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ARRA Investments in Geriatric Care Research

Public Health Burden
As people live longer, more complex approaches to care are needed to diagnose and treat diseases as well as preserve basic functions through the prevention of disabilities. Geriatric care is a medical specialty that addresses the comprehensive needs of older adults, taking place in community, ambulatory, acute, and long-term care settings. Members of an interdisciplinary geriatric care team can include doctors, nurses, direct care workers, therapists, pharmacists, and family members.

Improving the Quality of Patient Care
Aging can be accompanied by an increase in the number of medical conditions and treatments.  Ensuring that the right tools and knowledge are available for clinicians on the frontlines of patient care can result in positive patient outcomes and an enhanced quality of life.  ARRA-funded projects that support efforts to improve patient care for older adults include:
  • Developing “potentially optimized prescribing” (POP) algorithms to enhance prescribing practices by reducing the adverse effects of polypharmacy and providing therapeutic combinations that are more efficacious for patients with co-morbidities.  This algorithm will be validated by physicians and pharmacists.1
  • Evaluating the effectiveness of feeding tubes used by hospitals to improve the absorption of nutrients and reduce weight loss for older adults with dementia.2
  • Describing risk factors and long-term consequences of adverse medical events or medical injuries among older adults.3
  • Pilot testing and evaluating the effectiveness of a new protocol for patients coming to the emergency room after unexpected loss of consciousness (syncope) in order to reduce unnecessary diagnostic tests and hospitalizations. Syncope is a common reason for emergency department visits among older adults and can be symptomatic of a serious medical condition.4
  • Conducting an analysis of Medicare data to describe the role of hospitalists (physicians who devote all of their time to the care of hospitalized patients) to determine differences in patients outcomes compared to other types of clinicians.5
  • Pilot testing the use of a medication for elderly patients who are at increased risk for deterioration of brain function including delirium and cognitive impairment when they undergo anesthesia and non-cardiac surgery. 6
  • Defining the relationship between kidney disease, antiretroviral therapy, and cardiovascular disease among older adults who are HIV-positive. 7
Supporting Family Caregivers
Family caregivers are an integral component of geriatric care.  They enable older adults to be cared for in familiar settings and around familiar faces.  They can also serve as active advocates and liaisons between health care providers and their elderly patients.  The ability of family caregivers to provide such care can result in both personal and systemic cost savings.  ARRA-funded grants that support efforts to enhance and preserve such relationships include:
  • Identifying negative and protective factors related to physical and mental health outcomes among older adults and their caregivers who live in vulnerable communities.8
  • Translating evidence-based interventions to improve the health, well-being, and productivity of older adults with cognitive impairment and their family caregivers.9
  • Identifying best practices for health care professionals in communicating with patients and caregivers when the diagnosis of dementia is made and informed decisions are necessary.10
  • Enhancing the communication skills of physicians and family members for improved decision-making and outcomes during end-of-life and/or critical care.11
Empowering Older Patients
Empowering and educating patients on how to be more active in advocating for their own health can result in more informed decision making, preserve independence, and increase patient satisfaction.  ARRA-funded grants that enable and encourage older adults to be more active in their care include:
  • Utilizing Meals on Wheels volunteers as health literary coaches to improve patients’ communication skills and comprehension when interacting with health care providers.12
  • Training and encouraging nursing home staff to engage residents in making choices about their daily activities.13

  1. 1RC1AG036377-01 -- Improving Medication Therapy for Older Patients with Common Co-Morbidities -- Janice Schwartz (CA)
  2. 1RC1AG036418-01 -- Effectiveness of Feeding Tubes Among Persons with Advanced Cognitive Impairment -- Joan Teno (RI)
  3. 1R21AG031983-01A1 -- Investigation of Longitudinal Consequences of Adverse Events Among Older Adults -- Mary Carter (WV)
  4. 1RC1AG035664-01 -- Evaluating an Emergency Department Observation Syncope Protocol For Older Adults -- Benjamin Sun (CA)
  5. 1R01AG033134-01A1 -- Care of the Elder Hospitalized Patient: The Role of Hospitalists -- James Goodwin (TX)
  6. 3R01AG029656-03S2 -- Perioperative Cognitive Protection-Dexmedetomidine and Cognitive Reserve -- Jeffrey Silverstein (NY)
  7. 1R03AG034871-01 -- Kidney Disease, Antiretroviral Therapy and Cardiovascular Events in HIV-Infection -- Andy Choi (CA)
  8. 1R01AG026526-01A2 -- Caregiving Dyads in Vulnerable Communities -- Karen Fredriksen-Goldsen (WA)
  9. 1P30AG034592-01 -- NRC: Improving the Healthcare for Cognitively Impaired Elders and their Caregivers -- Linda Teri (WA)
  10. 1R03AG033860-01 -- Disclosing A Dementia Diagnosis: Analysis of Triadic Healthcare Encounter -- Brian Carpenter (MO)
  11. 3K23AG032875-02S1 -- A Randomized Trial To Improve Surrogate Decision-Making For Critically Ill Elders -- Douglas White (CA)
  12. 1R01AG034073-01 -- Meals on Wheels Volunteers As Health Literacy Coaches for Older Adults -- Vicki Freimuth (GA)
  13. 1R01AG032446-01A1 -- Providing Choice to Nursing Home Residents: A Quality of Life Intervention -- John Schnelle (TN)

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Page Last Updated on June 30, 2018 NIH...Turning Discovery Into Health®