Objective: Examine the feasibility of primary care interventions designed to decrease the burden of family caregivers of patients with Alzheimer~s Disease and related dementias(ADRD). Background: Although the burden and stress associated with caring for Alzheimer's patients is well documented, there is no agreement about which interventions best help family caregivers to cope. Caregivers frequently look to their primary care providers for providing assistance in dealing with patient behaviors and in managing their own burden; however, due to lack of knowledge, tile and resource constraints, the formal health care system has not always been as supportive of caregivers as the informal system. Methods: Caregivers of patients with dementia enrolled in two TennCare Managed Care Organizations in Memphis, TLC and Health First will be eligible for the study. Caregivers will be identified and recruited into the study through primary care providers. A total of 240 caregivers will be randomized to one of four stepped intervention groups: Usual Care; Information Care - written information on patient behavior management; Behavior Care - written information plus skills training in patient behavior management; and Enhanced Care - written information, skills training plus behavioral mollification strategies to decrease stress for the caregiver. As caregivers frequently cannot attend additional support services, the interventions will be in the context of primary care visits by the- patient. Following a checklist protocol, MCO physicians will discuss issues with intervention group caregivers and trained study interventionists will provide written information, patient behavior skills training and stress behavior modification. Outcomes to be assessed include: caregiver burden, depression, life satisfaction, perceived health status, and utilization of health care for caregiver and patient. Data will be analyzed by caregiver intervention assignment.
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