Dena Schulman-Green

Faculty

Dena Schulman-Green Headshot

Dena Schulman-Green

PhD FAAHPM

Associate Professor
Director of the Florence S. Downs PhD Program

1 212 998 5786

433 First Ave
New York, NY 10010
United States

Accepting PhD students

Dena Schulman-Green, MA, EdM, MS, PhD, FAAHPM is Director of the Florence S. Downs PhD Program in Nursing Research and Theory Development and Associate Professor at NYU Rory Meyers College of Nursing. Her 20+ years in clinical nursing research are grounded in an interdisciplinary background of psychology, gerontology, and palliative care. Schulman-Green’s scholarship centers on self- and family management of serious chronic illness, with an emphasis on early integration of palliative care. She is a lead developer of the internationally recognized Middle Range Theory of Self- and Family Management of Chronic Illness and co-developed the Managing Cancer Care intervention with women and family caregivers facing breast and ovarian cancer. Her funders include the National Institutes of Health, the American Cancer Society, and the National Palliative Care Research Center.

Currently, Schulman-Green leads and collaborates on various studies related to cancer, dementia, and palliative care. A recognized expert in qualitative and mixed methods research, she consults widely. Schulman-Green is deeply committed to mentorship, routinely involving PhD students and postdoctoral fellows in her work. She serves on the Leadership Development Committee of the American Academy of Hospice and Palliative Medicine and on the Editorial Board of the Journal of Pain and Symptom Management.

Prior to joining NYU Meyers, Schulman-Green was first a Research Scientist and later an Associate Professor at Yale School of Nursing, where she also directed the Qualitative and Mixed Methods Core of the Center for Biobehavioral Health. Additionally, she held faculty roles in the Palliative Medicine Fellowship Program and the Interprofessional Palliative Care Education Program at Yale School of Medicine and was instrumental in strengthening Yale’s palliative care research infrastructure.

Among her many honors, Schulman-Green has received the National Hospice and Palliative Care Organization Research Award, the Suzanne Feetham Nurse Scientist Family Research Award, the Yale School of Nursing’s Annie W. Goodrich Award for Excellence in Teaching, and NYU Meyers’ Dean’s Excellence in Mentoring Award. She has also been recognized among the World’s Top 2% of Scientists by Stanford University/Elsevier and is a Fellow of the American Academy of Hospice and Palliative Medicine and the New York Academy of Medicine.

Schulman-Green received a BA in Psychology and Religion from Boston University, a MA and EdM in Counseling Psychology from Columbia University, and a MS and PhD in Gerontology from University of Massachusetts Boston. She completed a post-doctoral fellowship in Breast Cancer and Palliative Care at Yale School of Nursing through a U.S. Army Department of Defense Breast Cancer Research Program Training Grant under the mentorship of Drs. Ruth McCorkle and Elizabeth Bradley.

Post-doctorate, Breast Cancer & Palliative Care- Yale School of Nursing
PhD, Gerontology- University of Massachusetts Boston
MS, Gerontology- University of Massachusetts Boston
EdM, Counseling Psychology- Columbia University, Teachers College
MA, Counseling Psychology- Columbia University, Teachers College
BS, Psychology and Religion- Boston University

Chronic disease
Gerontology
Global Health
Health Disparities
Mixed Methods Research
Oncology
Palliative care
Qualitative Research
Research methods
Serious illness
Self and Family Management
Theoretical and conceptual models
Women's health

American Academy of Hospice and Palliative Medicine
Eastern Nursing Research Society
Gerontological Society of America

Suzanne Feetham Nurse Scientist Family Research Award, Eastern Nursing Research Society (2019)
American Academy of Hospice and Palliative Medicine Poster Award (2017)
Annie W. Goodrich Award for Excellence in Teaching, Yale School of Nursing (2017)
American Academy of Hospice and Palliative Medicine Poster Award (2016)
American Academy of Hospice and Palliative Medicine Poster Award (2010)
Center for Disease Control Success Story Award (2010)
Ellison Medical Foundation Aging New Scholar Award Nominee, University of Massachusetts Boston (2006)
National Hospice and Palliative Care Organization Research Award (2004)
Inducted into Sigma Phi Omega, Gerontology Honor Society (1999)
Association for Gerontology in Higher Education/AARP Andrus Foundation Graduate Scholarship in Gerontology (1998)
Columbia University General Scholarship Award (1993)
Inducted into Psi Chi, Psychology Honor Society (1992)
Golden Key Honor Society, Boston University (1992)

