The proposed study represents a collaboration of university-based researchers and the Gerontology Program of the New Jersey Department of Health. The overall goal is to assess the benefits of day care services for family caregivers of older people with dementing illnesses. A secondary objective is to study patterns of service use. While an extensive literature documents the stressfulness of caring for a frail older person, relatively little research has investigated the benefits and drawbacks of various interventions for family members. In particular, day care and respite services have been proposed as a critical link in community-based long-term care, but evidence of benefits for the mental health and well-being of caregivers is limited. Drawing upon a general stress process model, we will investigate the proposed mechanisms by which respite is expected to benefit caregivers. Specifically, we expect that day care will affect the amount of time caregivers have available for other activities, which should result in changes in caregivers' appraisals of stressors and overall well-being. A quasi-experimental design will be used. Experimental subjects will be 200 principal family caregivers of dementia patients participating in a New Jersey program of day care, which provides extensive subsidies for the cost of services. A control sample matched on key variables (kin relationship which includes gender, living arrangements, race, and SES) will be drawn from a comparable population in another state in which day care subsidies are not widely available. Subjects will be evaluated at 3 points in time: prior to day care (or baseline for controls), 3 months, and 1 year. Data analysis will include repeated measures ANCOVA and model testing to determine the effects of the provision and amount of respite on caregivers' appraisals of stressors and well-being.
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