In a community-based approach, the investigators long-term goal is to empower African American family caregivers who are designated healthcare proxies to make informed end-of-life treatment decisions for participants with moderate to severe dementia before a life-threatening medical crisis occurs.

The investigators conducted a randomized controlled trial for efficacy of the Advance Care Treatment Program in an African American church-based community model. The investigators compared the effect of the experimental and control groups on knowledge, self-efficacy, intentions and behaviors from 4 urban African American churches randomly assigned to experimental (n=2) or control (n=2) conditions,304 (experimental n=152; control (n=152) health care proxies of participants that have advanced stage dementia: (a) were concurrently recruited in small classes each with 8-9 healthcare proxies.

"Inclusion Criteria"

• Caregiver spouse or adult child of care recipient
• Caregiver knowledgeable about care recipient's medical history
• Care recipient must be African American
• Care recipient must have moderate to severe stage dementia
• Care recipient must lack decisional capacity

"Exclusion Criteria"

• Not a caregiver
• Care recipient not African American,
• Care recipient without moderate to severe dementia

301 african american females and 54 african american males

African American family caregivers over the age of 18 who attend four specific urban mega churches who meet the eligibility criteria for the study.