Technology-Assisted Intervention for Remarried and Stepfamily Caregivers
Investigators: Carey Sherman
Funding: Alzheimer's Association, 2014-2017 (NIRG-14-321332)
The prevalence of Alzheimer?s disease and related dementias (AD) is expected to triple by 2050. Millions of family members provide long-term, community based care for persons w/ AD, and adverse effects of such intensive caregiving are well documented. At the same time, older Americans have increasingly diverse and complex marital and family histories due to sustained divorce rates, widowhood and remarriage. Over one-third of U.S. marriages are remarriages, and these trends will increasingly impact upcoming cohorts of AD patients and caregivers. Research has documented lower perceived obligation and lower rates of intergenerational support and assistance among stepfamily members. In the first studies of positive and negative support networks among remarried AD caregivers, Sherman and colleagues ( 2012, 2013) found low rates of stepfamily participation in care, high levels of care-related tension and conflict, especially regarding financial and medical decision making (Sherman and Bauer, 2008). Such conflicts were associated with significantly higher levels of caregiver burden and depression (Sherman, Webster & Antonucci, 2013). Existing caregiver interventions do not specifically address the unique challenges and needs of remarried AD caregivers. Thus, this proposed study seeks to develop a new, targeted psycho-educational intervention for remarried caregivers that will enhance caregiver knowledge, skills and strategies for self-care and use of support. This study responds to the Alzheimer?s Association call to develop new interventions that target the special needs of subgroups of caregivers and that identify and ameliorate the negative impacts of AD caregiving on family members. The proposed study?s three aims include: a) Design Remarried Caregiver Program (RCP): Focus groups with remarried caregivers, AD experts and stepfamily members (5; n=27) will provide input for the RCP curriculum. B) Delivery the RCP Intervention: Six RCP groups will be conducted (n=36). Use of readily available technologies (e.g., secure web-based modules, no-cost telephone conferencing for weekly sessions) will extend RCP?s reach and accessibility and minimize logistic challenges for participants. C) Assess RCP?s Impact on Caregiver Outcomes Compared to the Wait List Group: Repeated measure ANOVA and regression analyses of pre- and post- surveys and participant satisfaction questionnaires will compare RCP and wait-list participant outcomes. Wait list group members will receive the RCP post data collection. RCP participants are expected to report high satisfaction with the program, and report lower burden and depression, and greater sense of self-efficacy and support in their caregiving role compared to wait list group. Findings will contribute to AD research and practice, and will support future studies to conduct larger trials and explore additional delivery formats to reach remarried caregivers, a growing and highly vulnerable population of caregivers.