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Author ORCID Identifier
https://orcid.org/0009-0006-6423-4174
Date Available
6-15-2028
Year of Publication
2026
Document Type
Capstone
Degree Name
Doctor of Social Work (DSW)
College
Social Work
Department/School/Program
Social Work
Abstract
High emergency department (ED) utilization among persons living with dementia (PLWD) causes physical, emotional, and financial stress for individuals, families, and hospital systems. As the global population ages, rates of dementia will reach 152 million by 2050, and systems of care are unprepared to meet the complex needs of this population. Dementia is an incurable neurocognitive disease with progressive symptoms across the disease trajectory. Overwhelmed by increasing care needs, caregivers turn to the ED for assistance, but the fast-paced environment cannot meet the long-term care needs of PWLD. This manuscript examines the overutilization of the ED among PLWD through three products: a systematic literature review, a conceptual paper, and a practice application paper. The systematic literature review examines current studies to determine the effectiveness of clinical social work interventions in reducing ED visits for PLWD. The review demonstrates that psychotherapy for caregivers and dementia programs that combine two or more clinical social work interventions are effective in reducing ED visits among PLWD. A secondary finding of the systematic literature review is that interventions delivered via telehealth are equally effective as in-person interventions. The conceptual paper explores dementia care from a synthesized lens of systems and empowerment theories to understand multi-level factors contributing to the overreliance on ED care among PLWD. The blended framework identifies solutions for dementia care by examining how interconnected health and social systems, as well as power within those systems, influence social determinants of health, access to care, and the lived experience of PLWD. At their points of convergence, the two theories advocate for dementia care models that consider the person-in-the-environment, provide integrated care, promote social justice, and inform action-oriented social work solutions to the overreliance on ED care among PLWD. Lastly, the practice application paper proposes a new clinical social work intervention to meet the practical and emotional needs of dementia caregivers. Named PRISM (person-centered, responsive, integrated support for memory caregivers), the psychotherapy model provides a tailored approach for assisting caregivers. The therapeutic techniques empower caregivers to navigate health and social systems, identify and utilize resources, and address their own emotional needs to prevent burnout. Findings across all three products show that clinical social work interventions effectively reduce ED visits, technology increases access to preventive care, and supporting caregivers improves the health and well-being of both PLWD and their caregivers. The three papers conclude that social workers are vital to dementia care because they address social determinants of health, dismantle barriers to care, improve resource utilization, and provide empowering interventions. Implications for social work practice, policy, and research include shifting dementia care approaches from patient-focused medical models to proactive, psychosocial interventions that support the whole family, expanding dementia care programs and services, and researching ways to adapt interventions to meet the needs of diverse populations. The project recommends increasing the utilization of clinical social workers to provide holistic, tailored interventions that meet the needs of PLWD and their caregivers before a crisis leads them to the ED.
Recommended Citation
Donihoo, Virginia, "FROM CRISIS TO COMMUNITY: CLINICAL SOCIAL WORK STRATEGIES TO REDUCE EMERGENCY DEPARTMENT UTILIZATION AMONG PERSONS LIVING WITH DEMENTIA" (2026). DSW Capstone Projects. 82.
https://uknowledge.uky.edu/csw_grad_reports/82
