INTERVENTIONS TO CHANGE CAREGIVE & AD PATIENT OUTCOMES

这是对1989年10月1日提交审查的提案的修订。

This is a revision of a proposal submitted for review on October 1, 1989. The major goal of this 5 year intervention study is to assess the relative efficacy of a treatment program that provides caregivers with the skills necessary to change the problem behaviors of their spouse with Alzheimer's Disease, an intervention which teaches them to manage their own affective responses to caregiving challenges, and an intervention which combines both treatment strategies. Following psychosocial assessment of caregivers and cognitive and behavioral assessment of patients, 80 caregiver/patient dyads will be assigned to one of four intervention conditions: (1) behavior management skills training (BM) designed to change the most frequent and/or stress inducing problems exhibited by the patient; (2) affective self- management training (ASM) designed to teach caregivers to increase pleasant activities, reduce stress, and enhance positive mood; (3) combined behavior management skills and affective self-management training (COM) to assess any additive effects of both patient- and caregiver-focused intervention; and (4) wait-list control (WL) in which contact with trainers and general information will be provided through "friendly visits." Each intervention condition will run for 12 weeks; pre- and post-assessments will occur in Weeks 1 and 13, and training in Weeks 2-11. All participants will be reassessed 3- and 6-months after the intervention cycle. The groups will be compared on a number of caregiver and patient outcome measures including caregiver expression of stress, burden, self-efficacy, anger, and depression, and frequency of patient's behavioral excesses and deficits.