This project will develop and pilot an accessible, feasible and sustainable one-on-one, peer-led problem-solving intervention for family caregivers (CGs) of frail older adults. Negative effects of care provision on CGs' mental and physical well-being, and even longevity, are well documented. Despite a growing number of supportive programs for CGs, few meet real world needs and limitations. This exploratory/developmental research addresses this gap by developing and testing an intervention designed specifically to circumvent known barriers to implementing supportive programs for family CGs. Specifically, we shall develop and pilot an evidence-based, peer support intervention that capitalizes on the expertise of persons who best know the demands of family caregiving-former CGs themselves. Caregivers Help in Problem Solving (CHIPS) will train persons who previously cared for an elder relative but have transitioned out of that role to deliver a semi-structured intervention to persons currently caring for an impaired elder relative. The intervention, based in concepts of problem-solving therapy and peer support, will be designed expressly to address problems of accessibility, feasibility and sustainability that have plagued previous interventions for family CGs. Importantly, we proposed to examine the beneficial impact of CHIPS upon well- being not just of current CGs receiving the intervention, but also of the former CGs who will serve as lay interventionists. The proposed work sets the stage for full-scale intervention by delineating CHIPS program content, identifying and resolving barriers to effective implementation, and testing feasibility of the program.
Specific aims are: (1) to develop a comprehensive, problem-solving intervention for family CGs, including intervention materials based on stakeholder input and a manualized training program to prepare former CGs to be- come peer counselors for current CGs; (2) to establish feasibility of the prototype intervention in a small field pilot, and(3) to estimate its positive impact on CGs and PCs.
These aims will be pursued in a 2-year project culminating in an evidence-based psychoeducational intervention that will train former CGs to implement a semi-structured, individualized problem-solving intervention for persons currently caring for an impaired elder relative. This research, a first step toward a full-scale randomized trial (RCT), comprises two primary activities: (1) intervention development based on existing knowledge, new data collection with CGs and practitioners, and input from a panel of experts in the field, and (2) a field test to document feasibility and recruitment process, and establish sampling and staffing pa- rameters for the RCT.
The 34 million Americans who are currently providing informal care to a frail older relative experience considerable strain and feelings of burden, high rates of depression and emotional distress, impaired physical health, and even increased risk of death. Although intervention programs to ameliorate caregiving strain exist, they are both costly to the healthcare system and difficult for caregivers to attend. This project addresses this problem by developing and piloting an accessible, feasible and sustainable intervention using peer support by former caregivers to reduce strain and improve quality of care among current family caregivers.
