# Enabling Older Adults to 'LiveWell' with Advanced Heart Failure: Development of a Palliative Rehabilitation Model

> **NIH NIH K23** · MASSACHUSETTS GENERAL HOSPITAL · 2024 · $172,525

## Abstract

PROJECT SUMMARY/ABSTRACT
Americans aged 65 years and older account for 70% of heart failure (HF)-related hospitalizations each year, and
many in this population are burdened by multimorbidity, functional limitations, and high symptom burden. As HF
becomes advanced (New York Heart Association Class III-IV) disease burden increases substantially, especially
in the last 6 months of life when 80% of individuals are hospitalized at least once and many endorse significant
distress related to functional decline and inability to participate in life roles and activities. Despite widespread
recognition of the distinct benefits of physical rehabilitation and palliative care in improving symptoms and quality
of life among individuals with HF, these services are separate in their approach and underutilized. To date,
physical rehabilitation models have not been designed to simultaneously address the complex psychosocial and
functional needs of older adults with advanced HF. To optimize quality of life in this vulnerable population, a
novel rehabilitation strategy that holistically addresses biopsychosocial impairments is needed. My K23 proposal
will address this need by developing and testing LiveWell-HF, a home-based physical therapy model
supplemented with evidence-based, psychological strategies from early integrated palliative care to improve
coping and acceptance among older adults after hospitalization for advanced HF. Specifically, I aim to 1) develop
the preliminary LiveWell-HF model with provider and patient stakeholder input; 2) refine LiveWell-HF using an
open pilot study design; and 3) evaluate the feasibility, acceptability, and fidelity of the refined LiveWell-HF model
by conducting a pilot randomized controlled trial. Findings from these aims will inform a R01 efficacy trial as well
as future work to determine the impact of LiveWell-HF on healthcare utilization and an extension of the model
tailored for care partners. The aims of this proposal will be supported by my career development activities, which
focus on 1) developing advanced clinical and research expertise in palliative care, 2) qualitative and mixed
methods research to develop and refine evidence-based rehabilitation interventions, 3) clinical trials research,
and 4) leadership development. My exemplary team of mentors and advisors will be led by Dr. Christine Ritchie,
an internationally renowned geriatrician and palliative care physician with extensive experience conducting
mixed methods research and clinical trials in patients with serious illness. The complementary expertise of my
mentors and advisors, rich institutional environment at Massachusetts General Hospital and Harvard Medical
School, and my training plan will enable me to successfully complete the training and research aims in this
application. This K23 proposal will provide me with the skills and data needed to launch my career as an
independent investigator and leader at the intersection of physical rehabilitation, pall...

## Key facts

- **NIH application ID:** 10907700
- **Project number:** 5K23AG078412-02
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Tamra J Keeney
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $172,525
- **Award type:** 5
- **Project period:** 2023-08-15 → 2024-09-01

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10907700

## Citation

> US National Institutes of Health, RePORTER application 10907700, Enabling Older Adults to 'LiveWell' with Advanced Heart Failure: Development of a Palliative Rehabilitation Model (5K23AG078412-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10907700. Licensed CC0.

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