# Pragmatic Trials to Improve Care and Outcomes for Persons with Dementia in Long-Term Care

> **NIH NIH R13** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2020 · $50,000

## Abstract

ABSTRACT
There is ample evidence that persons with dementia -- who represent the majority of those living in nursing
homes and assisted living -- have numerous care needs. Medically, almost 90% of nursing home residents
with dementia have at least three comorbidities, as do roughly 60% of those with dementia in assisted living.
Psychosocially, 40% of persons with dementia have depression, and a large majority display behavioral
expressions of discomfort. The list of unmet care needs for persons with dementia in long-term care is
extensive, also including need for pain management, sensory limitations, activities of daily living, social
engagement, support with grief and loss, and end-of-life care, to name but a few. In addition, health care use is
challenging, with as many as 25% of hospitalizations being considered potentially avoidable.
Countless interventions have been developed and found to be efficacious to address these needs, but few
have effected actual change; reasons for lack of success are either that studies did not extended beyond
efficacy/explanatory testing, or because they were developed in a manner that limited utility in real-world
settings. Responsive to the excess of interventions that do not change practice, there has been a call for
pragmatic trials. Pragmatic trials move useful interventions from theory to application to generalizability across
settings, populations, and providers.
The need for pragmatic trials has received notable attention, but no efforts have been specific to persons with
dementia living in long-term care. Special considerations are important when planning trials and interventions
for persons with dementia in long-term care. In response, the proposed conference will convene national
leaders in research, academic scholarship, and long-term care and dementia-related associations and
societies, provider organizations, and providers themselves, to address (1) research issues related to the
conduct of pragmatic trials for persons with dementia in long-term care, and (2) implementation of pragmatic
innovations, and will (3) disseminate the proceedings and recommendations to diverse stakeholders.
It is intended that the proposed solutions will be expressly relevant to trials for persons living with dementia in
long-term care, and reflect innovative recommendations not already in the literature; that the resulting
recommendations will inform long-term care providers’ selection, adoption, and sustainability of pragmatic
innovations for persons with dementia, and expand their related capacity; and that the resulting strategies will
reflect a novel, coordinated mechanism of dissemination that will have notable impact to promote pragmatic
trials to improve care and outcomes for persons with dementia in long-term care.

## Key facts

- **NIH application ID:** 9994682
- **Project number:** 1R13AG067681-01
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Sheryl Zimmerman
- **Activity code:** R13 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $50,000
- **Award type:** 1
- **Project period:** 2020-09-01 → 2021-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9994682

## Citation

> US National Institutes of Health, RePORTER application 9994682, Pragmatic Trials to Improve Care and Outcomes for Persons with Dementia in Long-Term Care (1R13AG067681-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9994682. Licensed CC0.

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