The National Palliative Care Research Center

Curing suffering through palliative care research.


Krista Harrison PhD

Assistant Professor

University of California, San Francisco

Grant Year
Grant Term
2 years
Grant Type
Junior Faculty Career Development

Project Description
Experience and Palliative Care Needs of People Living at Home with Severe Dementia and their Caregivers

In the United States, more than 30% of people with advanced dementia die at home every year. Even more live at home with severe dementia, relying on help from caregivers with activities like dressing, eating and bathing while symptoms, behaviors, and ability to communicate progressively worsen. Despite agreement about the appropriateness of palliative care for dementia, few receive this care. Researchers have focused primarily on understanding the experience of people with dementia in nursing home settings and testing palliative care approaches to improve their quality of life. Yet relatively little work has been done to understand the alternative locations of care: residential home settings. The proposed study will address this critical knowledge gap about people living at home with severe dementia. First, I will use a nationally-representative dataset to describe the population and understand the medical, functional, and social factors associated with mortality and time to nursing home placement among people living at home with severe dementia. Second, I will use interviews with people with dementia and/or their caregivers to identify anticipated needs, values and priorities for palliative and end-of-life care decisions. As a PhD-trained health services and policy researcher, Assistant Professor in the UCSF Division of Geriatrics, and former leader within a large community-based hospice, I am well-positioned to conduct the proposed study. Engaging in the proposed research and career development activities under the mentorship of Christine Ritchie and Alex Smith, I will gain additional knowledge and skills with: a) clinical care for dementia, b) advanced quantitative methods, and c) interviewing people with dementia and caregivers. The NPCRC Career Development Award will provide me with necessary data and skills for strong K01 and R01 applications to develop and test evidence-based and person-centered primary palliative care interventions that address the needs of people living at home with severe dementia.


Krista Harrison, PhD, is an Assistant Professor in the Division of Geriatrics within the UCSF School of Medicine. She completed a PhD in Bioethics, Health Policy & Management at Johns Hopkins Bloomberg School of Public Health and postdoctoral training & at the University of California, San Francisco (UCSF) including an aging research fellowship and a certificate in implementation science. Before joining faculty at UCSF, Dr. Harrison evaluated national policies and programs at Mathematica Policy Research and led the research and education programs at Capital Caring, a large nonprofit hospice. Her mixed-method research aims to improve the quality of life of older adults with severe dementia and other serious illnesses who live in home- and community-based settings by transforming clinical practice, health systems, and policy. Dr. Harrison is also a UCSF Pepper Center Scholar, UCSF K Scholar, AAHPM Research Scholar, and Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute.