Abraham A. Brody

Faculty

Ab Brody headshot

Abraham A. Brody

FAAN PhD RN

Mathy Mezey Professor of Geriatric Nursing
Associate Director, Hartford Institute for Geriatric Nursing

1 212 992 7341

433 First Ave
Room
New York, NY 10010
United States

Accepting PhD students

Abraham A. Brody's additional information

Abraham (Ab) Brody, PhD, RN, FAAN is associate director of the HIGN, Mathy Mezey Professor of Geriatric Nursing and Professor of Medicine. He is also the founder of Aliviado Health, an implementation arm of HIGN focused on implementing high-quality, evidence-based care to support persons living with dementia and their care partners. His work centers on the intersection of geriatrics, palliative care, quality, and equity. This includes the development of interventions tailored for diverse and underserved older adults with serious illness and their care partners that can be implemented in real-world conditions are tested for effectiveness in large multi-site clinical trials. His work leverages emerging technologies, including precision health and machine learning, to support the interdisciplinary healthcare workforce.

Dr. Brody serves in many leadership roles, working across disciplines to help advance geriatrics and palliative care nationally and internationally. As Pilot Core Lead of the NIA IMPACT Collaboratory, he is responsible for heading the pilot program, which reviews and awards funds to help investigators prepare for large-scale pragmatic clinical trials for persons living with dementia and their care partners. He also is an experienced mentor and enjoys training early career faculty, PhD students, and post-doctoral scholars at NYU and nationally in geriatric and palliative focused intervention development and testing.

PhD - University of California, San Francisco (2008)
MSN - University of California, San Francisco (2006)
BA - New York University, College of Arts and Sciences (2002)

Home care
Palliative care
Non-communicable disease
Health Policy
Gerontology
Interprofessionalism
Chronic disease
Community/population health
Neurology
Research methods
Underserved populations

American Geriatrics Society
Eastern Nursing Research Society
Gerontological Society of America
Hospice and Palliative Nurses Association
International Home Care Nurses Organization
Palliative Care Research Cooperative
Sigma Theta Tau, Upsilon Chapter

Faculty Honors Awards

Fellow, American Academy of Nursing (2017)
Fellow, Palliative Care Nursing, Hospice and Palliative Nurses Association (2017)
Fellow, New York Academy of Medicine (2016)
Fellow, Gerontological Society of America (2016)
Nurse Faculty Scholar, Robert Wood Johnson Foundation (2014)
Sojourns Scholar, Cambia Health Foundation (2014)
Medical Reserve Corps, NYC, Hurricane Sandy Award (2013)
Goddard Fellowship, NYU (2013)
Research Scholar, Hospice and Palliative Nurses Association (2010)
Finalist, SRPP Section Young Investigator, Gerontological Society of America (2008)
Edith M. Pritchard Award, Nurses' Education Funds (2006)
Scholar, Building Academic Geriatric Nursing Capacity, John A Hartford (2006)
Finalist, Student Regent, University of California, San Francisco (2005)
Inducted into Sigma Theta Tau, Nursing Honor Society (2004)

Publications

An Evolutionary Concept Analysis of the "Fighter" in the Intensive Care Unit

Moreines, L. T., Brody, A. A., & Murali, K. P. (2024). Journal of Hospice and Palliative Nursing. 10.1097/NJH.0000000000001017
Abstract
Abstract
The purpose of this article was to analyze the concept of "the fighter in the intensive care unit (ICU)" per the scientific literature and the impact this mentality has on care administered in the ICU. A literature review and a concept analysis based on Rodger's evolutionary method were performed to identify surrogate terms, antecedents, attributes, and consequences pertaining to the "fighter" in the ICU. Thirteen articles with a focus on "the fighter" were included in this analysis. There is a strong desire to remain optimistic and maintain high spirits as a coping mechanism in the face of extreme prognostic uncertainty. Themes that emerged from the literature were the need to find inner strength and persist in the face of adversity. The concept of "the fighter in the ICU" can serve as either adaptive or maladaptive coping, depending on the larger clinical picture. Patient experiences in the ICU are fraught with physical and psychological distress. How the patient and family unit cope during this anxiety-provoking time is based on the individual. Maintaining optimism and identifying as a fighter can be healthy ways to adapt to the circumstances. This concept analysis highlights the importance of holistic care and instilling hope particularly as patients may be nearing the end of life.

