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Home, but homebound: The impact of caregiving, financial, and community resources on the lives of individuals with dementia

Award Number: R01AG060967
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Home, but homebound: The impact of caregiving, financial, and community resources on the lives of individuals with dementia Summary/Abstract Individuals with dementia live for many years at home in the community. Even though the community is the overwhelming preference for site of care, the experience of living with dementia in the community is not always optimal for patients and their caregiving families. Our previous work using data from the 2011 National Health and Aging Trends Study estimated that one million persons with dementia are homebound (i.e., rarely or never leave the home), the majority of whom also have other serious medical illnesses. This homebound population with dementia is larger than the number of individuals with dementia currently living in nursing homes. Although being homebound is likely to have a profound impact on the lived experience of individuals with dementia, we currently do not know the frequency of transitions in or out of homebound status or the implications of homebound status for patients' quality of life and access to care. Furthermore, an individual's ability to leave the home is not only determined by the cognitive and functional decline associated with dementia progression. Social resources including caregiving networks (social support, caregiver availability and well-being), financial factors (income, insurance, economic well-being), and community context (cohesion, walkability, service availability) also are likely to contribute. To achieve the study aims, we will use the longitudinal, nationally representative National Health and Aging Trends Study and the companion National Study of Caregivers with linkages to Medicare claims, the U.S Census and other geographic data. Through rigorous analysis of these data, we will examine how social resources impact if and when individuals with dementia become homebound, adverse consequences of homebound status, and critically, factors that help protect patients against homebound status. In addition to characterizing the timing of transitions to homebound status and nursing home placement among individuals living with dementia (Aim 1), we will also examine the impact of one's caregiving network, financial resources, and community/neighborhood context on transitions to homebound status among individuals with dementia (Aim 2), and evaluate the consequences of homebound status on valued life activities, unmet care needs, and potentially avoidable health care use (Aim 3). In summary, this project will critically enhance our understanding of the lived experience of patients with dementia by documenting the frequency and duration of episodes of being homebound, evaluating modifiable factors that predict homebound status, and quantifying the consequences of homebound status.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2023	THE JOHNS HOPKINS UNIVERSITY	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Aging Research	002	5	10/17/2023	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$484,153
2024	2022	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	1 GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Aging Research	001	4	10/17/2023	NON-COMPETING CONTINUATION	-$423,750
2024	2021	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	1 GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Aging Research	000	3	10/17/2023	NON-COMPETING CONTINUATION	-$60,403
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $409,375 )
2023	2023	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Aging Research	002	5	3/29/2023	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$211,958
2023	2023	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Aging Research	001	5	1/20/2023	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$197,417
2023	2022	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ONE GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Aging Research	000	4	1/20/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $409,375

Issue Date FY: 2022 ( Subtotal = $423,750 )
2022	2022	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ONE GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Aging Research	001	4	4/21/2022	NON-COMPETING CONTINUATION	$42,375
2022	2022	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ONE GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Aging Research	000	4	12/9/2021	NON-COMPETING CONTINUATION	$381,375
														Subtotal = $423,750

Issue Date FY: 2021 ( Subtotal = $423,750 )
2021	2021	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ONE GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Aging Research	000	3	12/11/2020	NON-COMPETING CONTINUATION	$381,375
2021	2021	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ONE GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Aging Research	001	3	2/11/2021	NON-COMPETING CONTINUATION	$42,375
														Subtotal = $423,750

Issue Date FY: 2020 ( Subtotal = $847,478 )
2020	2020	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ONE GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Aging Research	000	2	12/6/2019	NON-COMPETING CONTINUATION	$381,375
2020	2020	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ONE GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Aging Research	002	2	7/14/2020	SUPPLEMENT FOR EXPANSION	$423,728
2020	2020	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ONE GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Aging Research	001	2	1/23/2020	NON-COMPETING CONTINUATION	$42,375
														Subtotal = $847,478

Issue Date FY: 2019 ( Subtotal = $423,750 )
2019	2019	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ONE GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Aging Research	000	1	1/28/2019	NEW	$423,750
														Subtotal = $423,750

Grand Total All Awards = $2,528,103

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Home, but homebound: The impact of caregiving, financial, and community resources on the lives of individuals with dementia

Award Number: R01AG060967

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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