New York University Rory Meyers College of Nursing
Barriers to Hospice Care Transitions for Diverse Persons Living with Dementia
Dr. Murali is an assistant professor at New York University Rory Meyers College of Nursing interested in end-of-life care for seriously ill older adults in the home healthcare setting. Dr. Murali’s research focuses on improving end-of-life care coordination surrounding hospice transitions for racially and ethnically diverse people living with dementia and their care partners. She aims to develop transitional care coordination interventions to improve hospice transitions and reduce disparities in hospice use through embedded pragmatic clinical trials in real-world practice in home healthcare. Dr. Murali’s research is informed by her prior clinical experiences as a nurse and nurse practitioner delivering end-of-life care in the critical care setting.
Substantial disparities in hospice use have been documented for racially and ethnically diverse people living with dementia (PLWD) at the end of life. Efforts to increase hospice use and reduce disparities through culturally-sensitive care coordination during a transitional period have been limited. Therefore, exploring barriers to hospice care transitions among diverse PLWD can generate novel data for the development of interventions to reduce disparities and improve equitable hospice use. This award will provide Dr. Murali with training and mentorship to develop hospice care transitions interventions, develop the necessary skills to conduct health disparities and health equity research, and use mixed methods research design for intervention development to improve hospice transitions for diverse PLWD. This training will support the following
Specific Aims: (1) Explore perspectives of care partners, home healthcare staff, and providers about barriers to hospice transitions for racially and ethnically diverse PLWD (Qualitative Aim); (2) Survey care partners, home healthcare staff, and providers about key components of a transitional care coordination checklist intervention to guide hospice transitions for diverse PLWD (Quantitative Aim); and (3) Design a novel culturally sensitive transitional care coordination checklist intervention for hospice transitions in home healthcare for diverse PLWD and their care partners (Integrative Aim).This work will lead to the development and testing of the intervention in a future multi-site embedded pragmatic clinical trial to guide and improve hospice care transitions and prepare Dr. Murali to lead interventional research focused on improving hospice disparities and end-of-life transitional care for PLWD and their care partners.