K23 Study 3: A Feasibility Study of CAPABLE Transitions for Older Adults with ADRD

K23 研究 3：患有 ADRD 的老年人有能力过渡的可行性研究

• 批准号: 10117768
• 负责人: Adam C Simning
• 金额: $ 8.17万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-01 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10117768
• 关键词: Acute; Address; Administrative Supplement; Admission activity; Alzheimer' s Disease; Alzheimer' s disease related dementia; Applications Grants; Award; Back; Caregivers; Caring; Clinical; Clinical Trials; Communities; Data; Data Analyses; Dementia; Development; Elderly; Enrollment; Feasibility Studies; Fee-for-Service Plans; Foundations; Funding; Future; Goals; Grant; Health care facility; Home Health Agency; Home Health Care Agencies; Home environment; Hospitalization; Hospitals; Impaired cognition; Intervention; Literature; Medical; Medicare; Mentors; Motivation; National Institute on Aging; Nurses; Occupational Therapist; Outcome; Parents; Participant; Pilot Projects; Procedures; Quality of life; Randomized; Registered nurse; Research; Resources; Safety; Services; Skilled Nursing Facilities; Subgroup; Testing; Time; Vulnerable Populations; acute care; aging in place; base; beneficiary; career; community intervention; design; efficacy study; experience; functional disability; hazard; improved; innovation; inpatient service; multidisciplinary; novel; patient home care; patient oriented research; recruit; screening; therapy design

PROJECT SUMMARY/ABSTRACT Parent Award: This application seeks funding to expand the research objectives for the National Institute on Aging-funded Mentored Patient-Oriented Research Career Award, entitled: “Characterizing and Optimizing the Skilled Nursing Facility (SNF) to Home Transition” (K23 AG058757). This K23 parent award aims to develop and test an SNF-to-home care transitions intervention. We are requesting additional funds to enable us to examine the feasibility of this intervention among older adults with dementia. Background: Every year SNFs admit 250,000+ older adults with Alzheimer’s disease and related dementia (ADRD) for post-acute care. Compared to those without ADRD, SNF residents with ADRD are more likely to have poor post-SNF discharge outcomes. A community-based intervention consisting of a nurse, occupational therapist, and handyman (Community Aging in Place, Advancing Better Living for Elders (CAPABLE)) delivered a package of interventions to harness an older adult’s motivation by addressing functional goals that the older adult prioritizes as well as modifying home factors in support of these goals and to improve home safety. Although CAPABLE reduced functional impairment, home hazards, and use of inpatient services among functionally impaired older adults, it excluded older adults with frequent hospitalizations or cognitive impairment. Original Objectives: We have adapted CAPABLE to serve as a foundation for a new intervention – CAPABLE Transitions, which occurs within a Medicare-certified home health agency (CHHA) to help those with recent acute medical needs transition home. The primary objective is to conduct a feasibility study to test and refine procedures relating to: 1) Participant screening, enrollment, and retention, 2) fidelity to and perceived benefit of the intervention, and 3) data completeness for our outcomes. The secondary objective is to obtain preliminary data on home time, quality of life, and medical services use at 3 and 6 months following SNF discharge. The original design did not address the particular needs of older adults with ADRD and their caregivers. Expanded Objectives: Additional funds from this supplement will enable us examine the feasibility of CAPABLE Transitions specifically among those with ADRD and their caregivers. More ADRD Participants: With additional funds, we will provide CAPABLE Transitions to a total of 24 people with ADRD discharged from an SNF, a large enough subgroup to facilitate ADRD-specific feasibility analyses. Enhanced Innovation: More ADRD participants will allow us to examine whether we can deliver a multidisciplinary, CHHA-based in-home intervention to people with ADRD and their caregivers. Increased Impact: Additional funds will provide the resources needed to examine CAPABLE Transitions’ feasibility among those with ADRD and to obtain ADRD-specific data that would be instrumental for future grant applications (e.g., R34, R01) to test the mechanisms and efficacy of CAPABLE Transitions.

项目总结/摘要 家长奖：该申请旨在寻求资金，以扩大国家研究所的研究目标， 老龄化资助的指导以患者为导向的研究职业奖，题为：“表征和优化 熟练护理机构（SNF）到家庭过渡”（K23 AG 058757）。这个K23家长奖旨在发展和 测试SNF到家庭护理过渡干预。我们要求追加资金， 这种干预在老年痴呆症患者中的可行性。 背景：每年SNF都会接纳25万多名患有阿尔茨海默病和相关痴呆症的老年人 （ADRD）急性期后护理。与没有ADRD的人相比，患有ADRD的SNF居民更有可能 SNF后的出院结果不佳。一个以社区为基础的干预措施，包括一名护士， 治疗师和勤杂工（社区老龄化到位，促进老年人更好的生活（能力））交付 一套干预措施，通过解决老年人的功能目标来利用老年人的动机， 成年人优先考虑并修改家庭因素，以支持这些目标并改善家庭安全。虽然 CAPABLE减少了功能障碍、家庭危险和住院服务的使用， 在老年人中，它排除了经常住院或认知障碍的老年人。 最初目标：我们对“能力”进行了调整，以作为新干预措施的基础-“能力” 过渡期，发生在医疗保险认证的家庭健康机构（CHHA），以帮助那些最近急性 医疗需要过渡回家。主要目标是进行可行性研究，以测试和完善 与以下内容相关的程序：1）参与者筛选、入组和保留，2）忠实于 干预，以及3）我们结果的数据完整性。第二个目标是获得初步的 SNF出院后3个月和6个月的居家时间、生活质量和医疗服务使用数据。的 最初的设计没有解决ADRD老年人及其护理人员的特殊需求。 扩大的目标：来自该补充的额外资金将使我们能够研究能力的可行性 特别是ADRD患者及其护理人员之间的过渡。 更多ADRD参与者：有了额外的资金，我们将为总共24人提供有能力的过渡 ADRD从SNF出院，这是一个足够大的亚组，有助于ADRD特异性可行性分析。 增强创新：更多的ADRD参与者将使我们能够检查我们是否能够提供一个 对ADRD患者及其护理人员进行多学科、基于CHHA的家庭干预。 增加影响：额外的资金将提供所需的资源，以检查有能力的过渡， 在ADRD患者中的可行性，并获得ADRD特定数据，这将有助于未来的赠款 应用程序（例如，R34，R 01），以测试能力转换的机制和疗效。