Interventions and Predictors of Transition to Hospice for People Living with Dementia: An Integrative Review

Murali, K. P., Gogineni, S., Bullock, K., McDonald, M., Sadarangani, T., Schulman-Green, D., & Brody, A. A. (2025). The Gerontologist, 65(5). 10.1093/geront/gnaf046
Abstract
Abstract
BACKGROUND AND OBJECTIVES: Goal-concordant transition to hospice is an important facet of end-of-life care for people living with dementia. The objective of this integrative review was to appraise existing evidence and gaps focused on interventions and predictors of transition to hospice and end-of-life care for persons living with dementia across healthcare to inform future research.RESEARCH DESIGN AND METHODS: Using integrative review methodology by Whittemore and Knafl, five databases were searched (PubMed, CINAHL, Web of Science, Google Scholar, Cochrane Database for Systematic Reviews) for articles between 2000 and 2023. The search focused on dementia, hospice care, transitions, care management and/or coordination, and intervention studies.RESULTS: Fourteen articles met inclusion criteria after critical appraisal. Most were cross-sectional in design and conducted in nursing homes and hospitals in the U.S. persons living with dementia had multiple chronic conditions including cancer, diabetes, heart disease, and stroke. Interventions included components of hospice decision-making delivered through advance care planning, checklist-based care management for hospice transition, and palliative care for those with severe dementia. Predictors included increasing severity of illness including functional decline, organ failure, intensive care use, and the receipt of palliative care. Other predictors were related to insurance status, race and ethnicity, and caregiver burden. Overall, despite moderate to high-quality evidence, the studies were limited in scope and sample and lacked racial and ethnic diversity.DISCUSSION AND IMPLICATIONS: Prospective, multisite randomized trials and population-based analyses including larger and diverse samples are needed for improved end-of-life dementia illness counseling and hospice care transitions for persons living with dementia and their caregivers.

Interventions and Predictors of Transition to Hospice for People Living With Dementia: An Integrative Review

Murali, K. P., Gogineni, S., Bullock, K., Mcdonald, M., Sadarangani, T., Schulman-Green, D., & Brody, A. A. (2025). Gerontologist, 65(5). 10.1093/geront/gnaf046
Abstract
Abstract
Background and Objectives: Goal-concordant transition to hospice is an important facet of end-of-life care for people living with dementia. The objective of this integrative review was to appraise existing evidence and gaps focused on interventions and predictors of transition to hospice and end-of-life care for persons living with dementia across healthcare to inform future research. Research Design and Methods: Using integrative review methodology by Whittemore and Knafl, 5 databases were searched (PubMed, CINAHL, Web of Science, Google Scholar, and Cochrane Database for Systematic Reviews) for articles between 2000 and 2023. The search focused on dementia, hospice care, transitions, care management and/or coordination, and intervention studies. Results: Fourteen articles met inclusion criteria after critical appraisal. Most were cross-sectional in design and conducted in nursing homes and hospitals in the U.S. persons living with dementia had multiple chronic conditions including cancer, diabetes, heart disease, and stroke. Interventions included components of hospice decision-making delivered through advance care planning, checklist-based care management for hospice transition, and palliative care for those with severe dementia. Predictors included increasing severity of illness including functional decline, organ failure, intensive care use, and the receipt of palliative care. Other predictors were related to insurance status, race and ethnicity, and caregiver burden. Overall, despite moderate to high-quality evidence, the studies were limited in scope and sample and lacked racial and ethnic diversity. Discussion and Implications: Prospective, multisite randomized trials and population-based analyses including larger and diverse samples are needed for improved end-of-life dementia illness counseling and hospice care transitions for persons living with dementia and their caregivers.

“There Should Be A Nurse On Call”: Complex Care Needs of Low-Income Older Adults in Medicaid-Supported Assisted Living

