Teaching Resourcefulness to Women Caregivers of Elders with Dementia

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DESCRIPTION (provided by applicant): Teaching Resourcefulness to Women Caregivers of Elders with Dementia The major goal of this R21exploratory research grant is to pilot test and refine an adapted intervention that teaches resourcefulness skills to women dementia caregivers (CGs). The resourcefulness training (RT) intervention has strong theoretical grounding and there is beginning empirical evidence for its effectiveness in reducing stress, minimizing depressive symptoms, and promoting optimal quality of life for populations other than women dementia CGs. The proposed 2-year pilot study will provide qualitative and quantitative data for determining the necessity, acceptability, feasibility, fidelity, safety, and effectiveness of two innovatively designed methods of RT within the context of a small partially randomized preference trial with 120 women dementia CGs. In RT, the two methods to be tested (expressive writing, EW) and verbal disclosure, VD) are used for practicing / reinforcing resourcefulness skills. However, because research has shown that both EW and VD may be effective stress-reducing techniques, we will also examine those effects without RT. We propose that RT reinforced by EW or VD will provide CGs with essential skills for managing stress and preserving mental and physical health while providing care for their elderly care recipients (CRs). Quantitative data on measures of stress, cognitions, emotions, resourcefulness, and mental and physical health will be collected at baseline (T1) and at 1 week (T2) and 6 weeks (T3) post-intervention. Qualitative data will be obtained from CG journal (EW) / recordings (VD), data collector's field notes, follow-up logs, etc. Baseline Resourcefulness Scale (RS) scores and qualitative data from journals / recordings will be used to examine the necessity of the RT. CGs will be randomized into "random" or "choice" conditions and their data (i.e., journals, recordings, field notes, follow-up logs, participation / retention logs) will be examined to determine acceptability, feasibility, and fidelity of RT. Safety of RT will be monitored for adverse events and reports of psychological distress or elder abuse. Effectiveness of RT-EW and RT-VD (compared to EW and VD without RT) will be examined in relation to specific outcomes at time intervals suggested by Resourcefulness Theory and in relation to factors within the CG, CR, and CG situation. Most importantly, we will learn whether giving CGs a choice of EW or VD with or without RT improves their outcomes. Conclusions drawn from the critical examination of the six intervention parameters will inform further refinement and testing of RT for dementia CGs in a full scale randomized, controlled trial. Once established, such interventions will be useful in promoting optimal, healthy functioning among dementia CGs so that they can continue to provide adequate care for their CRs without sacrificing their own health and avoid placement of the elder in a long term care facility. PUBLIC HEALTH RELEVANCE Dementia is one of the greatest challenges facing elders in the U.S. and the public health significance of dementia caregiving has permeated the scientific and lay literature for decades. Despite the number of clinical trials testing interventions for reducing caregiver stress, none have tested methods of teaching them resourcefulness skills and none have allowed caregivers to choose a preferred intervention. Resourcefulness Training, the intervention to be tested in this study, is a cost-effective, easy-to-use method for reducing caregiver stress and promoting their optimal mental health.