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Assessing Palliative Care Needs in Nursing Homes Among Residents With Cognitive Impairment: UPLIFT Trial Findings
John G. Cagle, Peiyuan Zhang, Todd D. Becker, Alex Floyd, Tracie Schwoyer-Morgan, Becky Ridder, Kathleen Tschantz Unroe. Innovation in Aging, 2025-12-01
Topic: Risk, prevention and care in population studies
Abstract Palliative care (PC) has been shown to improve quality of care and life for nursing home (NH) residents. The PC needs and acuity of NH residents, particularly those with dementia, remain understudied. Using data from a large, NIA-funded trial evaluating PC in NHs, 655 residents with cognitive impairment were enrolled from 16 NHs across two states. NH staff, typically social workers and nurses, were trained as in-house PC leads. PC leads were asked to complete a PC screening on all enrolled residents to: identify needs; determine whether a PC consult is needed; and, if so, determine triage status for a consult visit. PC screening descriptives are presented and predictors of triage status were modeled. Initial screens were completed for 528 residents (80.6%) of all enrolled residents. Reasons for not being screened were resident discharge (e.g., to hospital) and death. Among six possible PC needs, 15% of residents had no identified needs, 42% had one need, and the remainder (42.8%) had ≥2 needs. The most prevalent needs were polypharmacy (58.1%), a lack of goals-of-care documentation (26.5%), functional decline/medical complexity (24.8%), unmanaged symptoms (19.7%), incongruent care (6.3%), and recent hospitalization (4.5%). Among those screened, a majority (n = 461, 87.3%) indicated a PC consult, with 5.4% of those cases being triaged as high priority. A greater number of needs (B=.42), polypharmacy (B=.33), and unmanaged symptoms (B=.31) significantly predicted higher triage priority (p<.001). Understanding residents’ PC needs can inform tailored policies and practices to address such gaps in care.
Key findings
- A greater number of needs (B=.42), polypharmacy (B=.33), and unmanaged symptoms (B=.31) significantly predicted higher triage priority (p<.001).
Why it matters
Among 655 nursing home residents with cognitive impairment, the most common palliative care needs were polypharmacy, missing goals-of-care documentation and functional decline, and most screened residents were referred for a palliative care consult. This describes palliative care needs in nursing homes, not a treatment or cure for Alzheimer's disease.
Study details
- Participants461
- Effect size80.6%; 42.8%; 58.1%
- Evidence strengthLow
How this study scored 39/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Innovation in Aging) |
| Journal's citation record | 0 / 4 | Innovation in Aging: journal h-index 48 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 461 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 1 / 6 | Cited 0.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Kathleen Tschantz Unroe: h-index 30 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Indiana University School of Medicine: institution h-index 784 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Total | 39 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Cagle, J. G., Zhang, P., Becker, T. D., Floyd, A., Schwoyer-Morgan, T., Ridder, B., et al. (2025). Assessing Palliative Care Needs in Nursing Homes Among Residents With Cognitive Impairment: UPLIFT Trial Findings. Innovation in Aging. https://doi.org/10.1093/geroni/igaf122.3370
Vancouver
Cagle JG, Zhang P, Becker TD, Floyd A, Schwoyer-Morgan T, Ridder B, et al. Assessing Palliative Care Needs in Nursing Homes Among Residents With Cognitive Impairment: UPLIFT Trial Findings. Innovation in Aging. 2025. doi:10.1093/geroni/igaf122.3370.
BibTeX
@article{cagle2025-cf83ede5,
author = {Cagle, John G. and Zhang, Peiyuan and Becker, Todd D. and Floyd, Alex and Schwoyer-Morgan, Tracie and Ridder, Becky and Unroe, Kathleen Tschantz},
title = {{Assessing Palliative Care Needs in Nursing Homes Among Residents With Cognitive Impairment: UPLIFT Trial Findings}},
journal = {Innovation in Aging},
year = {2025},
doi = {10.1093/geroni/igaf122.3370},
url = {https://doi.org/10.1093/geroni/igaf122.3370}
}
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