Promoting the "Good Life" among Nursing Home Residents with Alzheimer's Disease and Related Dementias: The Role of Special Care Units

项目概要/摘要 许多65岁以上患有阿尔茨海默病和相关痴呆症（ADRD）的成年人住在疗养院（NHs） 接受先进的医疗护理和监督，随着疾病的进展。然而，许多NHS正在努力 与最佳实践提供照顾居民与ADRD。阿尔茨海默氏症特殊护理单位（ASCUs） 是一个潜在的有前途的功能，在一些国家卫生机构有关更好的居民护理和成果。但我们 还没有了解这些单位的“特殊”之处以及相关的特点和护理实践 带来有益的结果和生活质量的提高。这条独立之路将有助于 实质上是我们对如何确保小说中ADRD居民的“美好生活”的理解， 结构化和循证方法，将候选人确立为卫生服务领域的新兴领导者 致力于推进ADRD患者护理研究的研究。在目标1中获得的数据 一项提案将提供来自ADRD患者、他们的家人和护理人员的重要第一手经验 提供者对这一人群的生活质量和护理做法的影响。这些研究结果将被纳入一个 目标2中的NH护理循证“美好生活”模型，并在目标3中实施和评估， 但严格的随机对照临床试验这些目标与NIA的优先事项保持一致，包括 与生育有关的挑战和负担，长期支持和服务的护理模式， 卫生保健机会的不平等，促进ADRD患者的健康。总的来说， 将告知随后的R 01申请，以便对“货物”进行更明确的审查 生活”的护理模式。研究结果也将对ADRD患者及其家庭，NHS，政策产生影响 制造商和研究人员就如何促进“美好生活”在长期护理社区。推动这一 通往独立的道路，候选人已经建立了一个特殊的，高度成就的承诺， 由长期护理研究领域的领先专家组成的导师团队，在NHS中进行务实的临床试验， 定性和定量方法，以及直接住院治疗。重要的是，这些成员成功地 目前和以前的合作，他们之间和与候选人，一个甚至服务于候选人的 论文委员会。除了创新的研究目标，这项建议将追求严格的培训 和职业发展活动，旨在补充和进一步候选人的关键研究技能 领域：定性方法，实用的临床试验设计，转化和实施科学，护理人员 在NHs的阴影观察直接居民护理，赠款写作，教学和学术演讲， 出版物。马里兰州大学社会工作学院很高兴支持这一建议和所有相关的 候选人的活动。这条通往独立之路的建议是自然和必要的下一步， 建立候选人作为一个独立的跨学科卫生服务研究人员和领导者致力于 识别、优化和传播ADRD患者的最佳护理实践。

Project Summary/Abstract Many adults over age 65 with Alzheimer’s disease and related dementias (ADRD) reside in nursing homes (NHs) to receive advanced medical care and supervision as the diseases progress. Yet, numerous NHs are struggling with best practices in the delivery of care to residents with ADRD. NH Alzheimer’s special care units (ASCUs) are one potentially promising feature in some NHs related to better resident care and outcomes. However, we are yet to understand what is ‘special’ about these units and the characteristics and care practices associated with beneficial outcomes and improved quality of life. This Pathway to Independence proposal will contribute substantially to our understanding of how to ensure the “Good Life” among residents with ADRD in a novel, structured, and evidence-informed approach, establishing the candidate as an emerging leader in health services research committed to advancing research on care for persons with ADRD. The data obtained in Aim 1 of this proposal will provide critical first-hand experiences from residents with ADRD, their families, and nursing staff providers on quality of life and care practices among this population. These findings will be integrated into an evidence-informed “Good Life” model of NH care in Aim 2 and implemented and evaluated in Aim 3 in a small but rigorous randomized controlled clinical trial. These Aims are well-aligned with NIA priorities including challenges and burdens associated with caregiving, models of care in long-term supports and services, disparities in health care access, and promoting health in persons with ADRD. Collectively, knowledge gained in this proposal will inform a subsequent R01 application to conduct a more definitive examination of the “Good Life” model of NH care. Findings will also have implications for persons with ADRD and their families, NHs, policy makers, and researchers on how to promote the “Good Life” in long-term care communities. To promote this Pathway to Independence, the candidate has established commitment from an exceptional, highly accomplished mentorship team of leading experts in long-term care research, conducting pragmatic clinical trials in NHs, qualitative and quantitative methodology, and direct resident care. Importantly, these members have successful current and prior collaborations amongst themselves and with the candidate, one even serving on the candidate’s dissertation committee. In addition to the innovative research Aims, this proposal will pursue rigorous training and career development activities designed to complement and further the candidate’s skills in key research areas: qualitative methods, pragmatic clinical trial design, translational and implementation science, caregiver shadowing in NHs to observe direct resident care, grant writing, teaching, and scholarly presentations and publications. The University of Maryland, School of Social Work is pleased to support this proposal and all related activities for the candidate. This Pathway to Independence proposal is the natural and necessary next step to establish the candidate as an independent interdisciplinary health services researcher and leader committed to identifying, optimizing, and disseminating best care practices for persons living with ADRD.