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

促进患有阿尔茨海默病和相关痴呆症的疗养院居民的“美好生活”：特殊护理单位的作用

• 批准号: 10669572
• 负责人: Jessica Trimmer
• 金额: $ 8.39万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10669572
• 关键词: Address; Adult; Age; Alzheimer' s Disease; Alzheimer' s disease diagnosis; Alzheimer' s disease related dementia; American; Area; Behavioral; Brain Diseases; Caregivers; Caring; Cessation of life; Characteristics; Clinical Trials Design; Collaborations; Community Healthcare; Competence; Complement; Complex; Comprehensive Health Care; Data; Diagnosis; Disease Progression; Educational process of instructing; Ensure; Environment; Family; Family Caregiver; Fellowship; Geographic Distribution; Geographic Locations; Geography; Goals; Grant; Health; Health Promotion; Health Services; Health Services Research; Home; Home Nursing Care; Hospitalization; Hospitals; Interview; Knowledge; Life; Literature; Location; Long-Term Care; Maryland; Medical; Mentorship; Methodology; Methods; Modeling; Neighborhoods; Nursing Homes; Nursing Models; Nursing Staff; Outcome; Ownership; Participant; Pathway interactions; Perception; Persons; Physical Restraint; Policy Maker; Population; Postdoctoral Fellow; Pragmatic clinical trial; Provider; Publications; Published Comment; Qualitative Methods; Quality of Care; Quality of life; Randomized Controlled Clinical Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Research; Research Personnel; Resources; Role; Sampling; Schools; Services; Social Work; Structure; Supervision; Symptoms; Time; Training; Translating; Translational Research; Universities; Well in self; Work; Writing; care delivery; career development; caregiving; decubitus ulcer; dementia care; deprivation; design; experience; health care availability; health care disparity; health care service utilization; human old age (65+); implementation science; improved; indexing; innovation; insight; member; novel; person centered; preference; prevent; programs; promote resilience; resilience; rurality; skills

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.

项目摘要/摘要 许多65岁以上的成年人患有阿尔茨海默氏病和相关痴呆症（ADRD），居住在护士住宅（NHS） 随着疾病的进展，接受先进的医疗和监督。然而，许多NHS都在挣扎 通过在ADRD向居民提供护理方面的最佳实践。 NH阿尔茨海默氏症的特殊护理单位（ASCUS） 在某些与更好的居民护理和结果有关的NHS中，这是一个潜在的有希望的功能。但是，我们 尚未了解这些单元的“特殊”以及相关的特征和护理实践 具有有益的结果和改善的生活质量。这种独立提案的途径将贡献 基本上是我们对如何确保在小说中确保ADRD居民中“美好生活”的理解， 结构化和证据的方法，确立候选人为卫生服务的新兴领导者 致力于为ADRD患者提供护理研究的研究。 AIM 1获得的数据 提案将提供ADRD，其家人和护士工作人员的居民的批判性第一手经验 该人群中生活质量和护理实践的提供者。这些发现将集成到 AIM 2中NH护理的证据信息“良好生活”模型，并在AIM 3中实施和评估。 但是严格的随机对照临床试验。这些目标与NIA的优先事项相结合，包括 与护理，长期支持和服务中的护理模式相关的挑战和伯恩斯， 医疗保健访问的差异，并在ADRD的患者中促进健康。共同获得知识 在此提案中，将告知随后的R01申请，以对“善良”进行更明确的检查 NH护理模型。发现也将对ADRD及其家人NHS的人，政策有影响 制造商和研究人员如何在长期护理社区中促进“美好生活”。促进这一点 候选人从独立的途径中建立了承诺 长期护理研究领先专家的识别团队，在NHS进行务实的临床试验， 定性和定量方法，并指导居民护理。重要的是，这些成员成功了 他们之间以及与候选人之间的当前和先前的合作，甚至在候选人的 论文委员会。除了创新的研究目的外，该建议还将进行严格的培训 和职业发展活动旨在补充和进一步的候选人在关键研究中的技能 领域：定性方法，务实的临床试验设计，翻译和实施科学，照料者 在NHS中遮蔽，以观察直接居民护理，赠款写作，教学和科学演讲以及 出版物。马里兰州大学社会工作学院很高兴支持该提议及所有相关的建议 候选人的活动。通往独立建议的途径是自然而必要的下一步 将候选人确立为独立的跨学科卫生服务研究人员和领导者致力于 为ADRD的人们确定，优化和传播最佳护理实践。