Supporting Dementia Caregivers During Medicare Home Health: Developing the DECLARE Needs Assessment Intervention

在 Medicare 家庭健康期间支持痴呆症护理人员：制定 DECLARE 需求评估干预措施

基本信息

批准号：
10643284
负责人：
Julia Burgdorf
金额：
$ 13.38万
依托单位：
VISITING NURSE SERVICE OF NEW YORK
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-06-01 至 2028-02-29
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10643284
关键词：
Address Admission activity Adverse event Advisory Committees Aftercare Alzheimer&apos s disease patient Alzheimer&apos s disease related dementia Ambulatory Care Area Assessment tool Caregiver support Caregivers Caring Clinical Collaborations Communication Communities Data Data Collection Dementia caregivers Deterioration Discipline of Nursing Doctor of Philosophy Elderly Electronic Health Record Electronics Eligibility Determination Evaluation Face Family Family Caregiver Feedback Focus Groups Fostering Funding Future Goals Grant Health Health Personnel Health system Healthcare Industry Home Home Care Services Home Health Care Agencies Hospitalization Hour Individual Infrastructure Institutionalization Intake Intervention Intervention Studies Interview Lead Learning Letters Link Measures Medical Medicare Mentors Mentorship Methods Modality Needs Assessment Notification Nursing Services Online Systems Outcome Pathway interactions Patient Care Patient risk Patients Persons Pilot Projects Policies Positioning Attribute Pragmatic clinical trial Process Provider Randomized Reporting Research Research Activity Research Personnel Resources Risk Running Sampling Schedule Scientist Self Assessment Self Efficacy Services Source Surveys Technology Testing Time Training Training Activity Visiting Nurse Work Workload Writing aging in place beneficiary care outcomes care recipients career career development caregiving clinical care community based care community living cost dementia care demographics design effective intervention empowerment experience family support health care quality health care referral health care settings human centered design improved informant innovation intervention refinement meetings multidisciplinary nonalzheimer dementia nursing skill online care patient home care pilot test portability prototype satisfaction skills stakeholder perspectives technology platform therapy design treatment as usual

项目摘要

PROJECT SUMMARY/ABSTRACT Through Medicare-funded skilled home health care (HH), community-living older adults may receive skilled nursing, therapy, and aide services in their home. HH is a crucial source of care for older adults with Alzheimer's Disease and Related Dementias (ADRD); 31% of the 3.4 million Medicare beneficiaries who access HH each year have ADRD. The majority (92%) of HH patients with ADRD require help from family and unpaid caregivers to implement the HH plan of care. Yet, caregiver needs are not systematically assessed during HH and they frequently face unmet training/support needs. Unmet caregiver needs contribute to increased costs, decreased patient/family satisfaction, and higher patient risk for hospitalization and institutionalization during HH. The proposed K01 will develop, refine, and pilot test an ADRD caregiver needs assessment intervention for HH: DECLARE (Dementia Caregivers' Link to Assistance and Resources). DECLARE will harness a web-based survey platform to elicit information from ADRD caregivers about their availability, capabilities, and needs at the time of HH admission. This data will then populate in the HH patient record along with suggested next steps for HH staff. Specific Aims include: (1) Develop an ADRD caregiver self-assessment intervention (DECLARE) prototype; (2) Iteratively refine the intervention (DECLARE) in partnership with key stakeholders; (3) Implement and pilot test DECLARE via an embedded Pragmatic Clinical Trial, evaluating for feasibility, acceptability, and impact on HH care team/caregiver communication and support. Aims will be pursued in partnership with Visiting Nurse Service of New Yok (VNSNY), the largest non-profit HH provider in the nation. Findings will support a planned R01 to test DECLARE's impact on patient clinical outcomes and caregiver self-efficacy and burden. Dr. Julia Burgdorf, PhD, is a Research Scientist at the Center for Home Care Policy & Research at VNSNY. She is ideally positioned to lead the proposed research as an expert in family caregiver involvement in HH care and an embedded researcher at VNSNY. Her career goal is to improve home- and community-based care for older adults by developing pragmatic clinical interventions that facilitate provider-led engagement and support of family caregivers, with a focus on caregivers for individuals with ADRD. To achieve this goal, Dr. Burgdorf will pursue targeted mentorship and training in 5 key areas during the K01: (1) consumer-facing technologies for clinical innovation in HH, (2) human-centered design, (3) intervention evaluation and embedded Pragmatic Clinical Trials, (4) ADRD research, and (5) independent grant writing. She has assembled an interdisciplinary mentoring and advisory team whose complementary research expertise and experience mentoring early career investigators will provide invaluable support and guidance, while fostering her ongoing collaborations with academic research settings and a major learning health system. This K01 would provide Dr. Burgdorf with the necessary time and learning experiences to transition to an independent investigator equipped to lead impactful interventional research improving provider/caregiver collaboration and care outcomes in the HH setting.

