# Communication in the Hospital: Impact on Patients with Alzheimer's Disease and Other Causes of Cognitive Impairments and their Surrogate Decision Makers

> **NIH NIH K24** · INDIANA UNIVERSITY INDIANAPOLIS · 2021 · $180,976

## Abstract

ABSTRACT
 Nearly half of hospitalized older adults are unable to make their own medical decisions and require a
family member or other surrogate to make decisions for them. Many surrogates make decisions about life and
death issues under conditions of high stress and often with poor support from clinicians. Surrogates rely on
various sources of emotional support and sources of value to make medical decisions, including personal,
religious and spiritual beliefs. However, both surrogates and clinicians report high levels of distress due to the
emotional and communication challenges of making decisions for others. As the population ages and a greater
number of older adults are at risk for cognitive impairment, the importance of surrogate decision making will
only increase. The COVID-19 pandemic has added greater urgency due to the many cognitively impaired
patients separated from their families during life threatening illness and hospitalization. Developing
interventions to promote high quality decision making will allow us to best support family members and to
provide the best possible care to older adults with Alzheimer’s disease and related disorders.
 Dr. Alexia Torke’s research has focused on the communication, ethical, religious and spiritual aspects
of decision making for those patients who are incapacitated and require a family surrogate to make decisions
for them. During her current period of funding from her K24 Midcareer Award in Patient Oriented Research,
she achieved the research goals proposed in the award, obtained an R01 grant as PI, and mentored several
successful junior faculty. This K24 renewal will continue to provide support for Dr. Torke’s program of research
and will allow her additional protected time to pursue her passion for mentoring others.
 The specific aims of this proposal are to develop the national network for a multicenter trial of spiritual
care delivered via telephone or video for surrogate decision makers of older adults in the ICU; conduct a pilot
study of the effects of scheduled video and audio conferencing facilitated by clinical navigators on the
experience of surrogate decision makers for hospitalized older adult patients who are incapacitated due to
Alzheimer’s disease and other causes of cognitive impairment; and continue to provide mentorship to junior
investigators conducting research on older adults who are vulnerable due to AD and other conditions.
 Indiana University provides an ideal location for this work. Dr. Torke’s primary appointment is in the IU
Center for Aging Research. The Center has provided infrastructure, intramural funding and space for Dr.
Torke’s research and for support of her mentees. Additional resources such as the Indiana Clinical and
Translational Sciences Institute and the Clinical Investigation and Translational Education program enrich
opportunities for mentees to obtain research training and funding support.

## Key facts

- **NIH application ID:** 10214974
- **Project number:** 2K24AG053794-06
- **Recipient organization:** INDIANA UNIVERSITY INDIANAPOLIS
- **Principal Investigator:** Alexia Mary Torke
- **Activity code:** K24 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $180,976
- **Award type:** 2
- **Project period:** 2016-09-15 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10214974

## Citation

> US National Institutes of Health, RePORTER application 10214974, Communication in the Hospital: Impact on Patients with Alzheimer's Disease and Other Causes of Cognitive Impairments and their Surrogate Decision Makers (2K24AG053794-06). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10214974. Licensed CC0.

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