Gillian Denise Sanders Schmidler

Primary Theme: Global Health

Although 15% of the world’s population has some form of disability, the system of public health and health services is not adequately organized to promote independence. Even the most developed and well-resourced nations have medically underserved regions and communities where the presence of disability is compounded by inequities in social determinants of health. In 2016, the Global Alliance on Disability and Health Innovation (GANDHI) launched to engage students, faculty, the Duke community and external partners to examine the system supporting transitions in health and healthcare for people who experience an acute illness or injury and are newly living with disability. With almost a dozen projects in multiple countries over 18 months, coupled with historical evidence that it takes 17 years for evidence-based solutions to be adopted as standard practice, GANDHI team members have asked: What makes an innovation stick? Why does it take so long to scale up interventions?

Primary Theme: Brain & Society

Alzheimer’s disease is a progressive brain disorder that damages and eventually destroys brain cells, leading to a loss of memory, thinking, other brain functions and ultimately life. It is the sixth leading cause of death in the United States and the only one of the top ten diseases without treatment to prevent, cure or slow its progression. Alzheimer’s disease does not only impact those with the disease, but also their caregivers. As the disease progresses, the loss of critical skills make navigating day-to-day living impossible without help from others. Family caregivers or “informal caregivers” provide the majority of long-term care for adults with the disease. Caring for a person with Alzheimer’s disease can take a heavy toll on the health, well-being, employment and finances of caregivers. While caregivers are a crucial part of the care equation, their work is often not well supported or coordinated with medical assessments or care plans. For example, caregivers are not currently included in the medical records of patients or involved in monitoring outcomes. When patients are no longer able to report outcomes for themselves, there is not currently a way to transition to caregiver-reported outcomes. This creates a missed opportunity for physicians and other stakeholders to gather additional information on Alzheimer’s diseasepatients. Incorporating input from caregivers could help build a more complete picture of the patient and potentially improve care.