Home Alone: Developing a Home-Based Intervention for People with Cognitive Impairment Who Live Alone

独自在家：为独居认知障碍患者制定家庭干预措施

• 批准号: 10590347
• 负责人: JOSEPH E. GAUGLER
• 金额: $ 20.45万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-01 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10590347
• 关键词: Acute; Address; Adoption; Adult; Age; Age-associated memory impairment; Alzheimer' s disease related dementia; Behavioral; COVID-19 pandemic; Caregivers; Caring; Characteristics; Cognition; Collection; Communities; Complex; Data; Data Element; Dementia; Dependence; Development; Diagnosis; Effectiveness; Elderly; Elements; Enrollment; Environment; Evaluation; Family Caregiver; Feeling; Goals; Health; Healthcare Systems; Home; Hospitalization; Impaired cognition; Independent Living; Individual; Institutionalization; Intervention; Length; Literature; Loneliness; Measures; Mental Health Services; Methods; Modeling; Morbidity - disease rate; Outcome; Participant; Persons; Phase; Positioning Attribute; Process; Provider; Randomized; Recommendation; Research; Resources; Risk; Risk Factors; Services; Social Well-Being; Stress; Supportive care; Testing; dementia care; design; evidence base; experience; feasibility testing; flexibility; home test; implementation science; improved; indexing; innovation; insight; instrumental activity of daily living; lens; mild cognitive impairment; novel; pilot test; programs; psychologic; response; social engagement; symposium; telephone based; theories; therapy design; therapy development

Project Abstract Descriptive research suggests that living alone with cognitive impairment (CI) is associated with many complex challenges, such as a lack of available and accessible services to facilitate living independently, and an elevated risk of hospitalization and institutionalization. Additionally, almost half of older adults who live alone with CI experience difficulty with a basic or instrumental activity of daily living. However, there are few interventions designed to assist older adults with CI who live alone to help them remain socially engaged in their existing living environment. We propose to develop a novel home-based intervention, called Home Alone, for persons living alone with CI (defined here as someone diagnosed with mild cognitive impairment/MCI or as someone with cognitive impairment without dementia as established on a validated telephone-based screener). Home Alone is a seven-module home-based program that is adapted from established, evidence- based mental health and dementia care interventions (behavioral activation, Skills2Care®, and the Tailored Activities Program). This proposed R21 will examine the feasibility, acceptability, and usefulness of Home Alone to assist persons living alone with CI or AD/ADRD to successfully navigate the challenges of living independently with dementia. The Specific Aims are: to 1) develop and adapt Home Alone for pilot testing among 15 persons with CI who live alone over a 3-month period. A convergent parallel mixed methods design will be utilized to determine whether various elements of Home Alone (e.g., delivery mode, length, and other intervention characteristics) require adaptation; and 2) pilot-test a revised version of Home Alone over a 6- month period among 50 participants living alone with CI. A sequential explanatory mixed methods design will be utilized to do so. We will determine whether Home Alone is carried out as intended and is deemed feasible, acceptable, and useful. The development of this theory- and evidence-informed intervention will directly address the need for further understanding of how to support people living alone with CI. If successful, the proposed R21 will position Home Alone for a subsequent randomized controlled evaluation and later as a flexible, much-needed evidence-based resource that is scalable for healthcare systems and dementia support programs.

项目摘要 描述性研究表明，独自生活具有认知障碍（CI）与许多人有关 复杂的挑战，例如缺乏可用和可访问的服务来促进独立生活，以及 住院和制度化的风险升高。此外，几乎一半的老年人独自生活 在CI经历的困难中，日常生活的基本或工具活动。但是，很少 旨在帮助CI的老年人旨在帮助他们保持社会参与的CI的干预措施 他们现有的生活环境。我们建议开发一种新颖的家庭干预措施，称为单独的家庭干预措施 对于与CI独自生活的人（在此定义为被诊断出患有轻度认知障碍/MCI的人或 在经过验证的基于电话的情况下确定的没有痴呆症的认知障碍的人 筛选器）。仅家庭是一个七模块的家庭计划，该计划适应已建立的证据 - 基于心理健康和痴呆症护理干预措施（行为激活，Skills2Care®和量身定制的 活动计划）。该提议的R21将检查家庭的可行性，可接受性和实用性 独自帮助独自生活的人与CI或AD/ADRD一起成功应对生活的挑战 独立于痴呆症。具体目的是：1）单独开发和适应试点测试 在3个月内独自生活的15人中。收敛的平行混合方法设计 将利用用于确定单独的各种家庭要素（例如，交付模式，长度和其他 干预特征）需要适应； 2）单独使用6台房屋的修订版。 50名参与者独自生活的月份。顺序挖掘混合方法设计将 被用来这样做。我们将确定单独的房屋是否是按预期进行的，并且被认为是可行的， 可以接受，有用。这种理论和证据的干预措施的发展将直接 解决需要进一步了解如何支持CI独自生活的人们的需求。如果成功， 拟议的R21将单独定位为随后的随机对照评估，后来作为 灵活的，急需的循证资源，可扩展到医疗保健系统和痴呆症支持 程序。