Dementia Clinical Trial
Official title:
Providers and Alzheimer's Caregivers Together
The primary goal of the study is documentation of effectiveness of a home-based intervention to reduce caregiver burden related to dementia caregiving, improve caregiver health status, and reduce caregiver and care recipient resource utilization.
This study focuses on an underserved, understudied population: African American and White
homebound persons with dementia and their caregivers (CGs). Severe dementia, frailty,
multiple disabling co-morbid diseases, lack of transportation, inability to afford or obtain
a sitter for the care recipient (CR), and lack of time in a CG's burdened daily schedule may
prevent care dyads (caregivers and their family member with dementia) from receiving
services in primary care settings and from participating in clinical studies. Homebound
issues may be particularly important for African American CGs, yet the minority CG
literature has not addressed relevant issues for homebound dyads. Nor are the chronic needs
of homebound dementia care dyads adequately attended by the current home health care system,
which now focuses on skilled nursing care. This study has been designed to address these
research deficits. The study will examine the benefit (through improving depression,
anxiety, and health perception) and the cost-effectiveness of home-based dementia caregiving
interventions, with attention to both the informal care provided by the CG and the use of
formal care services.
Care dyads will be randomized to either Usual Care or Enhanced Care. Both Usual Care and
Enhanced Care caregivers will receive usual home health care delivered by home health nurses
on the schedule determined by the patient's needs and set by the home care agency. For the
Enhanced Care caregivers, to ensure protocol adherence, using the same schedule as the home
health visits, trained interventionists from the research staff will deliver the
intervention. The interventionists will teach dementia family caregivers to cope with
difficult care recipient behaviors and challenges to caregiving and will teach caregivers
how to cope with their own responses to caregiving. Following established protocols and
using fifth grade level pamphlets and educational material, the interventionists will tailor
the intervention sessions to meet the individual needs of each care dyad in their own home
environment. Enhanced Care sessions will not exceed 60 minutes. Research specialists will
perform data collection visits in the care dyads’ homes at baseline, within 2 weeks of home
care ending and six months.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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