CAROLINE ESTHER STEPHENS portrait
  • Helen Lowe Bamberger Colby Presidential Endowed Chair in Gerontological Nursing, Con Nursing
  • Associate Professor, College Of Nursing
801-581-8576

Education

  • BS, Biological Psychology; Human Development & Aging (minor), University of California, Davis
  • BSN, Nursing, University of Pennsylvania
  • MSN, Geropsychiatric Advanced Practice Nursing/CNS, University of Pennsylvania
  • Post-Master's Certificate, Gerontological Nurse Practitioner, University of Pennsylvania
  • PhD, Gerontological Nursing & Health Policy, University of California, San Francisco
  • John A. Hartford Foundation/Atlantic Philanthropies Claire M. Fagin Postdoc, Clinical Health Services Research, University of California, San Francisco Dept of Social & Behavioral Science
  • VA Quality Scholars Post-doctoral Fellowship, Health Care Quality & Leadership , San Francisco VA/UCSF School of Medicine, Division of Geriatrics
  • Advanced Training in Clinical Research Certificate, Clinical Research, University of California, San Francisco CTSI

Biography

Dr. Stephens is an Associate Professor and the Helen Lowe Bamberger Colby Presidential Endowed Chair in Gerontological Nursing. As a PhD-prepared Gerontological Nurse Practitioner and Geropsychiatric Advanced Practice Nurse with over 20 years of clinical experience, she is a nationally recognized expert in the care of vulnerable older adults with complex mental and physical multi-morbidity. Her interdisciplinary community-engaged program of research is focused on improving the health and health care of this diverse population, particularly those at greatest risk for poor care transitions with unmet palliative care needs, and their caregivers. Her work employs diverse research methods including advanced quantitative analyses of large population-based datasets; qualitative research; focus groups; quality improvement; clinical trials; community-based participatory research; and implementation science. Key findings from her national population-based studies reveal that ED use by vulnerable nursing home residents is not only common, but frequently preventable. Her mixed-methods research has highlighted how suboptimal communication between hospitals, nursing homes and families, as well as poor access to appropriate and timely palliative care, contribute to frequent hospital transfers by our most high-risk older adults. Additional findings published in JAMA IM reveal that the majority of nursing home residents are eligible for palliative care, but most do not receive it outside of hospice. Moreover, families commonly react to changes in resident condition as a crisis, often leading them to advocate for care that is physically and psychologically taxing and ineffective.

Her extramurally-funded interdisciplinary program of research is focused on the changes at the intersection of health care systems through technology-enhanced palliative care delivery models for patients and caregivers in both urban and rural settings. She has developed the Improving Palliative Care Access Through Technology (ImPAcTT) intervention for nursing homes which has been shown to be acceptable and feasible, while lowering symptom severity, facilitating advanced care planning, and improving NH residents’ quality of life. In addition, she directs the Utah Caregiving Population Data Science Initiative (Utah C-PopS) which is a multi-disciplinary collaborative that brings together separate research teams across campus and the nation; fosters new institutional collaborations and partnerships; and provides training on how secondary data and population analyses can be leveraged to better understand the dynamics of caregiving within a family system. As part of this initiative, her specific research is focused on examining how the characteristics of nursing home residents and their families affect care trajectories and healthcare utilization at end of life, as well as how caring for a nursing home resident impacts the health of families.