2002
HEALTHCARE GRANTS
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$126,000 | 14 months
American Bar Association Fund for Justice and Education*
Naomi Karp, JD
"Healthcare Decision-Making for the Unbefriended Elderly:
Towards Legislative Improvements in New York State"
The
aim of this project is to help the many socially isolated and unbefriended
elderly obtain someone to make healthcare decisions for them. This topic
is particularly important in New York where the laws, developed to protect
people's right to determine the course of their own care, have created
a number of barriers preventing unauthorized care decisions for an individual.
This project will provide clinicians, ethics committees, healthcare
administrators and legislators with innovative methods for dealing with
these unbefriended patients in order to avoid the necessity for legal
intervention.
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$100,000
| 36 months
Calvary
Fund, Inc.*
Christopher Comfort, MD
"Fostering Competency in Healthcare Proxies"
This
project seeks to help healthcare proxies increase their competency as
healthcare decision makers. The focus will be on how proxies view their
capabilities, needs and deficiencies, with the goal of improving their
confidence and effectiveness as healthcare agents. To that end an intervention
strategy will be developed based on extensive information gathered from
100 proxies as they navigate the process of making healthcare decisions
for patients cognitively unable to do so for themselves. The materials
will then be tested for effectiveness with approximately 600 proxies
including the original 100. The intervention itself will be conducted
by social work staff in small group settings. Pre- and post-tests will
measure whether the program helped the proxies feel more secure and
competent in acting as healthcare agents. If successful, this intervention
will be integrated into the current admissions process at Calvary Hospital.
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$18,000
| 12 months
Columbia
University
Steven M. Albert, PhD, MSC
"Guide to Dementia Care for Home Health Aides"
This
grant supports the revisions, distribution and evaluation of the use
of a manual that was developed with funding from The Samuels Foundation
(1997-1998). This is a practical guide for home health aides working
with homebound dementia patients written in the words of the aides themselves.
In addition to its distribution, it is hoped that the guide will be
incorporated into mandatory training for home health aides.
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$15,000
| 12 months
Cornell University - Weill Medical College
Joseph J. Fins, MD
"Support for Communication/Dissemination Initiative for 'Contract
to Covenant' Project"
This
grant would provide funds for the development of a 24-page supplement
to the Hastings Center Report for the "From Contract to Covenant
in Advance Care Planning" project funded by the Samuels Foundation
(see 2000 grants). Upon successful completion of the peer review process,
the funds for this grant would be used to print the supplement.
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$200,000
| 18 months
Cornell University - Weill Medical College*
Joseph J. Fins, MD
"Fidelity, Wisdom and Love: Interactive Patient and Proxy Materials"
During
the first round of the Healthcare Agency Initiative, Dr. Fins' project,
"From Contract to Covenant in Advance Care Planning," developed
a mechanism to describe clearly the complex, personal aspects of the
patient-proxy relationship. This project takes that work to the next
stage by creating a practical, educational tool to help patients and
their proxies better understand and prepare for their roles and mutual
responsibilities, and to enhance the likelihood that patients' preferences
will be understood and followed. The product of the grant will be an
educational kit, including an introductory video describing the patient-proxy
relationship, educational workbooks, a leader's guide and supporting
materials, such as proxy forms and questionnaires geared toward a lay
audience.
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$55,500
| 12 months
Elders Share the Arts, Inc.
Anne Basting, PhD
"Dissemination of a Creative Story-Telling Activity for Dementia
Patients: TimeSlips"
The
goal of this project is to train approximately 50 staff people from
ten long term care programs (day care programs, nursing homes, etc.)
in New York City to use the TimeSlips method of story telling. TimeSlips
is a low cost activity to help to improve the quality of life of people
with dementia and those who care for them. The training includes a one-hour
per week storytelling session led by a certified TimeSlips storytelling
facilitator. Over the course of the 10 weeks, staff will move from observers
to facilitators. The project also includes ten education presentations
on TimeSlips to encourage other facilities to implement the method.
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$104,000
| 18 months
Fordham University*
Irene A. Gutheil, DSW
"Strengthening Healthcare Agency: A Protocol for Use with Hispanic
Elders"
During
the first round of Healthcare Agency grants, the project directors developed
the "Start Talking Early and Plan: A Program to Increase Communication
Between Elders and Their Healthcare Agents Program" (STEP), an
intervention to improve the process of healthcare decision making. This
project will build upon that work to create a similar intervention for
the Hispanic community. A culturally sensitive, bilingual protocol will
be developed and tested among elderly Hispanics receiving home care
from the Jewish Home and Hospital Long Term Home Healthcare Program
in the Bronx. The goal of the protocol will be to increase and improve
communication between the proxy and the person they will eventually
represent, rather than focus simply on completing forms. An extensive
communications strategy, piggy backing on the current efforts of the
STEP program, will target all healthcare and social work agencies in
New York City that serve the Hispanic elderly.
