Enhanced Dementia Instruction and Tool in Home Hospice Care (EDITH-HC)

项目摘要/摘要 这项K99/R00应用的长期目标是发展伊丽莎白·卢斯博士的能力 旨在减轻照顾者负担和改善阿尔茨海默病患者护理的研究 相关痴呆症(ADRD)接近生命尽头。在K99阶段，拟议的项目支持Luth博士 四个培训目标，使她能够发展并过渡为一名独立调查员， 文化包容、实用和可扩展的解决方案，以改善痴呆症患者的临终关怀。第一, 她将扩展她在核心实质性领域的知识，包括临终关怀、痴呆症护理和 招聘和留用。其次，她将学习制定、实施和传播行为 干预措施，重点是临床护理环境、劳动力培训和与社区的合作 合伙人。第三，她将学习如何为ADRD患者和护理人员设计和进行临床试验。 最后，对于第四个培训目标，卢斯博士将寻求职业发展机会，特别是 在赠款编写和合作领域。本申请的四个研究目标将进行如下 下面是。目标1将确定在照顾未充分研究的人群方面的共同挑战、战略和差距； 也就是说，居住在社区的痴呆症患者在生命即将结束时。这个目标是通过以下途径实现的 采访和调查非裔美国人和白人家庭照顾者和临终关怀临床医生。AIM 2用途 关键利益相关者(家庭护理人员、临床医生、专家)反馈以适应痴呆症为重点的培训材料 并为家庭临终关怀临床医生开发解决问题的工具，以改善护理结果。AIM 3考试 培训和工具的可行性和可接受性，并基于迭代反馈对其进行修订 与家庭照顾者和临床医生进行沟通。目标4确定培训方案的初步效果 和工具，以提高临床医生对家庭临终关怀中与痴呆症相关的挑战的了解，减少家庭 通过试点随机对照试验(RCT)，减少照顾者负担，并减少临终关怀取消登记。这个 拟议的研究旨在通过让非洲人参与来缩小差距和实现卫生公平 美国个人在所有阶段的信息收集和干预开发和测试。这个 拟议的项目符合NIA的使命，即进行关于衰老的行为研究，并促进 研究人员在老龄化中的发展。它也与NIA发展的战略目标保持一致 旨在解决阿尔茨海默氏症和改善不同人群中老年人健康的干预措施。Dr。 卢斯建议追求这些发展目标，并在 威尔康奈尔医学院的医学系和老年医学和姑息医学部， 提供理想的研究支持和资源环境，帮助她完成培训和研究 目标。

PROJECT SUMMARY/ABSTRACT The long-term objective of this K99/R00 application is to develop Dr. Elizabeth Luth’s capacity to conduct studies aimed at reducing caregiver burden and improving care for patients with Alzheimer’s Disease and related dementias (ADRD) nearing the end of life. In the K99 phase, the proposed project supports Dr. Luth in four training objectives that will allow her to develop and transition to an independent investigator who creates culturally inclusive, practical, and scalable solutions to improve end-of-life care for patients with dementia. First, she will extend her knowledge in core substantive areas including hospice care, dementia caregiving, and recruitment and retention. Second, she will learn to develop, implement, and disseminate behavioral interventions with an emphasis on clinical care settings, workforce training, and collaboration with community partners. Third, she will learn how to design and conduct clinical trials for ADRD patients and caregivers. Finally, for the fourth training objective, Dr. Luth will pursue professional development opportunities, specifically in the areas of grant writing and collaboration. The four research aims of this application will proceed as follows. Aim 1 will identify common challenges, strategies, and gaps in care for an understudied population; that is, community-dwelling patients with dementia near the end of life. This aim is achieved through interviewing and surveying African American and white family caregivers and hospice clinicians. Aim 2 uses key stakeholder (family caregivers, clinicians, experts) feedback to adapt dementia-focused training materials and to develop a problem solving tool for home hospice clinicians to improve care outcomes. Aim 3 examines the feasibility and acceptability of the training and tool and revises them based on an iterative feedback process with family caregivers and clinicians. Aim 4 determines the preliminary efficacy of the training program and tool to improve clinicians’ knowledge of dementia-related challenges in home hospice care, reduce family caregiver burden, and reduce hospice disenrollment through a pilot randomized controlled trial (RCT). The proposed research works towards reducing disparities and achieving health equity by involving African American individuals in all stages of information gathering and intervention development and testing. The proposed project is consistent with the NIA’s mission to conduct behavioral research on aging and foster the development of research scientists in aging. It is also aligned with the NIA’s strategic goals of developing interventions to address Alzheimer’s Disease and improve the health of older adults in diverse populations. Dr. Luth proposes to pursue these development goals and begin the proposed research with the support of the Department of Medicine and Division of Geriatrics and Palliative Medicine at Weill Cornell Medicine, which provide an ideal environment of research support and resources to help her achieve her training and research goals.