Most older adults will develop one or more chronic illnesses with which they may live for years, often with symptom distress and progressive functional dependence. There is now abundant evidence that the quality of life during these advanced stages of disease is poor. The goal of this OAIC is to establish a research program focused on the relationship of pain and other symptoms to independence and function in older people with serious illness. The OAIC is built from a foundation of grants totaling $34.4 million started by the Center's principals in the late 1990s. These grants have spawned an additional 42 grants totaling $18.8 million supporting research, career development, and infrastructure. In this proposal, we expand this research foundation through strengthened collaborations with colleagues in Psychiatry, Medicine, Orthopedics and at the Hebrew Home for the Aged, among others. These collaborations are the source for new research projects and junior faculty with interests in geriatrics and palliative care. Three of the OAIC cores will be led by individuals who have devoted their careers to geriatrics, a fourth is led by an expert in clinical trials methods who is CAQ'ed in geriatrics, and the fifth is led by a senior gerontologist. The OAIC will recruit and train academic leaders, and it will support pilot and exploratory studies. It will also establish 2 research cores (research design and analysis, measurement and data management) that will apply innovative methods not currently in widespread use in aging research but that are highly applicable to aging. The Center will bring together a) leadership by senior geriatricians who are long-standing colleagues with a shared track record of successful research and training program building;b) senior faculty with a substantial body of research contributions;and c) promising junior investigators. Our Center's theme has its roots in the deepest traditions of medicine: attention to the primacy of the relief of suffering. Ancient though this priority may be, medical research in general, and geriatric research in particular, are poised to bring modern techniques and knowledge to what is in fact a new area of focus for the OAIC program - the effective amelioration of pain and other symptoms to improve function and promote independence in older adults. The proposed Center will bridge geriatrics and palliative care and serve as a model for a new focused area of research within geriatrics.
Substantial data suggest that the care of older adults living with serious illness is in need of improvement. The proposed OAIC would establish a sustainable infrastructure to support the development of new investigators in geriatric palliative care research, support research in geriatric palliative care, and develop or adapt instruments, designs, and analytic methods necessary to improve care for seriously ill older adults.
|Xie, Kira; Gelfman, Laura; Horton, Jay R et al. (2016) State of Research on Palliative Care in Heart Failure as Evidenced by Published Literature, Conference Proceedings and NIH Funding. J Card Fail :|
|May, Peter; Garrido, Melissa M; Cassel, J Brian et al. (2016) Palliative Care Teams' Cost-Saving Effect Is Larger For Cancer Patients With Higher Numbers Of Comorbidities. Health Aff (Millwood) 35:44-53|
|Morrison, R Sean; Dickman, Eitan; Hwang, Ula et al. (2016) Regional Nerve Blocks Improve Pain and Functional Outcomes in Hip Fracture: A Randomized Controlled Trial. J Am Geriatr Soc 64:2433-2439|
|May, Peter; Garrido, Melissa M; Cassel, J Brian et al. (2016) Using Length of Stay to Control for Unobserved Heterogeneity When Estimating Treatment Effect on Hospital Costs with Observational Data: Issues of Reliability, Robustness, and Usefulness. Health Serv Res 51:2020-43|
|Boockvar, Kenneth S; Teresi, Jeanne A; Inouye, Sharon K (2016) Preliminary Data: An Adapted Hospital Elder Life Program to Prevent Delirium and Reduce Complications of Acute Illness in Long-Term Care Delivered by Certified Nursing Assistants. J Am Geriatr Soc 64:1108-13|
|Dumanovsky, Tamara; Augustin, Rachel; Rogers, Maggie et al. (2016) The Growth of Palliative Care in U.S. Hospitals: A Status Report. J Palliat Med 19:8-15|
|Kelley, Amy S; Morrison, R Sean (2015) Palliative Care for the Seriously Ill. N Engl J Med 373:747-55|
|Badr, Hoda; Smith, Cardinale B; Goldstein, Nathan E et al. (2015) Dyadic psychosocial intervention for advanced lung cancer patients and their family caregivers: results of a randomized pilot trial. Cancer 121:150-8|
|Zhu, Carolyn W; Scarmeas, Nikolaos; Ornstein, Katherine et al. (2015) Health-care use and cost in dementia caregivers: Longitudinal results from the Predictors Caregiver Study. Alzheimers Dement 11:444-54|
|Garrido, Melissa M; Balboni, Tracy A; Maciejewski, Paul K et al. (2015) Quality of Life and Cost of Care at the End of Life: The Role of Advance Directives. J Pain Symptom Manage 49:828-35|
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