Multimedia Support for Caregivers of the Seriously Ill

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DESCRIPTION (provided by applicant): This project will provide a web-based multimedia support program for employed family caregivers of older adults who require assistance with activities of daily living (e.g., dressing, bathing, feeding) and who are nearing the end of life. Framed in the context of the Lazarus & Folkman stress and coping model, the program will provide the caregiver with knowledge and cognitive/behavioral coping skills using text, video modeling, and graphic representations. A unique feature will be a Decision Assistance Tool (DAT), which will help the user logically consider complex alternatives in order to make an informed decision (e.g., about medical treatment options). The Phase I proof of concept included modules on caregiving skills, important medical/legal decisions, and finding resources, as well as initial development of the DAT. During the randomized program evaluation, users showed significant improvement in: a) self-efficacy to positively influence appraisals of stress and coping strategies, and b) behavioral intentions to adopt the strategies. Subjects found the program easy to use and gave it high satisfaction scores. Phase II development will add modules on: a) emotional/spiritual issues, b) balancing work with caregiving, c) the impact of serious illness on a care receiver, d) expectations at time of death, e) bereavement, f) a revised and expanded DAT, and f) a Personal Program Guide which will help users find contents relevant to their interests and needs. The Phase II program will also include video based skill building modules on medical advocacy and caregiver-family communication. Additionally, a separate section will be developed for customers/worksite managers to suggest how supervisors can reduce the stress and maintain the productivity of working caregivers, and keyboard-enter information about local resources for employees. The fully developed Phase II program will be produced in both Internet and CD-ROM versions and will be evaluated in a large randomized trial. As people age and near the end of life, they may need lots of help with daily activities like bathing and dressing and eating. Providing this help can be really hard on family members who have to be a caregiver and still keep their job, and it can be overwhelming for them. The proposed program provides automates support and education for the caregivers via the Internet, including articles, videos, and help thinking through tough decisions.