Murali, K. P., Lassell, R. K., Brody, A. A., Schulman-Green, D., & David, D. (2025). Journal of Palliative Medicine. 10.1089/jpm.2024.0445
Abstract
Abstract
Background: In the United States, nearly 1 million older adults reside in assisted living facilities, which aim to provide support for safe, autonomous living. However, low-income residents, especially those in Medicaid-supported facilities, experience unmet medical and social complex care needs and limited serious illness communication due to limited resources. Objective: The objective of this study was to explore the complex care needs and serious illness communication challenges experienced by low-income older adults in Medicaid-supported assisted living. Methods: A qualitative secondary framework analysis was conducted on data from a parent qualitative study involving 17 residents aged 60 and older with serious illnesses at a Medicaid-supported facility in New York City. Residents completed the Edmonton Symptom Assessment Scale and participated in semistructured interviews. This study was guided by the National Consensus Project for Quality Palliative Care, focusing on the residents’ experiences, complex care needs, and communication within palliative care domains. Results: Residents were predominantly Black and Hispanic, with nearly one-third having a history of homelessness or shelter use, and they experienced a high symptom burden. Four key themes emerged: (1) compromised quality of life; (2) high symptom burden and limited access to care, with residents reporting pain, fatigue, and emotional distress; (3) communication gaps while navigating health care, resulting in frustration and feelings of being unheard; and (4) fragmented care coordination, which exacerbated feelings of isolation and mistrust in the health care system. Conclusion: The findings reveal that Medicaid-supported assisted living residents encounter substantial challenges related to complex care needs and serious illness communication. There is an urgent need for community-based interventions to enhance care access, improve symptom management, and facilitate effective communication, ultimately supporting the residents’ quality of life and health outcomes. Enhanced training for staff and policy changes are key to addressing these systemic barriers to care.

“There Should Be A Nurse On Call”: Complex Care Needs of Low-Income Older Adults in Medicaid-Supported Assisted Living

Murali, K., Lassell, R. K., Brody, A., Schulman-Green, D., & David, D. (2025). Journal of Palliative Medicine. 10.1089/jpm.2024.0445
Abstract
Abstract
Background: In the United States, nearly 1 million older adults reside in assisted living facilities, which aim to provide support for safe, autonomous living. However, low-income residents, especially those in Medicaid-supported facilities, experience unmet medical and social complex care needs and limited serious illness communication due to limited resources. Objective: The objective of this study was to explore the complex care needs and serious illness communication challenges experienced by low-income older adults in Medicaid-supported assisted living. Methods: A qualitative secondary framework analysis was conducted on data from a parent qualitative study involving 17 residents aged 60 and older with serious illnesses at a Medicaid-supported facility in New York City. Residents completed the Edmonton Symptom Assessment Scale and participated in semistructured interviews. This study was guided by the National Consensus Project for Quality Palliative Care, focusing on the residents’ experiences, complex care needs, and communication within palliative care domains. Results: Residents were predominantly Black and Hispanic, with nearly one-third having a history of homelessness or shelter use, and they experienced a high symptom burden. Four key themes emerged: (1) compromised quality of life; (2) high symptom burden and limited access to care, with residents reporting pain, fatigue, and emotional distress; (3) communication gaps while navigating health care, resulting in frustration and feelings of being unheard; and (4) fragmented care coordination, which exacerbated feelings of isolation and mistrust in the health care system. Conclusion: The findings reveal that Medicaid-supported assisted living residents encounter substantial challenges related to complex care needs and serious illness communication. There is an urgent need for community-based interventions to enhance care access, improve symptom management, and facilitate effective communication, ultimately supporting the residents’ quality of life and health outcomes. Enhanced training for staff and policy changes are key to addressing these systemic barriers to care.

“Who You Are and Where You Live Matters”: Hospice Care in New York City During COVID-19Perspectives on Hospice and Social Determinants: A Rapid Qualitative Analysis

David, D., Moreines, L. T., Boafo, J., Kim, P., Franzosa, E., Schulman-Green, D., Brody, A. A., & Aldridge, M. D. (2025). Journal of Palliative Medicine, 28(1), 59-68. 10.1089/jpm.2024.0124
Abstract
Abstract
Context: Social determinants of health (SDOH) impacted the quality of home hospice care provided during the COVID-19 pandemic. Perspectives from professionals who provided care identify challenges and lessons learned from their experience. Objective: To examine hospice professionals’ perspectives of how SDOH affected the delivery of high-quality home hospice care in New York City (NYC) during the COVID-19 pandemic. Methods: We conducted semistructured interviews with 30 hospice professionals who delivered care to home hospice patients during the COVID-19 pandemic in NYC using a qualitative descriptive design. Purposive sampling was used to recruit professionals from a range of disciplines including physicians, advanced practice providers, nurses, social workers, chaplains, and hospice administration and management. Participants worked for one of two large NYC metro hospices and one outpatient palliative care practice serving the five boroughs of NYC and the surrounding suburbs. Rapid qualitative analysis was used to identify themes. Results: Thirty hospice professionals were interviewed, spanning a variety of clinical and administrative roles. Most (21 out of 30) reported that social determinants affected access and/or delivery of equitable hospice care. Two key themes emerged from interviews: (1) SDOH exist and affect the delivery of high-quality care and (2) disparities were exacerbated during the COVID-19 pandemic resulting in barriers to care. Subthemes outline barriers described by hospice professionals: decreased hospice enrollment, telehealth challenges, resulting in deficient patient/family education, shortages of nursing assistants in some neighborhoods, and diminished overall quality of hospice care for some patients. SDOH created barriers to hospice care through neighborhood factors, resource barriers, and system challenges. Conclusion: SDOH provide a context to understand disparity in the provision of hospice care. COVID-19 exacerbated these conditions. Addressing multidimensional barriers created by SDOH is key in creating high-quality and equitable hospice care, particularly during a crisis.