Complex Care Needs at the End of Life for Seriously Ill Adults With Multiple Chronic Conditions

Murali, K. P., Merriman, J. D., Yu, G., Vorderstrasse, A., Kelley, A. S., & Brody, A. A. (2023). Journal of Hospice and Palliative Nursing, 25(3), 146-155. 10.1097/NJH.0000000000000946
Abstract
Abstract
Understanding the complex care needs of seriously ill adults with multiple chronic conditions with and without cancer is critical for the delivery of high-quality serious illness and palliative care at the end of life. The objective of this secondary data analysis of a multisite randomized clinical trial in palliative care was to elucidate the clinical profile and complex care needs of seriously ill adults with multiple chronic conditions and to highlight key differences among those with and without cancer at the end of life. Of the 213 (74.2%) older adults who met criteria for multiple chronic conditions (eg, 2 or more chronic conditions requiring regular care with limitations of daily living), 49% had a diagnosis of cancer. Hospice enrollment was operationalized as an indicator for severity of illness and allowed for the capture of complex care needs of those deemed to be nearing the end of life. Individuals with cancer had complex symptomatology with a higher prevalence of nausea, drowsiness, and poor appetite and end of life and lower hospice enrollment. Individuals with multiple chronic conditions without cancer had lower functional status, greater number of medications, and higher hospice enrollment. The care of seriously ill older adults with multiple chronic conditions requires tailored approaches to improve outcomes and quality of care across health care settings, particularly at the end of life.

Defining a taxonomy of Medicare-funded home-based clinical care using claims data

Ankuda, C. K., Ornstein, K. A., Leff, B., Rajagopalan, S., Kinosian, B., Brody, A. A., & Ritchie, C. S. (2023). BMC Health Services Research, 23(1). 10.1186/s12913-023-09081-8
Abstract
Abstract
Background: As more Americans age in place, it is critical to understand care delivery in the home. However, data on the range of home-based services provided by Medicare is limited. We define a taxonomy of clinical care in the home funded through fee-for-service Medicare and methods to identify receipt of those services. Methods: We analyzed Fee-for-service (FFS) Medicare claims data from a nationally-representative cohort of older adults, the National Health and Aging Trends Study (NHATS), to identify home-based clinical care. We included 6,664 NHATS enrollees age ≥ 70 and living in the community, observed an average of 3 times each on claims-linked NHATS surveys. We examined provider and service type of home-based clinical care to identify a taxonomy of 5 types: home-based medical care (physician, physician assistant, or nurse practitioner visits), home-based podiatry, skilled home health care (SHHC), hospice, and other fee-for-service (FFS) home-based care. We further characterized home-based clinical care by detailed care setting and visit types. Results: From 2011–2016, 17.8%-20.8% of FFS Medicare beneficiaries age ≥ 70 received Medicare-funded home-based clinical care. SHHC was the most common service (12.8%-16.1%), followed by other FFS home-based care (5.5%-6.5%), home-based medical care (3.2%-3.9%), and hospice (2.6%-3.0%). Examination of the other-FFS home-based care revealed imaging/diagnostics and laboratory testing to be the most common service. Conclusions: We define a taxonomy of clinical care provided in the home, serving 1 in 5 FFS Medicare beneficiaries. This approach can be used to identify and address research and clinical care gaps in home-based clinical care delivery.

Emergency Nurses’ Perceived Barriers and Solutions to Engaging Patients With Life-Limiting Illnesses in Serious Illness Conversations: A United States Multicenter Mixed-Method Analysis

