CHRONIC MEMORY LOSS--HOME VS COMMUNITY INTERVEN TIONS

最近的研究集中在干预措施上，以帮助稳定

Recent research has focused on interventions to help stabilize the caregiving situation as families cope with chronic memory loss from dementia, but few studies have investigated dyadic or dual interventions targeted to both caregivers and care-receivers. This study will compare and contrast the efficacy of four such interventions (two home-based, two community-based) on family outcomes. The recently tested home-based cognitive stimulation intervention which continues to show promise, will be contrasted with in-home dyadic counseling, and with the community- based dual psycho-educational groups of the Alzheimer's Disease Research Center, and the Morning Out Club of the Alzheimer's Association (a modified day care approach). The aims of this research are: 1) to compare the effectiveness of the two home-based and the two community- based interventions on the physical and psychological well-being of the caregiver, the cognitive/behavioral functioning and well-being of the care-receiver, and the interaction status of the caregiver/care-receiver dyad in families coping with dementia; 2) to delineate characteristics of the caregivers and care-receivers who show improvement outcomes from each specific intervention, 3) to determine the cost-effectiveness of each intervention through analysis of money, time, and energy expenditure, and 4) to investigate ethnic and gender differences by intervention on the well-being and functional outcomes of the caregivers and care-receivers. Caregivers are expected to receive greater benefit from the more affectively-oriented interventions (having a support component), while care-receivers are hypothesized to benefit most from the more cognitively-oriented programs. In accord with previous research, condition differences are also expected in the person/environment factors (stress, personality, coping, support, income, and respite). Using an experimental design, over a three years period 140 participant dyads will be randomized into one of the four intervention conditions (35 dyads per condition; 20-60 per year), all participants, will be assessed in the home initially and after the 8- week intervention phase, with additional baseline assessment for the wait-listed controls. Multivariate techniques will be used to address the aims. Findings should provide valuable information for nursing, social work and other health disciplines on the personal, family, and financial feasibility of each intervention.