# Function, caregiving and adequacy of support before and after the transition to institutional settings

> **NIH NIH R03** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2022 · $161,500

## Abstract

PROJECT SUMMARY/ABSTRACT
When functional impairments in later life overwhelm available caregiving, older persons and their caregivers
commonly consider if moving from home into an institution, such as a nursing home, assisted living facility or
residential care facility for the elderly, is best for them. Persons and caregivers hope clinicians will help them
decide, but evidence and frameworks that clinicians can use to provide guidance are largely absent. We could
improve how clinicians help patients and caregivers navigate this process through a decision aid, but an aid
first requires data on how person- and caregiver-centered measures change with institutionalization and a
better understanding of what information persons and caregivers want. The objective of this proposal is to
supply those data and that understanding through mixed methods. Aim 1 will produce the first nationally
representative descriptions of trajectories in function, caregiving, and adequacy of support (eg, did persons
bathe less than they wanted due to lack of help) in the year before and after institutionalization and examine if
trajectories meaningfully differ in pre-specified subgroups (eg, by age, race, or type of institution). Aim 2 will
explore the experience of recently institutionalized older persons and their caregivers to understand the role of
function, caregiving and inadequate support in their transition and what information (if any) was and would
have been useful. We integrate our methods by using results from Aim 1 to inform sampling and by presenting
findings from Aim 1 to interviewees in Aim 2; by exploring feedback to a concrete example, we will gain a
better understanding of what kinds of information are useful to persons navigating this transition. Together,
these aims will be the foundation for future work developing decision aids for the institutionalization process
and then implementing and evaluating them in randomized controlled trials.

## Key facts

- **NIH application ID:** 10518344
- **Project number:** 1R03AG074038-01A1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Kenneth Lam
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $161,500
- **Award type:** 1
- **Project period:** 2022-09-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10518344

## Citation

> US National Institutes of Health, RePORTER application 10518344, Function, caregiving and adequacy of support before and after the transition to institutional settings (1R03AG074038-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10518344. Licensed CC0.

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