Failed generating bibliography.
Abstract
Abstract
Introduction: This study aimed to assess emergency nurses’ perceived barriers toward engaging patients in serious illness conversations. Methods: Using a mixed-method (quant + QUAL) convergent design, we pooled data on the emergency nurses who underwent the End-of-Life Nursing Education Consortium training across 33 emergency departments. Data were extracted from the End-of-Life Nursing Education Consortium post-training questionnaire, comprising a 5-item survey and 1 open-ended question. Our quantitative analysis employed a cross-sectional design to assess the proportion of emergency nurses who report that they will encounter barriers in engaging seriously ill patients in serious illness conversations in the emergency department. Our qualitative analysis used conceptual content analysis to generate themes and meaning units of the perceived barriers and possible solutions toward having serious illness conversations in the emergency department. Results: A total of 2176 emergency nurses responded to the survey. Results from the quantitative analysis showed that 1473 (67.7%) emergency nurses reported that they will encounter barriers while engaging in serious illness conversations. Three thematic barriers—human factors, time constraints, and challenges in the emergency department work environment—emerged from the content analysis. Some of the subthemes included the perceived difficulty of serious illness conversations, delay in daily throughput, and lack of privacy in the emergency department. The potential solutions extracted included the need for continued training, the provision of dedicated emergency nurses to handle serious illness conversations, and the creation of dedicated spaces for serious illness conversations. Discussion: Emergency nurses may encounter barriers while engaging in serious illness conversations. Institutional-level policies may be required in creating a palliative care-friendly emergency department work environment.

Engagement, Advance Care Planning, and Hospice Use in a Telephonic Nurse-Led Palliative Care Program for Persons Living with Advanced Cancer

Failed generating bibliography.
Abstract
Abstract
Persons living with advanced cancer have intensive symptoms and psychosocial needs that often result in visits to the Emergency Department (ED). We report on program engagement, advance care planning (ACP), and hospice use for a 6-month longitudinal nurse-led, telephonic palliative care intervention for patients with advanced cancer as part of a larger randomized trial. Patients 50 years and older with metastatic solid tumors were recruited from 18 EDs and randomized to receive nursing calls focused on ACP, symptom management, and care coordination or specialty outpatient palliative care (ClinicialTrials.gov: NCT03325985). One hundred and five (50%) graduated from the 6-month program, 54 (26%) died or enrolled in hospice, 40 (19%) were lost to follow-up, and 19 (9%) withdrew prior to program completion. In a Cox proportional hazard regression, withdrawn subjects were more likely to be white and have a low symptom burden compared to those who did not withdraw. Two hundred eighteen persons living with advanced cancer were enrolled in the nursing arm, and 182 of those (83%) completed some ACP. Of the subjects who died, 43/54 (80%) enrolled in hospice. Our program demonstrated high rates of engagement, ACP, and hospice enrollment. Enrolling subjects with a high symptom burden may result in even greater program engagement.

Improving sleep using mentored behavioral and environmental restructuring (SLUMBER): A randomized stepped-wedge design trial to evaluate a comprehensive sleep intervention in skilled nursing facilities

Chodosh, J., Mitchell, M. N., Cadogan, M., Brody, A. A., Alessi, C. A., Hernandez, D. E., Mangold, M., & Martin, J. L. (2023). Contemporary Clinical Trials, 126. 10.1016/j.cct.2023.107107
Abstract
Abstract
Introduction: Poor sleep is ubiquitous in skilled nursing facilities (SNFs) and is associated with a myriad of negative symptoms. Non-pharmacological interventions can improve sleep, yet sustainability has not been demonstrated. The Improving Sleep Using Mentored Behavioral and Environmental Restructuring (SLUMBER) trial will test whether a staff mentoring approach to address resident sleep issues positively impacts sleep quality and whether improved sleep benefits mood, cognitive performance, and activity engagement for residents living in SNFs. Intervention: This is a four-year hybrid type I effectiveness/implementation randomized stepped-wedge trial using a comprehensive sleep improvement program conducted in three urban SNFs. Methods: We will provide SNF staff with sleep promotion strategies over a four-month intervention. Staff will have access to in-person workshops, webinars, weekly sleep pearls via text messaging, environmental data, and expert program mentors. We will consent residents for data collection (at baseline, end of intervention, and three- and six-months post-intervention) including resident observations, questionnaires, and wrist actigraphy (to objectively measure sleep). We will also use selected Minimum Data Set 3.0 (MDS) measures. Conclusion: SLUMBER uses a unique strategy to iteratively improve sleep interventions through SNF staff buy-in, expert mentoring, and technological supports within a quality improvement framework. As a stepped-wedge trial, the initial SNF units provide opportunities for program improvement in subsequent units, accounting for variation across resident populations at different sites. Protocol limitations include strategies which may require substantial customization for greater spread. A comprehensive staff training program that addresses both sleep quality and related symptoms has the opportunity for considerable dissemination.

