Developing and evaluating new measures of family availability to provide care to people with dementia

制定和评估家庭可用性的新衡量标准，为痴呆症患者提供护理

• 批准号: 10728725
• 负责人: HwaJung Choi
• 金额: $ 192.87万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10728725
• 关键词: Address; Admission activity; Adult Children; Affect; Aging; Alzheimer' s disease related dementia; Area; Biological; Birth; Black Populations; Caring; Categories; Child; Child Care; Data; Dementia; Demographic Factors; Development; Disparity; Elderly; Employment; Ethnic Origin; Ethnic Population; Family; Family member; Frequencies; Future; Geographic Factor; Health; Health Care Costs; Health Policy; Health Status; Health care facility; Healthcare; Healthcare Systems; Hispanic Populations; Long-Term Care; Measurement; Measures; Methods; Nature; Pathway Analysis; Patients; Persons; Play; Population; Publishing; Race; Research; Research Methodology; Resources; Role; Rural; Siblings; Social Network; Socioeconomic Status; Spouses; Surveys; Variant; Vulnerable Populations; aging population; care costs; care systems; cohort; contextual factors; dementia care; disability; family influence; grandchild; health care disparity; health care service utilization; indexing; low socioeconomic status; novel; outreach; patient home care; programs; research study; rural area; socioeconomics; trend

PROJECT SUMMARY/ABSTRACT The number of people with Alzheimer’s disease and related dementias (ADRD) in the US will increase substantially, imposing a tremendous burden on patients, families, and the healthcare system. To inform the discussion of developing a sustainable and effective care system for people with ADRD, a better understanding of family care availability is critically important because it profoundly impacts care utilization and care costs at the onset and over the course of ADRD. The family care network/dynamics may have become more complicated in recent decades with increasing step relationships. Despite recent studies identifying important factors that influence family care availability, there is no published measure to assess the care availability encompassing a broad family context using national data. Although the nature of family networks has changed considerably, there is little empirical evidence on trends in family availability in view of caring for people with ADRD. The proposed study will address these important agendas with the following aims: First, the study will measure family care availability (FCA) for people with ADRD by capitalizing on family data from a nationally representative study of older adults. We will determine the extent to which family contextual factors (e.g., residential proximity, health status, relationship, and competing demands) influence the level and type of care provided for people living with ADRD. We will create multiple sub-indices of FCA specific to a relationship category (e.g., spouse, siblings, adult children, grandchildren) and develop a composite score of FCA. Second, it will determine the extent to which FCA predicts paid and unpaid care services used by people living with ADRD. We will measure FCA prior to the onset of ADRD and its potential impacts on care use and care transitions at the onset and during the subsequent years of ADRD. Third, the study will assess the variation in FCA across demographic (e.g., race/ethnicity) and socioeconomic groups, and birth cohorts. We will also examine the differential effects of FCA on healthcare interacting with other care resources (e.g., financial and care facilities) and assess variation across populations. By leveraging the preliminary data from a mixed methods research by the study team, the proposed research will characterize the broad range of family factors influencing the care availability and provision for people with ADRD. The study will, therefore, significantly advance the measurement of family care resources and inform future surveys on health and aging. Using the novel family availability measure, it will also help identify a vulnerable population lacking family care resources and predict care use and transitions over the course of ADRD. 1

项目总结/摘要 美国阿尔茨海默病和相关痴呆症（ADRD）患者的数量将增加 这对患者、家庭和医疗系统造成了巨大的负担。到 为ADRD患者制定可持续和有效的护理系统的讨论提供信息， 更好地了解家庭护理的可用性至关重要，因为它深刻地影响着 在ADRD发病时和病程中的护理利用率和护理费用。家庭照顾 近几十年来，网络/动力学可能变得更加复杂， 关系。尽管最近的研究确定了影响家庭护理的重要因素， 没有公布的措施来评估包括大家庭在内的护理服务的提供情况。 使用国家数据。虽然家庭网络的性质发生了很大变化， 从照顾ADRD患者的角度来看，关于家庭可用性趋势的经验证据很少。的 拟议的研究将处理这些重要议程，目标如下： 首先，该研究将通过以下方式衡量ADRD患者的家庭护理可用性（FCA）： 来自一项全国性的老年人代表性研究的家庭数据。我们将确定 哪些家庭背景因素（例如，居住邻近度、健康状况、关系和竞争 需求）影响为ADRD患者提供的护理水平和类型。我们将创建 特定于关系类别的FCA的多个子索引（例如，配偶，兄弟姐妹，成年子女， 孙子），并制定FCA的综合评分。其次，它将决定 FCA预测ADRD患者使用的有偿和无偿护理服务。我们将测量FCA 在ADRD发作前及其对发作时的护理使用和护理过渡的潜在影响， 在随后的几年里，ADRD。第三，该研究将评估FCA的变化， 人口统计学（例如，种族/民族）和社会经济群体以及出生队列。我们亦会研究 FCA对与其他护理资源相互作用的医疗保健的不同影响（例如，金融和 护理设施），并评估人群之间的差异。 通过利用研究小组混合方法研究的初步数据， 拟议的研究将描述影响护理可用性的广泛家庭因素 为有精神障碍的人提供帮助。因此，这项研究将大大推进测量 家庭护理资源，并为未来的健康和老龄化调查提供信息。利用小说中的家庭 这也将有助于确定缺乏家庭护理资源的弱势群体， 预测ADRD过程中的护理使用和过渡。 1