Most studies of interventions for caregivers of persons with Alzheimer's disease (AD) have been targeted at providing information about the disease and emotional support to the informal caregivers. The proposed study, based on the Stress Process Model, uses a randomized clinical trial design to examine the effectiveness of an intervention aimed at increasing family caregivers' skills in assessing triggers or antecedents of disruptive behaviors, identifying care receivers strengths and inabilities, and increasing the repertoire of interventions used to respond to disruptive behaviors. Two hundred sixty caregivers of persons with AD who have disruptive behaviors, who meet study entrance criteria and agree to participate, will be randomized to either the CSB intervention or an Information and Support Only (ISO) control. Participants will be drawn from a population of well-characterized AD patients diagnosed at the Rush Alzheimer s Disease Center. Family caregivers and AD patients will be followed for one year and interviewed at baseline, 5 weeks, 12 weeks, 6 months, and 1 year. Outcome measures will be standardized, psychometrically sound, and appropriate for sequential administration. The primary outcome measures are caregiver self-reported emotional distress and time to care receiver institutionalization. We hypothesize that for the CSB intervention group, caregivers will experience a greater decline in emotional distress and care receivers will experience longer time to institutionalization than control group counterparts. The study will also permit secondary analyses of the effectiveness of the extent to which change in outcomes is associated with background variables, including race, and with changes in mediators and care receiver disruptive behaviors.
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