Improving Communication for People Living with Dementia During Emergency Response
Dr. Pollack is a critical care physician and acting assistant professor within the Division of Pulmonary, Critical
Care, and Sleep Medicine at University of Washington. Her research focuses on the intersections of critical care,
geriatrics, palliative care, and emergency medicine, with an emphasis on communication for older adults with
dementia and their care partners during episodes of critical illness. Her research has demonstrated that
emergency medical services (EMS) providers play a key role in early critical care delivery for older adults living
with dementia, engaging in high stakes communication with patients’ care partners and making complex clinical
decisions with implications that extend beyond transport. Building on this work, she aims to develop
interventions to support high-quality communication and goal-concordant care during 911 EMS response for
people living with dementia and their care partners. Through this Career Development Award, she seeks to
strengthen her knowledge of emergency systems of care and develop methodological expertise in human-centered
intervention design, implementation science, and pragmatic clinical trial design.
People living with dementia (PLWD) are at risk of receiving medical treatments that may not align with their
goals and preferences. Prior studies suggest that advance care planning documents alone are insufficient to
ensure goal-concordant care during healthcare emergencies. Research on real-time serious illness
communication during pre-hospital emergency response remains sparse, with no interventions currently
designed to support emergency medical services (EMS) providers, patients, or their care partners in navigating
treatment decisions during these often high-stress encounters. This Career Development Award will provide Dr.
Pollack with the necessary experience and training in EMS systems of care, human-centered intervention
design, and the design and implementation of pragmatic clinical trials to prepare her to develop and test
communication-based interventions to improve care in pre-hospital settings for PLWD and their care partners.
This training will support the following Specific Aims: (1) Elicit EMS provider perspectives on barriers and
facilitators to high-quality communication and goal-concordant care for PLWD using qualitative methods, and
(2) Leverage human-centered design methods to develop an intervention supporting high-quality crisis
communication and elicitation of treatment preferences during pre-hospital emergency response for PLWD and
their care partners. This work will lay the foundation for a pilot pragmatic trial testing the feasibility and
effectiveness of a pre-hospital intervention to support high-quality crisis communication and goal-concordant
care for PLWD, with the potential to improve alignment between early treatment decisions and patient
preferences.