This project proposes a field experiment to evaluate the use of computer networks in home care. Computer networks create electronic links between remote sites. For example, homes can be linked to a clinical agency or to other homes. Within an existing free public-access community computer system, special programs and communication serices will be constructed to support informal caregivers managing complex illnesses in the home. These programs will expand the caregiver's reportoire of problem solving strategies and decrease the caregiver's sense of isolation. A decision support system ill help caregivers analyze complex decisions faced in home care. The messaging and electronic mail services will enable caregivers to maintain contact with other caregivers as well as with professional providers, serving as a """"""""support group without walls"""""""". Caregivers of Alzheimer's Disease (AD) patients were selected as the first target of this intervention. AD caregivers are prototypical of other caregivers. Two common difficulties experienced by these and other caregivers are (1) a loss of confidence in problem solving skills in the face of novel, complex and emotionally loaded patient care problems and (2) isolation resulting from the demands of constant care. Traditional. interventions (such as support groups) require that the caregiver leave the home and ay not occur at the time the caregiver needs the assistance. This proposal describes a unique approach to meeting the caregiver's needs through commonly available computer technology. This intervention's effectiveness in enhancing caregivers' problem solving skills and diminishing their sense of isolation will be evaluated in a two group field experiment. One hundred subjects (caregivers of AD patients) served from an AD clinic will be assigned randomly to either the experimental or the control group. For a period of one year the experimental subjects will have the computer network link in their homes. On-going monitoring of coputer use will complement measurement of care- giver decision skill and sense of isolation. This study tests whether computer networks provide an effective intervention with isolated caregivers and patients in the home. The increasing emphasis on non-institutional care demands new approaches to delivering treatment and support, while the availability fo computer technology provides the means to do so.
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