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

项目摘要/摘要 家长奖：这项申请寻求资金，以扩大国家研究所的研究目标 老龄化基金指导的以患者为导向的研究职业生涯奖，题为《塑造和优化 熟练护理设施(SNF)到家庭的过渡“(K23 AG058757)。这项K23家长奖旨在发展和 测试SNF到家庭护理过渡干预措施。我们正在申请额外的资金，使我们能够检查 这项干预措施在老年痴呆症患者中的可行性。 背景：SNF每年收治25万以上患有阿尔茨海默病和相关痴呆症的老年人 (ADRD)用于急性后护理。与没有ADRD的人相比，患有ADRD的SNF居民更有可能 SNF术后出院结果不佳。以社区为基础的干预措施，由护士、职业人员组成 治疗师和杂工(社区老龄化到位，为老年人提供更好的生活(有能力)) 通过解决老年人的功能目标来驾驭老年人动机的一揽子干预措施 成人优先考虑并修改家庭因素，以支持这些目标并提高家庭安全。虽然 能够减少功能损害、家庭危险和住院服务的使用 对于受损的老年人，它不包括经常住院或认知障碍的老年人。 最初目标：我们已调整为有能力作为新干预的基础-有能力 过渡，这发生在Medicare认证的家庭健康机构(CHHA)内，以帮助那些最近患有急性呼吸道疾病的人 医疗需要过渡回家。主要目标是进行可行性研究，以测试和改进 与以下相关的程序：1)参与者筛选、登记和保留；2)忠诚度和感知到的好处 干预，以及3)我们结果的数据完整性。次要目标是获得初步的 出院后3个月和6个月的家庭时间、生活质量和医疗服务使用情况的数据。这个 最初的设计没有解决患有ADRD的老年人及其照顾者的特殊需求。 扩大目标：从这一补充中获得额外资金将使我们能够审查能力的可行性 尤其是在ADRD患者及其照顾者之间的过渡。 更多的ADRD参与者：通过额外的资金，我们将为总共24人提供有能力的过渡 随着ADRD从SNF中退出，SNF是一个足够大的小组，以促进ADRD具体的可行性分析。 增强的创新：更多的ADRD参与者将使我们能够检查我们是否能够提供 对ADRD患者及其照顾者进行基于CHHA的多学科家庭干预。 影响增加：额外的资金将提供所需的资源，以审查有能力的过渡 在那些患有ADRD的人中进行可行性研究，并获得将有助于未来赠款的ADRD特有数据 应用程序(例如，R34、R01)，以测试有能力的转换的机制和有效性。

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.