Evidence map›Paper›PMID 38280225›Full record

ArticleJournal of the American Geriatrics Society2024

"It shouldn't be like this": Family caregivers navigating insurance for family members with dementia.

Mikayla Gordon Wexler, Deborah Watman, Sasha Perez, Claire Ankuda, Jennifer M Reckrey

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Observational
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Mikayla Gordon WexlerDepartment of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA.ORCID 0000-0001-5395-0809
Deborah WatmanDepartment of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Sasha PerezDepartment of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Claire AnkudaDepartment of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Jennifer M ReckreyDepartment of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.ORCID 0000-0001-8904-8200

Funding

The Role of Paid Caregivers in Home-Based Dementia CareK23AG066930 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI RECKREY, JENNIFER M · 2020 to 2024
$799k
Training Future Leaders in Aging ResearchT35AG067578 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI ALDRIDGE, MELISSA DIANE, SORIANO, RAINIER P · 2020 to 2024
$616k
NIA NIH HHS K23 AG066930NIA NIH HHS K23AG066930NIA NIH HHS T35 AG067578
6 · The paper itself

Abstract

backgroundAlmost 11.3 million family caregivers of people with dementia must navigate the health insurance landscape to meet the complex medical and long-term care needs of their family members. This study explores factors that influence family caregivers' decisions about insurance and how these choices affect the care and support people with dementia receive.

methodsSemi-structured interviews were conducted from June 2022 to January 2023 with 15 family caregivers of people with dementia dual eligible for Medicaid and Medicare and enrolled in home-based primary care in New York City. A set of open-ended questions were asked exploring caregivers' perspectives on navigating insurance plans. Interviews were recorded, transcribed, and analyzed using thematic analysis with both deductive and inductive coding.

resultsAnalysis revealed three major themes: (1) challenges of Medicaid enrollment, (2) making do with existing insurance, and (3) mistrust of the insurance system. Initial enrollment in Medicaid compounded the stress of adjusting to caregiving. The enrollment process was impacted by clinical factors, financial factors, and input from providers and social workers; however, caregivers could not identify a centralized system for obtaining insurance information and support. Once Medicaid was in place, participants described advocating on behalf of their family member within the constraints of their current insurance plans (Medicare and Medicaid) and ensuring they had the necessary knowledge to understand their family member's coverage. Participants voiced a need for ongoing vigilance to ensure their family members received needed care and support.

conclusionThe challenges family caregivers experience when navigating insurance for their family members with dementia contribute to caregiver burden. Robust and centralized professional support for family members both immediately after a family member's dementia diagnosis and as the disease progresses could increase caregivers' capacity to make insurance decisions that best support their family members with dementia.

Indexed as

CaregiversDementiaMedicaidAdultAgedAged, 80 and overFamilyFemaleHumansInsurance CoverageInsurance, HealthInterviews as TopicMaleMedicareMiddle AgedNew York Citycaregiversdementiadual‐eligibleinsurance

Identifiers

PMID38280225
PMCPMC11090749

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.