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

项目摘要 描述性研究表明，患有认知障碍（CI）的独居者与许多 复杂的挑战，如缺乏便利独立生活的可用和可获得的服务，以及 住院和收容的风险增加。此外，几乎一半的独居老年人 CI患者在日常生活的基本或工具性活动方面遇到困难。然而， 旨在帮助独居的CI老年人的干预措施，以帮助他们保持社会参与， 现有的生活环境。我们建议开发一种新颖的家庭干预，称为“独自在家”， 对于单独生活的CI患者（此处定义为被诊断患有轻度认知障碍/MCI或 根据经验证的基于电话的 筛选器）。独自在家是一个七模块的家庭为基础的计划，是改编自既定的，证据- 基于心理健康和痴呆症护理干预措施（行为激活，Skills 2Care ®和定制的 活动计划）。这项拟议的R21将审查家庭的可行性、可接受性和有用性， 帮助患有CI或AD/ADRD的独居人士成功应对生活挑战 与痴呆症无关。具体目标是：1）开发和调整Home Alone进行试点测试 在15名单独居住超过3个月的CI患者中。一种收敛的并行混合方法设计 将被用来确定《小鬼当家》的各种元素（例如，交货方式、长度等 干预特点）需要适应; 2）试点测试的修订版的家独自超过6- 50名单独生活的CI参与者。序贯解释性混合方法设计将 被用来这样做。我们将确定《小鬼当家》是否按计划进行，是否可行， 可接受的，有用的。这种理论和循证干预的发展将直接 解决进一步了解如何支持单独生活的CI患者的需求。如果成功， 拟议的R21将定位家庭独自一人，用于随后的随机对照评价，随后作为 灵活、急需的循证资源，可扩展用于医疗保健系统和痴呆症支持 程序.

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.