In a new JAMA Network Open study led by Julia Burgdorf and co-authors Chanee Fabius, Catherine Riffin, and Jennifer Wolff, caregivers were less likely to receive adequate transitional care training if they were Black; experienced financial difficulty; or cared for a Black, female, or Medicaid-enrolled older adult. These findings suggest that changes to the discharge process, such as using standardized caregiver assessments, may be necessary to ensure equitable support of family caregivers. Read more.

Read the new National Institute on Aging (NIA) summary report developed from the National Research Summit on Care, Services, Support for Persons with Dementia and Their Caregivers held during the summer of 2020. The summit was co-chaired by center director and summit steering committee Jennifer Wolff and David Reuben of UCLA. View the full report here.

A study led by Julia Burgdorf, and co-authors Elizabeth Stuart, Alicia Arbaje, and Jennifer Wolff in Medical Care found that family caregivers' activity-specific training needs may affect home health visit utilization. The researchers analyzed data from participants receiving Medicare-funded home health between 2011 and 2016 using linked National Health and Aging Trends Study (NHATS), Outcomes and Assessment Information Set (OASIS), and Medicare claims data. Key findings included that receipt of nursing visits was more likely when family caregivers had an identified need for training related to medication management or household chores and receipt of therapy visits was more likely when caregivers had an identified need for training related to self-care tasks. Read more. 

A study led by Chanee Fabius, and co-authors Portia Cornell, Wenhan Zhang, & Kali Thomas in Medical Care Research and Review found wide variability among states in the share of assisted living residents who were dual-eligible Medicare beneficiaries, ranging from 6% in New Hampshire to over 40% in New York. In states with a Medicaid state plan option covering services in assisted living or both a state plan and waiver, the percent of assisted living residents with dual-eligibility was more than 10 percentage points higher than in states with neither a state plan nor waiver. The researchers analyzed 2014 Medicare data for 506,193 adults who live in large (25+ beds) assisted living communities. Findings from the study provide a basis for understanding the role of Medicaid financing in access to assisted living for dual-eligible Medicare beneficiaries. Read more.

A study led by Amber Willink and Quincy Samus, and co-authors Karen Davis, Deirdre Johnston, Betty Black, Melissa Reuland, Ian Stockwell, Halima Amjad, and Constantine Lyketsos published in Innovation in Aging suggests that hospitalization risk reduction strategies may benefit from understanding and addressing caregiving circumstances. Managed-care plans with the flexibility to engage community health workers could benefit from a low-cost, high-touch intervention to meet the needs of enrollees with dementia. Read more. 

A study led by center director Jennifer Wolff and co-authors Danny Scerpella, Kimberly Cockey, Naaz Hussain, Tara Funkhouser, Diane Echavarria, Jennifer Aufill, Amy Guo, Danetta Sloan, Sydney Dy, Kelly Smith, and SHARING Choices Investigators in the American Journal of Hospice and Palliative Care found that SHARING Choices, an advance care planning intervention, was acceptable among older adults with and without cognitive impairment and may increase advance directive completion. The study engaged family in advance care planning of older adults with and without cognitive impairment in the primary care context. Patients remarked that SHARING Choices clarified communication and preferences while family reported a better understanding of their role in advance care planning and communication. SHARING Choices is now being tested in a pragmatic trial at 55 primary care clinics in the Baltimore-Washington area. Read more.

Lauren Hersch Nicholas is the lead author on a new paper published in JAMA Internal Medicine that found Medicare beneficiaries who go on to be diagnosed with dementia are more likely to miss payments on bills as early as six years before a clinical diagnosis. In collaboration with the Federal Reserve Board of Governors and the University of Michigan Medical School, the researchers also found that beneficiaries diagnosed with dementia who had a lower educational status missed payments on bills beginning as early as seven years before a clinical diagnosis as compared to 2.5 years prior to a diagnosis for beneficiaries with higher educational status. Read the full press release here and media coverage in The Washington Post, the Miami Herald, the Boston Globe, and AARP. 

A study led by center faculty Chanee Fabius and co-authors Noreen Shugrue and Julie Robison in the Journal of Gerontological Social Work examined relationships between home and community-based services, reinstitutionalization, and choice and control in daily activities for older adults in Connecticut. The researchers found that relative to receiving traditional services, having hourly or live-in personal care attendant services was associated with having lower odds of both reinstitutionalization and choice and control. Findings can help strengthen home and community-based services delivery for older adults living in the community. Read more. 

A study led by Halima Amjad and co-authors John Mulcahy, Judith Kasper, Julia Burgdorf, David Roth, Ken Covinsky, and Jennifer Wolff in the Journal of the American Geriatrics Society examined a nationally representative cohort of older adults with disabilities. Increased risk of hospitalization at 12 months was associated with having a primary caregiver who helped with healthcare tasks, reported physical strain, and provided more than 40 hours of care weekly. The findings suggest that hospitalization risk reduction strategies may benefit from understanding and addressing caregiving circumstances. Read more

The Hopkins’ Economics of Alzheimer’s Disease and Services (HEADS) Center is a new research center that seeks to improve the care and lives of those affected by Alzheimer’s disease and related dementias. The Center is led by Jennifer Wolff, PhD, Eugene and Mildred Lipitz Professor of Health Policy and Management and Director of the Roger C. Lipitz Center for Integrated Healthcare and Daniel Polsky, PhD, Bloomberg Distinguished Professor of Health Economics and Director of the Hopkins Business of Health Initiative.

The HEADS Center focuses on both understanding the full range of care needs and identifying and advancing solutions that address accessibility, affordability, quality, and equity of care. The Center will take a cross-school, interdisciplinary approach to build collaborations among faculty across the University and include the following initiatives:

• Funding to support novel pilot studies to advance population-based research and attract investigators to the field,
• The development of a high-capacity, secure computing environment to support novel population-based data analyses, and
• Community-building activities to support use of research resources, the dissemination of scientific findings, and partnerships with key stakeholders and advocacy organizations to translate findings into policy and practice.

Stay tuned for more information on the center!