Accessible Hearing Care for Reduction of Disruptive Behaviors and Caregiver Burden in Dementia

摘要 博士Carrie Nieman将加入耳鼻咽喉头颈外科系， 约翰霍普金斯医学院，在那里她将致力于她的听力损失和耳科临床实践。 她寻求这个指导职业发展奖，以填补她在护理培训的知识空白， 老年阿尔茨海默病患者听力损失和交流障碍的研究 相关性痴呆（ADRD）她的长期目标是建立一个独立的研究计划， 为痴呆症患者提供社区听力护理。候选人提出了一个全面的 培训计划，其中包括教学课程，实践经验，积极参与研讨会， 研讨会，以及由跨学科导师团队监督的专门会议和教程。培训 计划沉浸在约翰霍普金斯丰富的跨学科研究和临床环境尼曼博士 阿尔茨海默病研究中心，记忆和阿尔茨海默病治疗中心，约翰霍普金斯 老龄化和健康中心，以及Gallaudet大学和研究和教育中心， 老化和技术改进。具体培训目标包括：（1）接受认知老化方面的培训， 老年ADRD患者的神经心理学和临床评估和管理，（2）完成 混合方法的培训，并将技能应用于拟议的研究，（3）整合人为因素的方法， 听力保健，（4）将课程纳入试验设计和分析以及干预的先进技术 研究，以及（5）继续进行负责任的研究行为的培训，重点是弱势群体。 本研究的具体目标是：（1）在不同的听力损失和听力保健中， 社区居住的老年人认知障碍队列，以告知发展 综合沟通干预，（2）通过社区参与的方法，制定一个理论驱动， 以用户为中心的沟通干预，整合了低成本的非处方听力技术， (3)评估一个家庭传递的通信的可行性、可接受性和初步效果 通过随机对照试验进行干预。研究招募、保留和执行将 与约翰霍普金斯阿尔茨海默病研究中心合作进行，该中心是 阿尔茨海默氏症协会和马里兰州艺术学院社会设计中心。完成 拟议的研究将建立负担得起的，可获得的听力护理作为一种低风险，低成本的 减少痴呆症患者破坏性行为和照顾者负担的方法及其 照顾者在这个奖项结束时，候选人将获得的技能，知识， 初步数据，以成功地竞争独立的资金，并最终告知发展 新的听力保健模式，扩大获得沟通和参与所需的工具。

ABSTRACT Dr. Carrie Nieman will be joining the faculty in the Department of Otolaryngology-Head & Neck Surgery at the Johns Hopkins School of Medicine, where she will dedicate her clinical practice to hearing loss and otology. She seeks this Mentored Career Development Award to fill knowledge gaps in her training in the care and study of hearing loss and communication impairments among older adults with Alzheimer’s disease and related dementias (ADRD). Her long-term goal is to establish an independent research program devoted to community-delivered hearing care for persons with dementia. The candidate proposes a comprehensive training plan that incorporates didactic coursework, hands-on experiences, active participation in seminars and workshops, and dedicated meetings and tutorials overseen by a transdisciplinary mentor team. The training plan immerses Dr. Nieman in the rich interdisciplinary research and clinical environments of the Johns Hopkins Alzheimer’s Disease Research Center, the Memory and Alzheimer’s Treatment Center, the Johns Hopkins Center on Aging and Health, as well as Gallaudet University and the Center for Research and Education on Aging and Technology Enhancement. Specific training goals include: (1) receive training in cognitive aging and the neuropsychological and clinical assessment and management of older adults with ADRD, (2) complete training in mixed methods and apply skills to the proposed study, (3) integrate a human factors approach to hearing care, (4) incorporate coursework in trial design and analysis and advanced techniques in intervention research, and (5) continue training in responsible research conduct, with emphasis on vulnerable populations. The specific aims of the proposed research are to: (1) characterize hearing loss and hearing care in a diverse cohort of community-dwelling older adults with cognitive impairment to inform the development of a comprehensive communication intervention, (2) develop, via a community-engaged approach, a theory-driven, user-centered communication intervention that integrates low-cost, over-the-counter hearing technology, and (3) assess the feasibility, acceptability, and preliminary efficacy of a home-delivered communication intervention through a randomized controlled pilot study. Study recruitment, retention, and execution will be conducted in partnership with the Johns Hopkins Alzheimer’s Disease Research Center, the local chapter of the Alzheimer’s Association, and the Maryland Institute College of Art Center for Social Design. Completion of the proposed research will establish the potential for affordable, accessible hearing care as a low-risk, low-cost approach to reduction of disruptive behaviors and caregiver burden among persons with dementia and their caregivers. At the conclusion of this award, the candidate will have obtained the skills, knowledge, and preliminary data to successfully compete for independent funding and, ultimately, inform the development of new models of hearing care that expand access to the tools necessary for communication and engagement.