About

Karl Pillemer, Ph.D., is one of America’s leading family sociologists and researchers on aging. He is a Professor of Human Development at Cornell University and Professor of Gerontology in Medicine at the Weill Cornell Medical College. Throughout his career, Dr. Pillemer’s research has focused on how family relationships develop and change over time, with particular attention to issues such as family estrangements and reconciliation. His work combines academic rigor with practical advice, aiming to help families mend fractured relationships and build bridges over family rifts. Dr. Pillemer is the author of the book "Fault Lines," which addresses family estrangements affecting more than 65 million Americans, offering science-based evidence, dramatic stories, and practical tools for reconciliation. His research and writing provide valuable insights into family dynamics and aging, helping those estranged and their loved ones find paths to healing and connection.

Research topics

• Medicine
• Environmental health
• Psychiatry
• Gerontology
• Medical emergency
• Nursing
• Demography
• Political Science
• Virology
• Criminology
• Economics
• Economic growth
• Family medicine
• Psychology

Selected publications

• Quality aging as an integrative concept in gerontology

  Journal of Aging Studies · 2026-02-28

  articleSenior author
  PublisherDOI

• Primary Care Utilization Among Legally Adjudicated Elder Mistreatment Cases in Comparison to Other Older Adults

  Journal of the American Geriatrics Society · 2026-04-01

  articleOpen access

  BACKGROUND: Elder mistreatment is associated with adverse health outcomes and increased Emergency Department (ED) and hospital utilization patterns in the period surrounding initial mistreatment identification. Less is known about outpatient primary care utilization, but it has been hypothesized that elder mistreatment victims may use this care less frequently than other older adults due to isolation and poor connection to outpatient providers. METHODS: We used multiple measures of outpatient primary utilization patterns including fractured care (continuity of care index (COCI) and usual provider of care (UPC) index) in the 360 days before and after mistreatment identification. Data were adjusted using US Centers for Medicare and Medicaid Services Hierarchical Condition Categories risk scores. RESULTS: This study included 114 cases and 410 controls. Median age was 72 years (IQR, 68-78 years), and 340 (64.9%) were women. During the 720 days surrounding mistreatment identification, cases were more likely to have had at least one outpatient primary care visit (adjusted odds ratio [AOR], 2.05 [95% CI, 1.12-3.73]; p = 0.02) and visits to multiple primary care providers (AOR, 1.51 [95% CI, 0.99-2.29]; p = 0.05). In unadjusted and adjusted models, both COCI and UPC were significantly lower in cases than controls during the 360 days prior to identification but not in the 360 days post-identification or when examining the entire 720 days. More cases received both outpatient primary care and ED/hospital care during the 720 days (58.8% vs. 33.7%; p < 0.001). CONCLUSION: Contrary to hypotheses, older adults experiencing mistreatment were not less likely to use outpatient primary care than other older adults during the period surrounding mistreatment. Additional research is needed to examine potential explanations and explore opportunities to improve detection and intervention in primary care.

  PublisherOA PDFDOI

• A Staff Intervention Targeting Resident‐to‐Resident Aggression in Assisted Living: A Cluster‐Randomized Trial

