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.
Bio
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.
Email: zcooper@bwh.harvard.edu