项目概要/摘要通过 Medicare 资助的熟练家庭医疗保健 (HH)，社区生活的老年人可以获得熟练的在家中提供护理、治疗和辅助服务。 HH 是老年痴呆症患者的重要护理来源疾病和相关痴呆症（ADRD）； 340 万 Medicare 受益人中的 31% 分别获得 HH 年有ADRD。大多数 (92%) 患有 ADRD 的 HH 患者需要家人和无偿护理人员的帮助实施 HH 护理计划。然而，在 HH 期间并没有系统地评估护理人员的需求，他们经常面临未满足的培训/支持需求。未满足的护理人员需求导致成本增加、减少患者/家属满意度以及 HH 期间患者住院和住院治疗的风险较高。这拟议的 K01 将为 HH 开发、完善和试点测试 ADRD 护理人员需求评估干预措施： DECLARE（痴呆症护理人员的援助和资源链接）。 DECLARE 将利用基于网络的调查平台，从 ADRD 护理人员那里获取有关他们的可用性、能力和需求的信息 HH 入院时间。然后，该数据将连同建议的后续步骤一起填充到 HH 患者记录中 HH 工作人员。具体目标包括： (1) 制定 ADRD 护理人员自我评估干预措施（DECLARE）原型; (2) 与主要利益相关者合作，迭代完善干预措施（DECLARE）；（三）实施通过嵌入的实用临床试验进行试点测试 DECLARE，评估可行性、可接受性和对 HH 护理团队/护理人员沟通和支持的影响。将与来访者合作实现目标纽约护士服务中心 (VNSNY)，美国最大的非盈利 HH 提供商。调查结果将支持计划 R01 测试 DECLARE 对患者临床结果以及护理人员自我效能和负担的影响。 Julia Burgdorf 博士是 VNSNY 家庭护理政策与研究中心的研究科学家。作为家庭护理人员参与 HH 护理方面的专家，她非常适合领导拟议的研究以及 VNSNY 的嵌入式研究员。她的职业目标是改善家庭和社区护理通过制定务实的临床干预措施来促进老年人的参与和支持家庭护理人员，重点关注 ADRD 患者的护理人员。为了实现这一目标，布格多夫博士将在 K01 期间，在 5 个关键领域寻求有针对性的指导和培训：(1) 面向消费者的技术 HH 的临床创新，(2) 以人为本的设计，(3) 干预评估和嵌入式实用主义临床试验，(4) ADRD 研究，以及 (5) 独立资助写作。她集结了跨学科的指导和咨询团队，其互补的研究专业知识和指导早期职业生涯的经验调查人员将提供宝贵的支持和指导，同时促进她与学术研究环境和主要的学习健康系统。这台 K01 将为 Burgdorf 博士提供必要的时间和学习经验，以过渡为独立调查员，有能力领导有影响力的调查员介入研究改善家庭环境中提供者/护理人员的合作和护理结果。

项目成果

期刊论文数量（1）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Variation in Home Healthcare Use by Dementia Status Among a National Cohort of Older Adults.

全国老年人群体中痴呆症状况对家庭医疗保健使用的变化。

DOI：
发表时间：
2024-03-01
期刊：
影响因子：
0
作者：
Burgdorf, Julia G;Ornstein, Katherine A;Liu, Bian;Leff, Bruce;Brody, Abraham A;McDonough, Catherine;Ritchie, Christine S
通讯作者：
Ritchie, Christine S