Date Presented 04/05/2025
Exploring the perspectives of caregivers of individuals with Alzheimer’s disease and related dementias (ADRD) of medication management reveals decision-making dynamics, communication gaps, and deprescribing needs. Insights will inform OT to enhance caregiver support and improve care quality.
Primary Author and Speaker: Sarah Joseph
Additional Authors and Speakers: Tara C. Klinedinst
PURPOSE: The purpose of this study is to explore caregiver-reported perspectives on managing medications for older adults with Alzheimer’s Disease and Related Dementias (ADRD), focusing on understanding caregiver decision-making processes and knowledge gaps related to medication risks and deprescribing (reducing or stopping medications when risks outweigh benefits).
DESIGN: This was a qualitative descriptive design using semi-structured interviews conducted via Zoom.
METHOD: Interviews focused on exploring caregiver perspectives on medication use, knowledge of associated risks, barriers to deprescribing, and needed resources. Thematic analysis of interview data is ongoing (16/25 interviews completed).
RESULTS: Preliminary analysis of interview data from 16 unpaid caregivers revealed three themes including 1) the ‘trial-and-error’ process of decision-making, 2) communication gaps with healthcare teams, and 3) psychotropic medications as ‘first line of defense’. First, caregivers reported challenges negotiating ADRD care under ever-changing circumstances. Second, caregivers reported inconsistencies in information from healthcare providers, particularly around deprescribing. Lastly, most caregivers noted that psychotropic medications were beneficial for improving behaviors and quality of life, with few or no adverse events. All caregivers desired additional support with medication decision-making, whether provided online or in-person.
CONCLUSION: Our findings reveal critical gaps in caregiver knowledge and communication with healthcare providers, specifically regarding the deprescribing process as well as the need for resources for medication decision-making. This research will inform development of a caregiver intervention to support deprescribing.
IMPACT STATEMENT: Occupational therapists are well-equipped to provide training and support to empower caregivers to make proactive and informed healthcare decisions, a priority.
References
Alzheimer’s Association. (2023). Alzheimer’s disease facts and figures. Alzheimer’s Disease and Dementia. https://www.alz.org/alzheimers-dementia/facts-figures
Muñoz-Contreras, M. C., Segarra, I., López-Román, F. J., Galera, R. N., & Cerdá, B. (2022). Role of caregivers on medication adherence management in polymedicated patients with Alzheimer’s disease or other types of dementia. Frontiers in Public Health, 10, 987936. https://doi.org/10.3389/fpubh.2022.987936