Assessing Delirium Severity in Dementia: Item Development and Psychometric Validation for a Delirium Severity Instrument

Hshieh, T., Schulman-Green, D., Fong, T. G., Metzger, E., Arias, F., Helfand, B., Marcantonio, E., Schmitt, E., Tabloski, P., Jones, R. N., & Inouye, S. K. (2024). Journal of Gerontological Nursing, 50(9), 24-30. 10.3928/00989134-20240809-06
Abstract
Abstract
PURPOSE: Despite the importance of measuring delirium severity in patients with Alzheimer’s disease and related dementias (ADRD), no validated instrument currently exists. Our goal was to generate items for use in such an instrument. METHOD: An interdisciplinary expert panel developed items to assess seven domains and 21 subdomains of delirium severity. Nursing experts provided input on items. RESULTS: Experts achieved consensus on 21 items, including best respondents for each item, and appropriate look-back periods. Nursing experts emphasized the need for educating nursing staff and obtaining information from caregivers. CONCLUSION: Careful, nuanced identification of distinguishing features is key for generating items for measuring delirium severity in persons with ADRD. Once developed, engaging nurses will be essential to facilitate adoption and relevance of the tool.

Family Management Skills Reported by Parents of Preterm Infants in the NICU Using the Self- and Family Management Framework (SFMF)

Weber, A., Bakas, T., Schulman-Green, D., Voos, K. C., Rice, J. B., Bailey, R., Reigel, A., Oudat, Q., Holmes, M., Tubbs-Cooley, H. L., & Kaplan, H. C. (2024). Advances in Neonatal Care, 24(2), 119-131. 10.1097/ANC.0000000000001140
Abstract
Abstract
Background: Across the globe, family-integrated care (FICare) has become an evidence-based standard in which parents deliver the majority of infant care in the neonatal intensive care unit (NICU). Because of extensive barriers to parent presence, adaptations to FICare may be required for successful implementation. Family management theory may provide structure to the Parent Education of FICare and help nurses guide parents’ skill development as equal care members. Purpose: To identify family management skills employed by NICU parents using the Self- and Family Management Framework (SFMF). Methods: We conducted secondary analyses of qualitative interview data from NICU parents (n = 17) who shared their experiences of using family management skills to care for their infant. We categorized skills according to 3 main self- and family management processes: Focusing on Infant Illness Needs; Activating Resources; and Living With Infant Illness. Results: Parents reported several family management skills currently identified in the SFMF, as well as new skills such as conflict management, power brokerage, and addressing resources related to social determinants of health. Parent activation of resources was critical to sustaining parent focus on the infant’s illness needs. Implications for Practice and Research: By teaching skills that parents reported as helping them manage infant care, neonatal nurses may better facilitate parent integration into the care team. Future researchers can incorporate the skills identified in this study into the design of family management interventions that facilitate FICare implementation in the United States.

Lessons Learned Establishing the Palliative Care Research Cooperative's Qualitative Data Repository

Meghani, S. H., Mooney-Doyle, K., Barnato, A., Colborn, K., Gillette, R., Harrison, K. L., Hinds, P. S., Kirilova, D., Knafl, K., Schulman-Green, D., Pollak, K. I., Ritchie, C. S., Kutner, J. S., & Karcher, S. (2024). Journal of Pain and Symptom Management, 68(3), 308-318. 10.1016/j.jpainsymman.2024.05.027
Abstract
Abstract
Data sharing is increasingly an expectation in health research as part of a general move toward more open sciences. In the United States, in particular, the implementation of the 2023 National Institutes of Health Data Management and Sharing Policy has made it clear that qualitative studies are not exempt from this data sharing requirement. Recognizing this trend, the Palliative Care Research Cooperative Group (PCRC) realized the value of creating a de-identified qualitative data repository to complement its existing de-identified quantitative data repository. The PCRC Data Informatics and Statistics Core leadership partnered with the Qualitative Data Repository (QDR) to establish the first serious illness and palliative care qualitative data repository in the U.S. We describe the processes used to develop this repository, called the PCRC-QDR, as well as our outreach and education among the palliative care researcher community, which led to the first ten projects to share the data in the new repository. Specifically, we discuss how we co-designed the PCRC-QDR and created tailored guidelines for depositing and sharing qualitative data depending on the original research context, establishing uniform expectations for key components of relevant documentation, and the use of suitable access controls for sensitive data. We also describe how PCRC was able to leverage its existing community to recruit and guide early depositors and outline lessons learned in evaluating the experience. This work advances the establishment of best practices in qualitative data sharing.

