Title:PACT Clinical Innovation Study: Engaging Caregivers in the Care of Veterans with Dementia, VA Form 10-0537, Appendices a-u.
OMB Control Number:2900—New.
Type of Review:New data collection.
Abstract:The data collected on VA Form 10-0537, Appendices a-u, will be used to examine the feasibility and extent to which a patient-centered and dementia care management program for veterans and their caregivers facilitates access to and use of medical and social services. The information will help VA develop and test a care management intervention that will improve dementia care for patients and family caregivers.
Affected Public:Individuals or households.
Estimated Annual Burden:704 hours.
Estimated Average Burden per Respondent:88 minutes.
Frequency of Response:On occasion.
Estimated Number of Respondents:160.
Estimated Number of Responses:480.
Dated: August 16, 2012.
By direction of the Secretary.
Program Analyst Director, Enterprise Records Service.