  Journal of the American Geriatrics Society · 2026-01-09

  articleOpen accessSenior author

  BACKGROUND: Resident-to-resident aggression (RRA) in long-term care settings is widespread with the potential for serious detrimental outcomes. However, few evidence-based training, intervention, and implementation strategies exist. The objective was to evaluate intervention process outcomes (knowledge), and proximal and distal outcomes (increased recognition, documentation, and reporting) in assisted living facilities. METHODS: Staff reported on RRA with respect to 930 residents (495 intervention and 435 usual care) from 14 New York assisted living facilities (7 per group). Data were collected at baseline, 6 and 12 months. Intervention site staff received training, while usual care staff did not. Knowledge outcomes were measured using two 10-item scales. Recognition and documentation for care planning were measured on an ongoing basis in real time, and longitudinal reporting of past two-week events through a structured interview. Mixed models were used to evaluate continuous knowledge variables. Outcome evaluation was conducted on an intent-to-treat basis using Poisson regressions for longitudinal count data measuring recognition/documentation and reporting. RESULTS: A total of 238, 263, and 217 staff attended Modules 1-3, respectively. There was a statistically significant increase in knowledge post-training, controlling for pre-training levels (estimated mean = 1.37, 95% CI, 1.11-1.62, p < 0.001 for Module 1 and estimated mean = 0.46, 95% CI, 0.21-0.70, p < 0.001 for Module 2). The program statistically significantly increased recognition and documentation of RRA in real time (estimated log mean = 4.34, 95% CI, 1.22-7.45, p = 0.006); there were 92 incidents reported by intervention group staff as contrasted with one in the usual care group. In terms of longitudinal reporting of events using a structured interview, a significant between-group difference was observed (estimate = 0.64, 95% CI, 0.18-1.09, p = 0.006). CONCLUSIONS: The training intervention was demonstrated as effective in enhancing knowledge, recognition/documentation, and reporting of RRA in assisted living, replicating findings in nursing homes. It is recommended that this program be disseminated in long-term care facilities. TRIAL REGISTRATION: Clinical Trials.gov identifier: NCT03383289 registered December 26, 2017. The first subject was enrolled May 26, 2018; the last subject was enrolled August 2022; follow-up data collection was completed June 5, 2023.

  PublisherOA PDFDOI

• An Online Psychoeducational Pilot Program with Homecare Workers of Dependent Older Adults

  GeroPsych · 2025-02-19

  articleSenior author

  Abstract: Homecare workers play an important role in caring for dependent older adults, but no resources are targeted specifically at this population. This study describes the implementation of an online psychoeducational pilot program among homecare workers of older adults receiving dependent care and presents the preliminary results in research settings. The research design was quasiexperimental and consisted of 20 homecare workers completing baseline and postintervention assessments. The intervention consisted of a 6-week online psychoeducational program conducted by a psychologist via videoconferencing. Attendance and dropout rates were recorded, along with the completion of homework assignments, participation in intervention sessions, and the collection of qualitative information about the intervention’s acceptability indexes. We discuss the lessons learned from the implementation of the pilot study, followed by the preliminary results regarding its effects on the well-being of care workers (trend toward improvements in burnout, anxiety, and depression). Finally, we propose clinical implications and future directions for online program development.

  PublisherDOI

• Moderating Effect of Family Function Between Dysfunctional Thoughts and Emotional Distress in Dementia Caregivers: Kinship Differences

  Family Process · 2025-03-01

  articleOpen access

  Caring for a family member with dementia impacts caregivers' mental health. Daughters who provide care seem to be particularly affected due to their multiple roles. The study analyzed the role of dysfunctional thoughts and family function for understanding caregivers' depressive and anxiety symptoms, focusing on the potential moderating effect of family function in the relationship between dysfunctional thoughts and distress. In addition, it examined potential differences in the obtained associations considering the kinship relationship. A total of 278 family caregivers of people with dementia were divided into four groups (wives, husbands, daughters, sons). Sociodemographic variables, family obligations, dysfunctional thoughts, frequency and discomfort associated with problematic behaviors, family function, anxious symptomatology, and depressive symptomatology were assessed. Regression analyses revealed that the moderating effect of family function was significant only for daughters. For depressive symptomatology, the model explained 28.6% of the variance for daughters, showing that high levels of dysfunctional thoughts were associated with increased depressive symptoms when family function was low or intermediate (p < 0.001), but not when it was high. Similarly, for anxious symptomatology, the model explained 23.9% of the variance for daughters, with dysfunctional thoughts again associated with higher anxiety symptoms when family function was low or intermediate (p < 0.001), but not significantly when family function was high. These findings suggest that a well-functioning family may buffer the negative impact of rigid caregiving beliefs, particularly for daughters. The results highlight the importance of interventions aimed at improving family dynamics to enhance caregivers' well-being.