Navigating a "good Death" during COVID-19: Understanding Real-Time End-of-Life Care Structures, Processes, and Outcomes Through Clinical Notes

Franzosa, E., Kim, P. S., Moreines, L. T., McDonald, M. V., David, D., Boafo, J., Schulman-Green, D., Brody, A. A., & Aldridge, M. D. (2024). Gerontologist, 64(10). 10.1093/geront/gnae099
Abstract
Abstract
Background and Objectives: The coronavirus disease 2019 (COVID-19) pandemic severely disrupted hospice care, yet there is little research regarding how widespread disruptions affected clinician and family decision-making. We aimed to understand how the pandemic affected structures, processes, and outcomes of end-of-life care. Research Design and Methods: Retrospective narrative chart review of electronic health records of 61 patients referred and admitted to hospice from 3 New York City geriatrics practices who died between March 1, 2020, and March 31, 2021. We linked longitudinal, unstructured medical, and hospice electronic health record notes to create a real-time, multiperspective trajectory of patients' interactions with providers using directed content analysis. Results: Most patients had dementia and were enrolled in hospice for 11 days. Care processes were shaped by structural factors (staffing, supplies, and governmental/institutional policies), and outcomes were prioritized by care teams and families (protecting safety, maintaining high-touch care, honoring patient values, and supporting patients emotionally and spiritually). Processes used to achieve these outcomes were decision-making, care delivery, supporting a "good death,"and emotional and spiritual support. Discussion and Implications: Care processes were negotiated throughout the end of life, with clinicians and families making in-the-moment decisions. Some adaptations were effective but also placed extraordinary pressure on paid and family caregivers. Healthcare teams' and families' goals to meet patients' end-of-life priorities can be supported by ongoing assessment of patient goals and process changes needed to support them, stronger structural supports for paid and family caregivers, incentivizing relationships across primary care and hospice teams, and extending social work and spiritual care.

Patient experiences with tissue-based genomic testing during active surveillance for prostate cancer

Leapman, M. S., Sutherland, R., Gross, C. P., Ma, X., Seibert, T. M., Cooperberg, M. R., Catalona, W. J., Loeb, S., & Schulman-Green, D. (2024). BJUI Compass, 5(1), 142-149. 10.1002/bco2.277
Abstract
Abstract
Background: Tissue-based gene expression (genomic) tests provide estimates of prostate cancer aggressiveness and are increasingly used for patients considering or engaged in active surveillance. However, little is known about patient experiences with genomic testing and its role in their decision-making. Methods: We performed a qualitative study consisting of in-depth, semi-structured interviews of patients with low- or favourable-intermediate-risk prostate cancer managed with active surveillance. We purposively sampled to include patients who received biopsy-based genomic testing as part of clinical care. The interview guide focused on experiences with genomic testing during patients' decision-making for prostate cancer management and understanding of genomic test results. We continued interviews until thematic saturation was reached, iteratively created a code key and used conventional content analysis to analyse data. Results: Participants' (n = 20) mean age was 68 years (range 51–79). At initial biopsy, 17 (85%) had a Gleason grade group 1, and 3 (15%) had a grade group 2 prostate cancer. The decision to undergo genomic testing was driven by both participants and physicians' recommendations; however, some participants were unaware that testing had occurred. Overall, participants understood the role of genomic testing in estimating their prostate cancer risk, and the test results increased their confidence in the decision for active surveillance. Participants had some misconceptions about the difference between tissue-based gene expression tests and germline genetic tests and commonly believed that tissue-based tests measured hereditary cancer risk. While some participants expressed satisfaction with their physicians' explanations, others felt that communication was limited and lacked sufficient detail. Conclusion: Patients interact with and are influenced by the results of biopsy-based genomic testing during active surveillance for prostate cancer, despite gaps in understanding about test results. Our findings indicate areas for improvement in patient counselling in order to increase patient knowledge and comfort with genomic testing.