The purpose of this study is to determine the effectiveness of a comprehensive counseling and support intervention for people who care for parents with Alzheimer's disease (AD) or other dementias on outcomes such as stress, depression and ability to postpone or avoid nursing home placement.
Although a range of studies have examined the stress and depression of family caregivers of persons suffering from dementia, the effectiveness of psychosocial interventions to assist caregiving families and their disabled elderly relatives is uncertain. The comprehensive support protocol to be implemented, the Enhanced Counseling and Support (ECS) program, has been successfully implemented at the Silberstein Aging and Dementia Research Center of New York University School of Medicine (NYU-ADRC) over the past 19 years. However, the initial evaluation of the ECS was limited to a single geographic area (New York City proper) and a specific type of dementia caregiver (spouses). The specific aims of this 4-year project are as follows: 1) Examine whether the ECS can achieve positive outcomes for adult child caregivers. Few psychosocial interventions are directed specifically at adult child caregivers, and evaluating the ECS in adult child caregiving situations, which few studies have done, will further demonstrate the effectiveness of this program and add considerably to the AD caregiver intervention literature; and 2) Determine if the ECS, an intervention of proven efficacy for AD caregivers in a northern U.S. urban community (New York City), will also be effective in alleviating negative outcomes among AD caregivers at a Midwestern project site. The study will ascertain whether the comprehensive support program developed at NYU is generalizable to caregivers from areas other than the New York City area and leads to similar benefits that are maintained over long periods of time (i.e., up to 3.5 years). In order to accomplish the specific aims of the project, the following study hypotheses have been proposed: 1. Adult child caregivers in the treatment conditions of the University of Minnesota (UM) and NYU-ADRC will report similar decreases on measures of stress when compared to usual-contact controls; 2. Adult child caregivers in the intervention conditions at both sites will develop improved social support resources and experience significantly greater decreases of family conflict in a similar manner; 3. Adult child caregivers in the treatment conditions at UM and NYU-ADRC will report similar decreases on global measures of psychological distress, such as depression. Similarly, treatment caregivers will report greater increases in subjective health than their counterparts in the usual-contact control; and 4. Membership in the treatment condition of the ECS and its benefits (e.g., increased social support, decreased stress) will lead to delayed institutionalization (e.g., nursing home placement) of care recipients at the UM and NYU-ADC sites.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
161
Approximately six individual and family consultation sessions (2 individual, 3 family, 1 individual) within the first 4 months with adult child caregivers and/or their family members; support group participation (recommended at least once a month) after the completion of the individual and family consultation sessions for the duration of the project (up to 3 years after the intake interview); ad hoc consultation (ongoing in-person, telephone, or email support on an as-needed basis) for the duration of the project (up to 3 years after the intake interview); New York University Caregiver Intervention
University of Minnesota, School of Nursing, 6-150 Weaver-Densford Hall
Minneapolis, Minnesota, United States
Silberstein Institute for Aging and Dementia, Department of Psychiatry, NYU School of Medicine
New York, New York, United States
Care recipient nursing home/institutional placement
Adult child caregivers self-reported whether the care recipient was admitted to a residential care setting and the date of admission.
Time frame: baseline, 4, 8, 12, and 18 months; 24, 30, 36 months if possible
Caregiver emotional stress
Measures of role captivity, role overload, and general perceived stress.
Time frame: baseline, 4, 8, 12, and 18 months; 24, 30, 36 months if possible
caregiver depression
The Geriatric Depression Scale.
Time frame: baseline, 4, 8, 12, and 18 months; 24, 30, 36 months if possible
caregiver social support
Three single items that measured perceptions of support received by the adult child caregiver.
Time frame: baseline, 4, 8, 12, and 18 months; 24, 30, 36 months if possible
Caregiver subjective health
Single item self-reported health as well as measures derived from the OARS.
Time frame: baseline, 4, 8, 12, and 18 months; 24, 30, 36 months if possible
secondary stressors
Measures of family and role conflict.
Time frame: baseline, 4, 8, 12, and 18 months; 24, 30, 36 months if possible
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