Assessing the influence of family care resources on care utilization and transitions for older adults with dementia

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PROJECT SUMMARY/ABSTRACT Older adults with Alzheimer’s Disease and Related Dementias (ADRD) are especially vulnerable to the virus as many of them have comorbidities. Despite the need of frequent hands-on care due to their limitations in physical and cognitive functioning, home care services and institutional care services are limited and challenging during the pandemic. Family care support may mitigate the adverse effect of the pandemic on care utilization of persons with ADRD. However, there is substantial variation in family care availability across populations which may result in unequal consequences of COVID-19. Those with little family care availability (e.g., no spouse or no adult child nearby) are likely to be most vulnerable during the pandemic and may need to rely on institutional care despite the greater health risk. The pandemic has also profoundly impacted the social and economic circumstances of many families (e.g., job loss and home schooling) and consequently, on their care availability for older adults with ADRD. Despite an urgent public health need to address unmet care need for older adults, little is known about changes in family care availability and its influence on care use by persons with ADRD during the COVID-19 pandemic. To address this gap in evidence and hence inform interventions to minimize the adverse consequences of the pandemic on persons with ADRD and their families, the study has the following aims: First, the project will determine the extent to which family care availability (e.g., presence of healthy spouse, presence of adult children coresident or living nearby) moderates the influence of COVID-19 pandemic on care received by persons with ADRD. It will also assess differences in the impact of the pandemic on care utilization by persons with ADRD across demographic and socioeconomic groups. It will use nationally representative longitudinal studies to examine changes in care received by persons with ADRD over time -- including both the pre-pandemic and pandemic period. Newly added survey questions on COVID-19 to these studies will be also examined. Second, it will assess the extent to which COVID-19 pandemic affected family care availability for a person with ADRD and hence changed the care role of each family member and care allocations among family members. To understand family dynamics in caregiving while responding to various challenges during the pandemic, we will use a mixed-methods approach. The proposed aims are within the scope of the parent study (K01AG057820) since they assesse the implications of COVID-19 pandemic for family care availability and its consequences for older persons with ADRD and their family caregivers. Results from the study will inform public health interventions and policy to mitigate adverse consequences of the pandemic and identify vulnerable population groups among older persons with ADRD and their families. 1