Care for a terminally ill cancer patient presents personal, social, and economic hardships for family members. Logistical factors, such as difficulty arranging transportation, can prevent caregivers from getting help. This is especially true for elderly spousal caregivers who may have medical problems of their own. Computer and communications technologies can be used to enhance the ability of elderly caregivers to access formal and informal resources. The objective of the proposed three-year project is to evaluate the efficacy of an innovative nursing-led intervention for spousal caregivers of patients at the End-of-Life. The intervention is called Tele-Care. The proposed project will evaluate the impact of the 10 session Tele-Care intervention on 64 caregivers compared to 64 caregivers in a minimal support control condition. The major specific aim of the project is to evaluate the effectiveness of the Tele-Care intervention on depression, social support, and personal growth. Secondary aims are to: 1) gather information on differences between White American and Hispanic responses to the intervention and to 2) evaluate the use of the computer/telephone system among White American and Hispanic caregivers. Ethnicity plays an important role in caregiving and the increasing ethnic diversity of the population points to the need to investigate ethnic differences in responses to the demands of caregiving. A major contribution of this research is the evaluation of the efficacy of a multidisciplinary intervention that combines psychological, engineering, and nursing solutions. Further, the study will explore the specificity of application of the intervention within varying ethnic/cultural groups. In order to examine the long-term efficacy of the Tele-Care intervention on the caregivers' functioning, information will also be gathered 6 months after the death of the spouse.