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$7,500
| 2 months
Grantmakers in Health
Lauren LeRoy, PhD
"Annual Meeting: Strengthening the Future of Health and Philanthropy"
This grant is to support the annual meeting to be held in New York City
from February 27 through March 1, 2002.
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$120,000
| 12 months
New York City Health and Hospitals Corporation/Jacobi Medical Center*
Steven R. Hahn, MC
"How Long Does It Take to Plan Ahead: Getting Advance Planning
into HHC Hospitals"
The
goal of this project is to demonstrate to the management of the HHC,
the public hospital system in NYC, that it is feasible to adopt a policy
requiring all primary care physicians to discuss advance directives
and selection of a healthcare proxy with their patients. The project
will determine if necessary information about the need to have a healthcare
agent can be conveyed to patients in discussions varying from 5 to 15
minutes. The effect of the duration of the discussion will be measured
by a count of the number of patients who complete a healthcare proxy
statement. They will also assess the degree to which the named agent,
or proxy, seems to understand the patient's wishes. One of the major
outcomes will be the determination of the most effective and efficient
time frame for the initial discussion. In other words, does it make
a difference if the doctors discussed the issue for 5 minutes, as compared
with 10 or 15, or not at all? The results will lay the groundwork to
persuade practitioners that it is possible to incorporate advance directive
discussions into their everyday practice.
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$190,000
| 24 months
New York University*
Mathy Mezey, EdD, FAAN, and Gloria Ramsey, RN, JD
"Working with the African American Church Community to Encourage
End of Life Planning and Proxy Form Completion"
This
project seeks to establish an ongoing program of educational activities
in the Convent Avenue Baptist Church aimed at encouraging African Americans
to complete advance directives and appoint healthcare agents. A simple
evaluation will measure whether people actually complete the forms as
a result of the intervention.
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$160,000
| 18 months
New York University Downtown Hospital*
Lester W. Blair, MD
"Burden, Support and Educational Needs of Chinese-American Healthcare
Agents"
This
project builds on a highly successful intervention to increase the number
of Chinese-American New Yorkers appointing healthcare agents that was
funded in the first round of the Healthcare Agency initiative. This
new project, rather than simply trying to increase the numbers of proxies
completed, approaches the issue from the perspective of the culturally
specific challenges facing the Chinese-American agent and seeks to provide
information, support and help in performing the task of making healthcare
decisions for someone else. Employing the Peer Advocate model that worked
so well in the first intervention, the project directors will interview
Chinese-American agents to learn about their experiences and needs and
develop an intervention to address these findings. The final product
of the grant will be culturally relevant materials for the Chinese-American
community that address the complex issues of healthcare agency from
the agent's point of view. In addition, a trained cadre of Peer Advocates
will be ready to help Chinese Americans deal with advance care planning
and the process of substituted healthcare decision making.
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$380,000
| 18 months
Partnership for Caring (PfC)
Karen Orloff Kaplan, MPH, ScD
"Coordinating Center: Continued Management of the Healthcare Agency
and Palliative Care Initiatives"
PfC
operates a Coordinating Center for two program initiatives for the Samuels
Foundation: 1) to strengthen the process of healthcare agency; and 2)
to enhance palliative care for those with severe chronic illness. This
grant extends the funding for a second round of grant making in each
program area.
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$290,000
| 30 months
Research Foundation of City University of New York
Roberta K. Graziano, DSW
"Support for a Second Cohort of Students for the Social Work Program
to Better Serve the Health Needs of the Elderly"
The
Foundation previously funded the development of an MSW curriculum with
specific content in aging and geriatric health. The Foundation supported
the implementation of this program's first cohort of students (see 2000
grants). This grant supports the continued implementation with a second
cohort of students and the evaluation of this work-study curriculum.
The program has been designed to enable employees of community agencies
serving the elderly in New York City to attain an MSW Degree with a
specific course of study entitled "Aging in Health," while
continuing to work.
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* Notes projects funded as a result of the RFP (request for proposals)
program administered by Partnership for Caring for the Foundation's
Healthcare Agency Initiative.
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