The National Palliative Care Research Center

Curing suffering through palliative care research.


Zara Cooper MD, MSc

Associate Professor

Brigham and Women's Hospital

Grant Year
Grant Term
2 years
Grant Type
Pilot & Exploratory Project Support Grant

Project Description
The Trauma Dyad: Tending to Caregivers of Injured Frail Elders

Over 14.7 million informal caregivers help seriously ill older adults with their daily activities, medical care, and financial and medical decisions. Although most caregivers find great satisfaction in their role, many are plagued with adverse physical, emotional, and financial effects related to the burdens of caregiving, leading to worsened health and greater healthcare utilization for care recipients. Given that informal caregivers play a critical role in providing value-driven healthcare to an increasing number of patients, improving caregivers’ outcomes has become a palliative care and national policy priority. Trauma among older adults is increasing dramatically and will account for almost 40% of trauma admissions by 2050. Many of these individuals are frail and have high-illness burden at baseline. After injury, these patients suffer functional decline and high rates of institutionalization and hospital readmissions, increasing their dependence on informal caregivers. Despite increasing numbers of older trauma patients, little is known about informal caregiving within this population. The goal of this proposal is to use complementary approaches to examine informal caregiving after geriatric trauma, identify targets to improve outcomes, and establish preliminary data for a federally-funded grant to pilot test an intervention to reduce caregiver burden. In Aim 1, we will link two secondary datasets to Medicare Claims to create a national profile informal caregiving for older adults after trauma. In Aim 2, we will survey caregivers (n=100) at two trauma centers to obtain data about modifiable factors that can reduce caregiver burden unavailable in secondary datasets. This will also demonstrate the feasibility of longitudinal surveys for caregivers of trauma patients.  In Aim 3, we will obtain input from multidisciplinary stakeholders in trauma care (e.g., Geriatric Trauma Coalition, Trauma Program Managers, and the American Association for the Surgery of Trauma) to design a trauma center-based intervention.    

Zara Cooper, MD, MSc, FACS, is an acute care surgeon, trauma surgeon and surgical intensivist at Brigham and Women’s Hospital (BWH) where she serves as Kessler Director for the Center for Surgery and Public Health (CSPH). Dr. Cooper is an associate professor of surgery at Harvard Medical School, associate faculty at Ariadne Labs, and adjunct faculty at the Marcus Institute for Aging research, all in in Boston, MA. A graduate of the Mount Sinai School of Medicine, Dr. Cooper completed her General Surgery Residency and Critical Care Fellowship at BWH; a Trauma Fellowship at Harborview Medical Center and the University of Washington in Seattle; and training in hospice and palliative medicine at Dana-Farber Cancer Institute and BWH. Her research aims to improve palliative and geriatric care for older seriously ill surgical patients.