Assessing the influence of family care resources on care utilization and transitions for older adults with dementia

项目总结/摘要 患有阿尔茨海默病和相关痴呆症（ADRD）的老年人特别容易受到病毒的影响， 他们中的许多人患有合并症。尽管由于他们的局限性，需要频繁的动手护理， 身体和认知功能，家庭护理服务和机构护理服务有限， 疫情期间的挑战。家庭护理支持可减轻大流行对护理的不利影响 使用ADRD患者。然而，在家庭护理的可获得性方面， 这可能导致COVID-19的不平等后果。那些几乎没有家庭护理的人 (e.g.,没有配偶或附近没有成年子女）在大流行期间可能最脆弱，可能需要 尽管面临更大的健康风险，但仍依赖机构护理。大流行病还深刻影响了社会 和许多家庭的经济情况（例如，失业和家庭教育），因此， 老年ADRD患者的护理可用性。 尽管公共卫生迫切需要解决老年人未得到满足的护理需求，但人们对这些变化知之甚少。 在COVID-19大流行期间，家庭护理可用性及其对ADRD患者使用护理的影响。 为了解决证据方面的这一差距，从而为干预措施提供信息，以最大限度地减少 为了解ADRD患者及其家庭的流行情况，该研究的目的如下： 首先，该项目将确定家庭护理可用性的程度（例如，健康的配偶， 成年子女同住或居住在附近）缓和了COVID-19大流行对护理的影响 由ADRD患者接收。它还将评估大流行对护理利用的影响的差异 ADRD患者在人口和社会经济群体中的分布。它将使用具有全国代表性的 纵向研究，以检查ADRD患者随时间推移接受的护理变化-包括 大流行前和大流行期间。这些研究中新增加的关于COVID-19的调查问题也将 考察 第二，它将评估COVID-19大流行对家庭护理可用性的影响程度， 因此，改变了每个家庭成员的照顾角色和家庭成员之间的照顾分配。到 了解家庭在应对疫情期间各种挑战的同时， 使用混合方法。 拟定的目标在母研究（K 01 AG 057820）的范围内，因为它们阿塞塞了影响 2019冠状病毒病大流行对家庭护理可用性及其对ADRD老年人及其 家庭护理人员。研究结果将为公共卫生干预措施和政策提供信息，以减轻不良影响。 在患有ADRD的老年人中确定弱势群体， 家人 1

PROJECT SUMMARY/ABSTRACT Older adults with Alzheimer’s Disease and Related Dementias (ADRD) are especially vulnerable to the virus as many of them have comorbidities. Despite the need of frequent hands-on care due to their limitations in physical and cognitive functioning, home care services and institutional care services are limited and challenging during the pandemic. Family care support may mitigate the adverse effect of the pandemic on care utilization of persons with ADRD. However, there is substantial variation in family care availability across populations which may result in unequal consequences of COVID-19. Those with little family care availability (e.g., no spouse or no adult child nearby) are likely to be most vulnerable during the pandemic and may need to rely on institutional care despite the greater health risk. The pandemic has also profoundly impacted the social and economic circumstances of many families (e.g., job loss and home schooling) and consequently, on their care availability for older adults with ADRD. Despite an urgent public health need to address unmet care need for older adults, little is known about changes in family care availability and its influence on care use by persons with ADRD during the COVID-19 pandemic. To address this gap in evidence and hence inform interventions to minimize the adverse consequences of the pandemic on persons with ADRD and their families, the study has the following aims: First, the project will determine the extent to which family care availability (e.g., presence of healthy spouse, presence of adult children coresident or living nearby) moderates the influence of COVID-19 pandemic on care received by persons with ADRD. It will also assess differences in the impact of the pandemic on care utilization by persons with ADRD across demographic and socioeconomic groups. It will use nationally representative longitudinal studies to examine changes in care received by persons with ADRD over time -- including both the pre-pandemic and pandemic period. Newly added survey questions on COVID-19 to these studies will be also examined. Second, it will assess the extent to which COVID-19 pandemic affected family care availability for a person with ADRD and hence changed the care role of each family member and care allocations among family members. To understand family dynamics in caregiving while responding to various challenges during the pandemic, we will use a mixed-methods approach. The proposed aims are within the scope of the parent study (K01AG057820) since they assesse the implications of COVID-19 pandemic for family care availability and its consequences for older persons with ADRD and their family caregivers. Results from the study will inform public health interventions and policy to mitigate adverse consequences of the pandemic and identify vulnerable population groups among older persons with ADRD and their families. 1