Multiple Chronic Conditions among Seriously Ill Adults Receiving Palliative Care

Murali, K. P., Yu, G., Merriman, J. D., Vorderstrasse, A., Kelley, A. S., & Brody, A. A. (2023). Western Journal of Nursing Research, 45(1), 14-24. 10.1177/01939459211041174
Abstract
Abstract
The objective of this study was to characterize multiple chronic conditions (MCCs) among seriously ill adults receiving palliative care at the end of life. A latent class analysis was conducted to identify latent subgroups of seriously ill older adults based on a baseline Charlson comorbidity index (CCI) measurement, a measure of comorbidity burden, and mortality risk. The three latent subgroups were: (1) low to moderate CCI with MCC, (2) high CCI with MCC, and (3) high CCI and metastatic cancer. The “low to moderate CCI and MCC” subgroup included older adults with chronic obstructive pulmonary disease (COPD), cardiovascular disease, congestive heart failure, myocardial infarction, dementia, diabetes, and lymphoma. A “high CCI and MCC” subgroup included individuals with severe illness including liver or renal disease among other MCCs. A “high CCI and metastatic cancer” included all participants with metastatic cancer. This study sheds light on the MCC profile of seriously ill adults receiving palliative care.

Neuropsychiatric symptoms in people living with dementia receiving home health services

Lassell, R. K., Lin, S. Y., Convery, K., Fletcher, J., Chippendale, T., Jones, T., Durga, A., Galvin, J. E., Rupper, R. W., & Brody, A. A. (2023). Journal of the American Geriatrics Society, 71(12), 3865-3873. 10.1111/jgs.18548
Abstract
Abstract
Background: We sought to describe neuropsychiatric symptoms (NPS) among people living with dementia (PLWD) from diverse racial and ethnic groups receiving home health services while accounting for dementia severity, individual symptom prevalence, and neighborhood disadvantage. Methods: A prospective study using cross-sectional data from n = 192 PLWD receiving skilled home healthcare in New Jersey enrolled in the Dementia Symptom Management at Home Program trial. We prospectively measured symptom prevalence with the Neuropsychiatric Inventory Questionnaire and dementia severity using the Quick Dementia Rating System. A one-way ANOVA determined NPS prevalence by dementia severity (mild, moderate, severe). Fisher's exact tests were used to assess the association of individual symptom prevalence with race and ethnicity and cross tabs to descriptively stratify individual symptom prevalence by dementia severity among groups. A Pearson correlation was performed to determine if a correlation existed among neighborhood disadvantages measured by the Area Deprivation Index (ADI) state decile scores and NPS prevalence and severity. Results: Participants identified as non-Hispanic White (50%), non-Hispanic Black (30%), or Hispanic (13%). NPS were prevalent in 97% of participants who experienced 5.4 ± 2.6 symptoms with increased severity (10.8 ± 6.6) and care partner distress (13.8 ± 10.8). NPS increased with dementia severity (p = 0.004) with the greatest difference seen between individuals with mild dementia (4.3 ± 2.3) versus severe dementia (5.9 ± 2.3; p = 0.002). Few differences were found in symptom prevalence by racial and ethnic sub-groups. Nighttime behaviors were higher in non-Hispanic Black (78%), compared with non-Hispanic Whites (46%) with moderate dementia, p = 0.042. State ADI scores were not correlated with the number of NPS reported, or severity. Conclusions: NPS were prevalent and increased with dementia severity with commonalities among racial and ethnic groups with varying levels of neighborhood disadvantage. There is a need for effective methods for improving NPS identification, assessment, and management broadly for homebound PLWD.

Nurses, Psychological Distress, and Burnout: Is There an App for That?

Murali, K. P., Brody, A. A., & Stimpfel, A. W. (2023). Annals of the American Thoracic Society, 20(10), 1404-1405. 10.1513/AnnalsATS.202307-629ED

One accurate measurement is worth 1000 expert opinions—Assessing quality care in assisted living

David, D., & Brody, A. A. (2023). Journal of the American Geriatrics Society, 71(5), 1358-1361. 10.1111/jgs.18284