Developing a Screening Protocol for Family Caregivers of Older Persons with and without Dementia Seen in Primary Care

项目摘要 在美国，近800万老年人依靠家庭和其他无偿照顾者（邻居; 朋友），以帮助他们的健康护理。这些护理人员共同提供了总护理的75-80% 为社区居住的老年人提供24小时的服务，并填补医疗保健系统的多个空白： 访问，协调护理，并协助治疗方案。援助的提供和充分性 家庭和无报酬照顾者提供的保健服务对保健费用和保健质量有直接影响， 老年人然而，在卫生保健提供系统中没有系统地确定护理人员， 需求没有得到常规评估。初级保健做法是很好的定位，以帮助确定和 满足有风险的家庭照顾者的需要，特别是那些患有与自杀有关的疾病的人的需要， 强调或有培训或支持的需求未得到满足-通过系统的筛选和转诊。这个目标 该项目的目的是制定、实施和试点测试一个针对家庭照顾者的筛查-转诊系统， 陪同老年人进行初级保健访问，明确考虑痴呆症的不同需求 和非痴呆症护理人员。目标1将进行有史以来第一次全国范围的调查， 美国初级保健提供者（医生、护士、社会工作者、医生助理）的做法 在乎目标2-4将利用与三个初级保健实践的伙伴关系，为不同的患者群体提供服务 让关键利益相关者（护理人员、患者和医疗保健专业人员）参与制定、完善和 对筛查-转诊协议进行试点测试。凯瑟琳·里芬博士是理想的位置，带头这一行的 她在应用老年学方面的学术背景， 家庭关系和健康。她的长期目标是领导一个社会科学研究项目， 在现实世界中为家庭照顾者设计、评估和传播循证干预措施。 为了实现这一目标，Riffin博士将在K 01期间在四个关键领域进行额外的培训和指导 奖励期间：实施科学，医疗保健政策制定，干预研究和独立赠款 写作和专业发展。职业发展活动将包括正式的课程，应用 学习和研究机会，以及家庭领域领先专家的持续指导 卫生服务研究和应用研究方法。瑞芬医生已经组建了一个强大的， 多学科的导师和顾问团队，在家庭护理，临床试验设计， 医疗保健政策和实施科学，并在指导初级研究人员方面拥有丰富的经验 走向独立如果获得资助，该奖项将为瑞芬博士提供密集的培训，研究经验， 和导师需要启动她的职业生涯作为一个成功的独立调查员。

PROJECT SUMMARY In the United States, nearly 8 million older adults rely on family and other unpaid caregivers (neighbors; friends) for assistance with their health care. These caregivers collectively provide 75-80% of the total care hours to community-dwelling older persons, and fill multiple gaps in the health care system: attending doctor's visits, coordinating care, and assisting with treatment regimens. The availability and adequacy of assistance provided by family and unpaid caregivers has direct implications for health care costs and quality of care of older adults. Yet, caregivers are not systematically identified in health care delivery systems, and their abilities and needs are not routinely assessed. Primary care practices are well positioned to aid in identifying and addressing the needs of at-risk family caregivers – in particular, persons who suffer from caregiving-related stress or have unmet needs for training or support – through systematic screening and referral. The goal of this project is to develop, implement, and pilot test a screening-referral system for family caregivers who accompany older adults to their primary care visits, with explicit consideration of the distinct needs of dementia and non-dementia caregivers. Aim 1 will conduct the first ever nationwide survey of caregiver screening practices among US providers (physicians, nurses, social workers, physician assistants) working in primary care. Aims 2-4 will leverage partnerships with three primary care practices serving diverse patient populations to engage key stakeholders (caregivers, patients, and health care professionals) in developing, refining, and pilot testing the screening-referral protocol. Catherine Riffin, PhD is ideally situated to spearhead this line of research given her academic background in applied gerontology, and productive track-record of research on family relationships and health. Her long-term goal is to lead a program of social scientific research that designs, evaluates and disseminates evidence-based interventions for family caregivers in real-world contexts. To achieve this goal, Dr. Riffin will pursue additional training and mentorship in four key areas during the K01 award period: implementation science, healthcare policy-making, intervention research, and independent grant writing and professional development. Career development activities will consist of formal coursework, applied learning and research opportunities, and ongoing mentorship from leading experts in the fields of family caregiving, health services research, and applied research methods. Dr. Riffin has assembled a strong, multidisciplinary team of mentors and advisors with expertise in family caregiving, clinical trial design, healthcare policy, and implementation science, and with extensive experience in mentoring junior researchers to independence. If funded, this award will provide Dr. Riffin with the intensive training, research experience, and mentorship needed to launch her career as a successful independent investigator.