits from tech-enablement than dementia. AI in particular will revolutionize dementia care navigation and caregiver support by vastly expanding access and availability of this critically needed service.” To bring this vision to reality, Joe took the bold step of establishing an evidence-based caregiver coaching intervention – in partnership with the Alzheimer’s Association and funded by a $2.8 million fast-track NIH SBIR grant. The caregiver support protocol, which is core to the Rippl care model, combines humans and technology to provide caregivers with personalized coaching, educational resources, and other critical support. In a randomized controlled trial (RCT) involving 495 caregivers, the results showed remarkable improvements in key areas of caregiver well-being and skill development. All of which independent evidence has shown to drive better outcomes for patients and lower costs, specifically reducing utilization related to emergency room and hospital visits.
Key Findings
The study revealed that caregivers experienced:
- Reduced Caregiver Burden: Participants reported a significant decrease in emotional and physical strain, a common issue for caregivers who often take on overwhelming responsibilities without sufficient support.
- Improved Financial Self-Efficacy: Caregivers became more confident in managing the financial aspects of caregiving, such as accessing resources and planning for care expenses.
- Decreased Anxiety and Emotional Strain: The program provided not only practical tools but also emotional support, reducing anxiety and improving caregivers’ overall mental health.
- Enhanced Caregiver Mastery: Caregivers felt more capable and empowered to navigate the challenges of dementia care, thanks to personalized coaching and tailored action plans.
- Reduced Frequency of Behaviors: Caregivers reported their care partner living with dementia had fewer behavioral issues as a result of the proactive planning and support received.
This intervention model is particularly effective because it combines the flexibility of technology with human connection. The virtual format ensures scalability and accessibility, making it easier for caregivers to engage no matter their location or situation.
Dr. Katherine Judge found the results impressive. “The 6-week program had beneficial impacts across a wide-range of caregiver outcomes, including unmet needs, caregiver strains, mastery, and well-being. Additionally, the program significantly reduced the behavioral difficulties and the associated distress experienced by caregivers.” She also noted the evidence-based program was designed to be pragmatic, scalable, and cost-effective which are important and necessary features for sustaining caregiver programs outside of a research context. Lastly, Judge indicated the likelihood of broader generalization of study findings was promising given the range of caregivers represented across age, socio-economic status, relationship to their care partner, and the amount and length of time spent providing care.
Why this is important
Dementia is the most expensive disease for our seniors, costing the healthcare system $345B today and set to explode to $1T by 2050 and the US population ages.[2] Medicare reports that seniors living with dementia drive healthcare costs [3] times higher than the Medicare average.3 Unmanaged caregiver strain drives up utilization with a recent study showing patients having $1000 higher monthly costs when their caregiver is not provided the necessary support to manage their burden and mental health.[4]
Dr. Jamie Sharp, Chief Medical Officer at Rippl weighed in, “We know that when caregivers lack the necessary support and tools, emergency rooms become catch-alls. Avoidable ED admissions for people with dementia spiral into excessive inpatient and post-acute costs. Research shows reducing caregiver strain leads to better outcomes for the patients in their care. This controlled study validates that the interventions Rippl is providing, by putting both patient and caregiver in the center, creates the conditions that keep patients out of the ER and safe at home.”
“Caring for a loved one with dementia can be incredibly challenging, and it’s critical that we provide caregivers with the support they need to navigate this journey,” Chung added. “This program’s ability to deliver impactful, evidence-based support through technology represents a major step forward in scaling effective caregiver support. This study joins a growing body of research, in particular from prestigious research programs at UCSF[5] and UCLA[6], that collectively show remotely delivered team-based dementia care models, like the Rippl Care Model, improve outcomes and lower costs.”
A Model for the Future of Dementia Care
The invention also demonstrated that caregivers’ improved well-being directly impacted the people they care for. Reductions in caregiver stress and burden often translated to better care outcomes for individuals with dementia. For example, participants reported a reduction in the frequency of their loved one’s hard to manage behaviors along with a reduced amount of distress they experienced due to behaviors. In addition, caregivers who felt more equipped to handle daily caregiving tasks were less likely to experience burnout, which in turn contributed to more consistent and attentive care.
Moreover, the program’s focus on creating individualized care plans—including setting both caregiving and financial goals—helped caregivers feel more in control of their situations, which is critical in long-term care settings where emotional resilience is often strained. Reducing stress-inducing behaviors while building up confidence and proactively planning for what might come up creates an environment where caregivers can stay in control and avoid the ER and hospital altogether.
Caregiver coaching and support is deeply integrated into Rippl’s broader care model. As a leading virtual dementia care company, Rippl is committed to delivering high-quality, comprehensive care that addresses the needs of both people living with dementia and their caregivers. With this evidence-based approach at its core, Rippl is setting a new standard for how technology and coaching can work together to improve health outcomes and lower costs.
Full report available at: ripplcare.com/report
Joseph Chung is the CTO & Head of AI at Rippl and the former CEO of Kinto. He led the NIH-funded Care Coaching study, focusing on the development of tech-based support for dementia caregivers.
Dr. Katherine Judge is a professor at Cleveland State University, specializing in caregiver interventions. She co-authored the published findings from the Care Coaching study, conducted in collaboration with the Alzheimer’s Association.
Sources
[1] https://jamanetwork.com/journals/jamaneurology/fullarticle/2797274
[3] The data source for this analysis is derived from the 2019 CMS Limited Data Set (5% sample), which includes Original Medicare eligibility and claims data for over 3 million unique members across the US. Neurocognitive disorder members have at least one ICD-10-CM Diagnosis code (primary or secondary) in a codelist defined by Rippl Care at any point in CY 2019 in Exhibit C.
[4] https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2809588
[5] https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2751946
[6] https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2719196
