Family caregiving continues to be a major public health issue facing the nation. With the aging of the baby boomers, the demand for family caregiving will increase dramatically at the same time that the supply of providers is diminishing. To address these challenges, researchers have developed and assessed intervention strategies designed to support and enhance the capacity of family caregivers, but to date little emphasis as been placed on caregivers undergoing major transitions in their caregiving careers. The purpose of this study is to assess the effects of an intervention designed to enhance health and quality of life of caregivers and their placed relatives by focusing on caregivers who recently placed their relative in a long-term care facility. Recent findings from our group and others on transitions in the caregiving career due to care recipient placement and death suggest unique opportunities for intervention with great public health significance. Focused on caregivers who recently placed their relative, our intervention is designed to ameliorate depression and anxiety common after placement, prevent negative post-death outcomes such as complicated grief, and improve the quality of life of nursing home residents. The study design is a two-group, randomized clinical trial comparing an active intervention condition to an information-only control group. Vulnerable family caregivers will be randomly assigned to one of two conditions: 1) in the active intervention condition, caregivers of recently-placed residents will receive a multi- component intervention designed to target three areas of need - emotional well-being, knowledge and procedures of nursing homes, and end-of-life care planning;2) in the information-only control condition, caregivers will receive treatment as usual with the addition of written information about areas of need identified for the active treatment intervention. The intervention will be delivered within a 6-month period and caregivers and their care recipients will be followed for an 18-month period with assessments occurring at 6- month intervals. We expect that approximately half of the care recipients will die during the follow-up period, enabling us to prospectively assess the impact of death and the intervention on post-death caregiver outcomes. The intervention is expected to impact both short-term and long-term caregiver emotional distress and burden as well as bereavement-related distress.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR009573-03
Application #
7630601
Study Section
Nursing Science: Adults and Older Adults Study Section (NSAA)
Program Officer
Aziz, Noreen M
Project Start
2007-07-25
Project End
2012-05-31
Budget Start
2009-06-01
Budget End
2010-05-31
Support Year
3
Fiscal Year
2009
Total Cost
$347,561
Indirect Cost
Name
University of Pittsburgh
Department
Psychiatry
Type
Schools of Medicine
DUNS #
004514360
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
Stahl, Sarah T; Schulz, Richard (2018) Feeling Relieved After the Death of a Family Member With Dementia: Associations With Postbereavement Adjustment. Am J Geriatr Psychiatry :
Stahl, Sarah T; Arnold, Alice M; Chen, Jia-Yuh et al. (2016) Mortality After Bereavement: The Role of Cardiovascular Disease and Depression. Psychosom Med 78:697-703
Stahl, Sarah T; Albert, Steven M (2015) Gender differences in physical activity patterns among older adults who fall. Prev Med 71:94-100
Schulz, Richard; Boerner, Kathrin; Klinger, Julie et al. (2015) Preparedness for death and adjustment to bereavement among caregivers of recently placed nursing home residents. J Palliat Med 18:127-33
Stahl, Sarah T; Schulz, Richard (2014) Changes in routine health behaviors following late-life bereavement: a systematic review. J Behav Med 37:736-55
Stahl, Sarah T; Albert, Steven M; Dew, Mary Amanda et al. (2014) Coaching in healthy dietary practices in at-risk older adults: a case of indicated depression prevention. Am J Psychiatry 171:499-505
Schulz, Richard; Rosen, Jules; Klinger, Julie et al. (2014) Effects of a Psychosocial Intervention on Caregivers of Recently Placed Nursing Home Residents: A Randomized Controlled Trial. Clin Gerontol 37:347-367
Heckhausen, Jutta; Wrosch, Carsten; Schulz, Richard (2013) A lines-of-defense model for managing health threats: a review. Gerontology 59:438-47
Schulz, Richard; Beach, Scott R; Cook, Thomas B et al. (2012) Predictors and consequences of perceived lack of choice in becoming an informal caregiver. Aging Ment Health 16:712-21
Rosen, Jules; Stiehl, Emily M; Mittal, Vikas et al. (2011) Stayers, leavers, and switchers among certified nursing assistants in nursing homes: a longitudinal investigation of turnover intent, staff retention, and turnover. Gerontologist 51:597-609

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