The proposed project addresses a neglected area in the study of care for Alzheimer~s dementia (AD) patients: an understanding of the patient's perspective of specific patient needs and the effectiveness of interventions in facilitating the patient's adaptation to AD and positive patient outcomes. Using Lawton's description of quality of life outcomes in AD patients, the project includes both developmental and research outcomes designed to identify specific patient needs and factors related to positive patient outcomes, potentially facilitating positive caregiver outcomes, reduced depression rates in AD patients, positive patient behaviors, maintenance of patient self-care behaviors, and increased preservation of the patient's """"""""personhood"""""""". Using both quantitative and qualitative methods, a descriptive, longitudinal design is proposed to test the relationships among person-centered variables (meaning of the event, personality traits, maintenance of past activities), external variables (social support, quality of caregiver/patient relationship, facilitation of patient self care), and the patient's quality of life outcomes (physical health, functional ability, cognitive function, social behavior, and psychological well-being). A total of 85 newly diagnosed patient and 85 caregiver subjects will be recruited from the Indiana AD Center at Indiana University, yielding a power level between .68 and .99. A baseline assessment for all predictor and outcome variables will occur the first two months following the patient's dementia diagnosis, with repeated assessments at 6, 12, and 18 months following the baseline assessment. An open-ended, semi-structured interview schedule will be used to assess the patient's perspective of the meaning of the disease, behaviors of others, specific patient needs, and denial of the illness. Additionally, a newly developed instrument needed to measure psychological well being in AD patients will be tested.
