The Indian Health Service (IHS) has launched a new training and education initiative through TRIAD (Training and Resources for the IHS on Alzheimer’s and Dementia). Dr. Mary Koithan serves as project director for this IHS-funded contract, which is managed by the University of Washington. 

TRIAD is designed to help health care professionals build the skills, compassion, and cultural respect necessary to care for elders living with memory challenges. It includes four key parts:

• Clinical dementia training  
• Workforce development (Geriatric Nurse Fellowship and Geriatric Scholars Programs) 
• Teleconsultation service
• ECHO Collaboration

Clinical dementia training is the newest component within TRIAD. In her role as a clinical professor at the University of Washington School of Nursing, Dr. Koithan will lead the nursing section. She will guide five courses that focus on nursing care for people living with dementia and their caregivers and serve as the faculty lead for the Geriatric Nurse Fellows, an IHS workforce development program.

TRIAD training courses will be offered through live webinars, the IHS Learning Management System, and in-person sessions at annual conferences. These training courses are geared toward the following health professionals:

• Primary care providers
• Nurses
• Community Health Representatives (CHRs)
• Pharmacists 
• Dentists 
• Behavioral health specialists

Bringing together multiple specialties to learn from the same foundation helps strengthen dementia care in tribal communities.

“What excites me most about this work is that it goes beyond education. Too often, we provide training but can’t answer the specific, real-world questions providers face in clinical care,” said Dr. Koithan. “This initiative creates space for providers across disciplines to receive additional support to improve the care delivered to elders.”

Pictured: Dr. Mary Koithan, project director for Training and Resources for the IHS Alzheimer’s and Dementia Program (TRIAD), a funded contract managed by the University of Washington.  

​​​​​​Geriatric Nurse Fellowship: Clinical Impact
Behavioral Health Care for Adults in the Primary Care Setting

Esme Roddy, an Advanced Practice Psychiatric Mental Health Nurse at the Indian Health Center of Santa Clara Valley, participated in the IHS Geriatric Nurse Fellowship Program. Her project focused on examining how primary care providers view the behavioral health needs of older adults.

Esme’s project aimed to improve services and referrals while increasing screening for depression and substance use. She concluded that older adults often have behavioral health needs, but connecting them to integrated care is difficult. Esme also learned that referrals to behavioral health services are only sometimes accepted.

Key findings of her project include:

• Continue to assess the effectiveness of the current workflow and consider implementing screening tools specific to geriatric patients
• Create a warm handoff process for patients hesitant to accept behavioral health referrals
• Pamphlets in multiple languages with information about Integrated Behavioral Health (IBH) services are needed

As a result of her project, a standardized screening protocol for depression and substance use was introduced in primary care at the Indian Health Center of Santa Clara Valley. This protocol is being reviewed to measure its effectiveness.

IHS Alzheimer’s Program Dementia Resource Hub

Check out these helpful Alzheimer’s and dementia caregiving and provider resources on the IHS Alzheimer’s Program and partner websites:

• TALK: Find conversation starters for families. Talking about Alzheimer's disease with a child of any age can be difficult, especially when a parent, grandparent, or other family member receives a diagnosis. Find resources on the Alzheimer’s Association website for teens and children.
• LEARN: Access free webinars anytime. Webinars and online training offer easily accessible learning opportunities that allow participants to learn conveniently from any location. Visit the Alzheimer's Program on our Past Webinars page to begin learning today!