Abstract:
The majority of care for >10 million older adults with dementia (PWD) in the United States depends on at least on 11 million unpaid care partners (CPs). CPs are at greater risk of adverse physical, psychological, and cognitive health outcomes relative to non-caregiving peers. The goal of this paper is to establish the rationale, design, and protocol for a pilot randomized control trial to test the efficacy of the CP-focused intervention, ICECaP: Individualized Coordination and Empowerment for Care Partners of Persons with Dementia. ICECaP involves the assignment of a trained dementia care coordinator to a CP. The care coordinator maintains at least monthly contact with the CP with hybrid delivery (in-person, phone, e-mail, and video calls) and provides individualized support with care coordination for the CP navigating the PWD\'s care in a complex healthcare system, as well as supportive counseling, psychoeducation, and skills training for the CP. This trial will compare outcomes from baseline to 12-months among CPs who receive ICECaP versus routine care (controls). Outcomes include CP depression, burden, anxiety, and quality of life; CPs\' reactions to the behavioral symptoms of dementia; and use of support services for the PWD. This trial will also assess mechanisms of intervention efficacy including changes in CP dementia knowledge, caregiving preparedness, self-efficacy, and optimism. Publication of this intervention protocol will benefit other dementia care teams seeking to support CPs and PWDs.
摘要:
在美国,超过1000万老年痴呆症患者(PWD)的大部分护理至少取决于1100万无偿护理伙伴(CPs)。CP面临更大的不良身体风险,心理,和相对于非护理同龄人的认知健康结果。本文的目标是建立理论基础,设计,以及一项试验随机对照试验的方案,以测试以CP为重点的干预措施的有效性,ICECaP:痴呆症患者护理伙伴的个性化协调和赋权。ICECaP涉及将训练有素的痴呆症护理协调员分配给CP。护理协调员通过混合分娩至少每月与CP保持联系(当面,电话,电子邮件,和视频通话),并通过护理协调为CP在复杂的医疗保健系统中导航PWD的护理提供个性化支持,以及支持性咨询,心理教育,和CP的技能培训。该试验将比较接受ICECaP与常规护理(对照)的CP从基线到12个月的结果。结果包括CP抑郁,负担,焦虑,和生活质量;CPs对痴呆症行为症状的反应;以及为PWD使用支持服务。该试验还将评估干预效果的机制,包括CP痴呆知识的变化,护理准备,自我效能感,和乐观。该干预方案的发布将使寻求支持CP和PWD的其他痴呆症护理团队受益。