  PublisherOA PDFDOI

• Health Patterns of Dementia Caregivers With Chronic Pain: Latent Profile Analysis of the PROMIS-29 Measure

  Journal of Applied Gerontology · 2025-07-30 · 1 citations

  article

  = 273). Utilizing latent profile analysis of the 29-item Patient-Reported Outcomes Measurement Information System (PROMIS-29), we identified three discrete groups: an average group (48%), a low health challenges group (30%), and a high health challenges group (22%). Women were more likely to be in the high (vs. low) health challenges group. There are discrete health patterns of caregivers with chronic pain, with over 20% reporting comorbid poor health and functioning that may negatively affect caregiving quality. Screening caregivers for high impact pain in clinical settings should be considered and prioritizing these caregivers for interventions may be an efficient use of resources.

  PublisherDOI

• Pain-attributed care task difficulty among dementia caregivers with chronic pain

  Frontiers in Pain Research · 2025-11-05

  articleOpen access

  Introduction Chronic pain is highly prevalent among dementia family caregivers (henceforth “caregivers”). We used a nationwide sample of caregivers with chronic pain to identify the extent to which caregivers attribute pain to any difficulty they have with caregiving. Methods Caregivers ( N = 269) reported if they experienced difficulty performing ten individual care tasks and if ‘yes’, how much of the difficulty they attributed to pain (0 = not a reason for my difficulty, 10 = the biggest reason for my difficulty). We ran ANOVA models to determine between-group differences in pain-attributed difficulty with care tasks. Results When asked about the extent to which pain contributed to the difficulty helping care recipients with a given care task, caregivers’ average response was 6.81 for basic activities of daily living and 6.49 for instrumental activities of daily living. Compared to White caregivers, Black caregivers attributed less of their difficulty with basic activities of daily living to pain (estimate = –1.17, p = 0.04). Discussion Caregiver pain is not only highly prevalent may also be consequential to caregiving outcomes.

  PublisherOA PDFDOI

• Motivations of Older Climate Change Activists: Five Major Pathways to Engagement

  Innovation in Aging · 2025-12-01

  articleOpen accessSenior author

  Abstract Mobilizing older environmental volunteers can provide a powerful solution to addressing both the environmental crisis and the aging society—two global challenges critical to achieving the United Nations’ sustainability development goals. Understanding how to motivate this demographic to engage in environmental volunteering is essential for harnessing the benefits of this solution. However, limited research directly addresses this topic. This study conducted semi-structured interviews with 54 older environmental activists to examine their motivations and patterns of engagement. Coding and analysis of the interviews identified five key motivational themes: 1) problem-solving, involving movement from issue identification to action; 2) the desire to contribute and make an impact; 3) immediate personal considerations; 4) beliefs and values; and 5) emotional motivations. Key findings include: 1) a strong desire to expand knowledge and challenge oneself to learn new skills; 2) an emphasis on the quality of social relationships rather than using volunteering to combat loneliness; and 3) both positive and negative emotions about nature motivating action. Future directions for research are discussed, including the emotional regulation role of nature and motivational differences across various volunteer programs, modes, and intensities. Also presented are practical insights for organizations to design more effective volunteer programs and infrastructures, helping recruit and retain older volunteers for environmental and climate change action.

  PublisherOA PDFDOI

• Prevalence and Risk Factors of Resident to Staff Aggression in Long Term Care Facilities in Hong Kong

