Alzheimer's disease claims more than one victim: Family members who provide care for persons with dementia experience serious negative impacts in the areas of physical and psychological health and social functioning. Dementia-related behavior problems, including caregiver's subjective inability to attribute problem behaviors to the disease and their over-appraisal of care-recipients' abilities to control them, contribute substantially to these impacts. The accumulated stresses of the objective burdens of providing care and bearing the costs of maintaining the person with dementia of the alzheimer's type (DAT), extended social isolation, and lack of family support further contribute to the negative impacts. This three year project proposes to test the effectiveness of a randomized inter-disciplinary, family systems-based, non-pharmacological and psychoeducational intervention on 140 families of persons with dementia of the Alzheimer's type. The goal of the program is to decrease the caregivers' perceptions of behavior problems in persons with DAT and to decrease the depression experienced by caregivers. We postulate that the way a family perceives and organizes around the dementing disorder of a member affects the strain the primary caregivers experience, the behavior of the care-recipient (as judged by the caregiver), and the depression experienced by the primary caregiver. This intervention focuses on increasing the concordance of a family's understanding of Alzheimer's disease, enhancing their understanding and skill in the management of behavior problems and increasing the family's support for the primary caregiver and person with DAT. The preliminary study demonstrated that it is feasible to implement the family intervention and desired outcomes can be obtained. The design of this study will test whether the desired outcomes are attributable to the intervention. Repeated measures ANCOVA will be used to test for Group X Time effects.
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