Older adults and their families coping with mild dementia and memory loss face unique challenges in providing care and managing cognitive and functional symptoms. These challenges can result in negative psychosocial outcomes for both caregivers (CGs) and care receivers (CRs). For CRs, dementia deteriorates their cognitive abilities and functional capacities, leading to negative emotional, social, and behavioral outcomes (e.g., loss of self, depression, anxiety). For CGs, the stress of care giving increases depression, health problems, and role and intra-psychic strains (e.g., strained family relationships, emotional strain). Since family CGs provides the vast majority of daily home care for persons with dementia, it is imperative that interventions support their ability to continue providing care and effectively cope with their role. Interventions supporting CRs' remaining cognitive and functional skills are important in maximizing their abilities and improving psychosocial outcomes. The proposed 2-year pilot investigation is a randomized controlled study that tests the efficacy of an innovative intervention for care giving dyads dealing with mild dementia. The intervention """"""""Acquiring New Skills While Enhancing Remaining Strengths (ANSWERS)"""""""" combines educational skills training (traditionally only used with family CGs) and cognitive rehabilitation skills training (traditionally only used with older CRs). ANSWERS is unique because it trains both members of care giving dyads to implement a core set of educational and cognitive rehabilitation techniques in the home. ANSWERS is grounded in a Strength-Based Approach that draws upon and enhances CRs' remaining cognitive and functional abilities, while serving as a low-cost resource to help CGs cope. The proposed study includes 70 care giving dyads comprised of a CR with mild dementia and his/her primary family CG. Dyads will be randomly assigned to the treatment group (n=35) or control group (n=35). The intervention protocol follows a set curriculum that includes three education skills components and three cognitive rehabilitation skills components: communication & redirection, problem-solving & reframing, and realistic goal setting (the educational skills); and spaced retrieval, cognitive task analysis, and external memory aids (the cognitive rehabilitation skills). The Stress Process Model is the conceptual framework that guides study hypotheses for how the ANSWERS intervention is expected to improve psychosocial outcomes for both CGs and CRs. Psychosocial outcomes include various dimensions of general well-being (e.g., depression, anxiety, quality of life) and intra-psychic and role strains (e.g., relationship strain, self-efficacy). If efficacious, findings from this controlled test will be used to refine the ANSWERS intervention, which will be tested for effectiveness in a larger, federally-funded trial. ? ? ?
| Dawson, Nicole T; Powers, Sara M; Krestar, Maura et al. (2013) Predictors of self-reported psychosocial outcomes in individuals with dementia. Gerontologist 53:748-59 |
| Krestar, Maura L; Looman, Wendy; Powers, Sara et al. (2012) Including individuals with memory impairment in the research process: the importance of scales and response categories used in surveys. J Empir Res Hum Res Ethics 7:70-9 |
| Judge, Katherine S; Yarry, Sarah J; Orsulic-Jeras, Silvia (2010) Acceptability and feasibility results of a strength-based skills training program for dementia caregiving dyads. Gerontologist 50:408-17 |
| Judge, Katherine S; Menne, Heather L; Whitlatch, Carol J (2010) Stress process model for individuals with dementia. Gerontologist 50:294-302 |