  Innovation in Aging · 2025-12-01

  articleOpen access

  Abstract Resident-to-staff aggression (RSA) is common in long-term care facilities. It is associated with adverse physical and psychological consequences for staff, deteriorates resident-staff relationships, and greater staff turnover intention. Drawing on a sample of 703 care workers from 70 long-term care facilities, this study sought to determine the prevalence and risk factors of RSA in Hong Kong. RSA is common in this sample: 97.6% reported verbal aggression, 10.7% physical assault, 8.5% sexual violence, 13.7% annoying behaviors. Logistic regression analyses were conducted to determine factors associated with physical assaults, sexual violence, and annoying behaviors, controlling for duration (minutes) and location (common area vs resident rooms) of RSA. Physical assaults was associated with perpetrator behavioral problems (OR = 1.08, p&amp;lt;.001), resident male gender (OR = 2.40, p&amp;lt;.05), dementia (OR = 21.87, p&amp;lt;.001), staff lack of experience in dementia care (OR = 17.59, p&amp;lt;.001), need to provide dementia care (OR = 15.89, p&amp;lt;.01), lack of training (OR = 10.06, p&amp;lt;.01, and perceived insufficient training (OR = 2.97, p&amp;lt;.01). Sexual violence was associated with perpetrator male gender (OR = 22.51, p&amp;lt;.001), staff younger age (OR=.93. p&amp;lt;.05) and female gender (OR=.14, p&amp;lt;.01). Annoying behaviors was associated with perpetrator behavioral problems (OR = 1.07, p&amp;lt;.001), younger age (OR=.94, p&amp;lt;.95), male gender (OR = 3.04, p&amp;lt;.01), dementia (OR = 2.31, p&amp;lt;.01), staff female gender (OR=.32, p&amp;lt;.01), lack of experience in dementia care (OR = 3.56, p&amp;lt;.05), needs to provide dementia care (OR = 12.31, p&amp;lt;.01), lack of training (OR = 11.52, p&amp;lt;.001), and perceived insufficient training (OR = 2.52, p&amp;lt;.01). Addressing resident behavioral problems and providing sufficient staff training may help prevent RSA

  PublisherOA PDFDOI

• The History of Social and Behavioral Research in Gerontology

  Innovation in Aging · 2025-12-01

  articleOpen accessSenior author

  Abstract Celebrating GSA’s 80th anniversary, we launched the inaugural session of “History of Gerontology” at GSA 2024, which generated significant interest and enthusiasm among members and attendees. The session highlighted the importance of continuing this initiative to provide an educational and scholarly exchange platform rooted in historical perspectives. Building on this momentum, we propose a second symposium in this series, focusing on the history and importance of social and behavioral research in gerontology. This theme aligns well with this year’s focus, “Innovative Horizons in Gerontology,” fostering discussions on how advancement in social and behavioral research can generate novel insights into disease prevention and well-being promotion. While social and behavioral research in gerontology encompasses many significant topics, our three panelists will focus on their expertise in long-term care, caregiving, and stress research, sharing valuable insights and experiences. Dr. Kathleen Wilber will reflect on lessons from over five decades of long-term care program and policy development. Dr. Steven H. Zarit will discuss the evolution of caregiving research and the challenges of capturing the complexity of caregiving. Dr. David Chiriboga will examine the history of stress research and its contributions to advancing gerontology. The discussant, Dr. Karl Pillemer, will engage panelists and the audience in exploring the role of social and behavioral research in Translational Geroscience. This symposium provides an opportunity for the Academy for Gerontology in Higher Education (AGHE) and the broader GSA community to reflect on the lasting impact of social and behavioral research in enhancing support for the aging population. This is a collaborative symposium between the Age Inclusivity in Higher Education and Generativity and Aging Interest Groups.

  PublisherOA PDFDOI

Recent grants

• Resident-to-Resident Elder Mistreatment Intervention for Dementia Care in Assisted Living

  NIH · $3.7M · 2017–2023

• NIH Grant P50AG011711

  NIH · $9.3M · 2003

• NIH Grant R01MH042163

  NIH · $563k · 1993

Frequent coauthors

• Mark S. Lachs

  Presbyterian Hospital

  228 shared

• Jeanne A. Teresi

  Hebrew Home

  142 shared

• Tony Rosen

  NewYork–Presbyterian Hospital

  100 shared

• Joseph P. Eimicke

  New York Psychoanalytic Society and Institute

  97 shared

• J. Jill Suitor

  Purdue University West Lafayette

  95 shared

• Mildred Ramírez

  Cornell University

  90 shared

• M. Carrington Reid

  86 shared

• Stephanie Silver

  Columbia University Irving Medical Center

  82 shared

Awards & honors

• Hazel E. Reed Human Development Professor in the College of…