Function, caregiving and adequacy of support before and after the transition to institutional settings

过渡到机构环境之前和之后的功能、照顾和支持的充分性

• 批准号: 10687131
• 负责人: Kenneth Lam
• 金额: $ 0.55万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10687131
• 关键词: Activities of Daily Living; Age; Aging; Anecdotes; Assisted Living Facilities; Award; Bathing; Caregivers; Caring; Complex; Data; Data Aggregation; Decision Aid; Dementia; Elderly; Family; Feedback; First Aid; Foundations; Friends; Future; Geriatrics; Goals; Grant; Growth; Health; Health Professional; Home; Home Nursing Care; Hour; Impairment; Institution; Institutionalization; Institutionalized Persons; Interview; Life; Living Arrangement; Low income; Measures; Mentors; Methods; Normalcy; Nursing Homes; Outcome; Palliative Care; Patients; Persons; Population Heterogeneity; Positioning Attribute; Process; Qualitative Methods; Race; Randomized, Controlled Trials; Research; Role; Sampling; Service delivery model; Specific qualifier value; Subgroup; Surveys; Testing; Training; United States National Institutes of Health; Vulnerable Populations; Work; career; caregiving; cohort; ethnic diversity; experience; functional disability; improved; instrumental activity of daily living; lens; programs; recruit; residential care facility; sex; trend

PROJECT SUMMARY/ABSTRACT When functional impairments in later life overwhelm available caregiving, older persons and their caregivers commonly consider if moving from home into an institution, such as a nursing home, assisted living facility or residential care facility for the elderly, is best for them. Persons and caregivers hope clinicians will help them decide, but evidence and frameworks that clinicians can use to provide guidance are largely absent. We could improve how clinicians help patients and caregivers navigate this process through a decision aid, but an aid first requires data on how person- and caregiver-centered measures change with institutionalization and a better understanding of what information persons and caregivers want. The objective of this proposal is to supply those data and that understanding through mixed methods. Aim 1 will produce the first nationally representative descriptions of trajectories in function, caregiving, and adequacy of support (eg, did persons bathe less than they wanted due to lack of help) in the year before and after institutionalization and examine if trajectories meaningfully differ in pre-specified subgroups (eg, by age, race, or type of institution). Aim 2 will explore the experience of recently institutionalized older persons and their caregivers to understand the role of function, caregiving and inadequate support in their transition and what information (if any) was and would have been useful. We integrate our methods by using results from Aim 1 to inform sampling and by presenting findings from Aim 1 to interviewees in Aim 2; by exploring feedback to a concrete example, we will gain a better understanding of what kinds of information are useful to persons navigating this transition. Together, these aims will be the foundation for future work developing decision aids for the institutionalization process and then implementing and evaluating them in randomized controlled trials.

项目摘要/摘要 当以后生活的功能障碍不堪重负时，老年人及其护理人员 通常考虑是否从家里搬到疗养院，辅助生活设施或 老年人的住宅护理设施最适合他们。人和照顾者希望临床医生会帮助他们 决定，但是临床医生可以用来提供指导的证据和框架在很大程度上没有。我们可以 改善临床医生如何帮助患者和护理人员通过决策援助来导航这一过程 首先需要有关以制度化和以人为中心和照顾者为中心的措施的数据 更好地了解人员和看护者想要的信息。该提议的目的是 通过混合方法提供这些数据和理解。 AIM 1将在全国生产第一个 在功能，护理和支持足够的功能中的轨迹的代表描述（例如 在制度化之前和之后的一年中，由于缺乏帮助，沐浴比他们想要的少 轨迹在预先指定的亚组（例如，年龄，种族或机构类型）上有意义地不同。 AIM 2意志 探索最近制度化的老年人及其照顾者的经验，以了解 功能，护理和支持不足的过渡以及哪些信息（如果有） 很有用。我们通过使用AIM 1的结果来通知采样并介绍我们的方法 AIM 1到AIM 2的受访者的发现；通过探索对具体示例的反馈，我们将获得一个 更好地理解哪些信息对于导航这种过渡的人有用。一起， 这些目标将成为未来工作为制度化过程开发决策辅助的基础 然后在随机对照试验中实施和评估它们。