One 60 minute baseline orientation phone visit with a coach to get verbal consent for participation in the study. Controls will receive usual care from their primary care provider and/or psychiatrist. We will give participants an information package from the Alzheimer's Association including a list of resources. To assist with retention, and to measure responses to secure messages, we will send a template secure message to control dyads once per month in which we remind participants to contact their primary care provider if they have any issues with behavioral and psychological symptoms of dementia. Dyads in the attention control may receive information and training from their primary care provider and the Alzheimer's Association. This "attention control" is proposed to assess the additional impact of STAR-VTF above treatment as usual. Investigators do not intend to track non-study training receipt in the control arm.

The Kingston Caregiver Stress Scale (KCSS) is designed to allow a family member (or other) caregiver to express his/her level of perceived stress, as it relates to caregiving. It can also be used to monitor changes in stress levels over time, as the caregiver's situation changes. Scores range from 10-50; a higher scores indicates higher levels of stress.

We report the number of caregivers who completed their 8 week surveys by study arm.

We report the number of caregivers who completed their 6-month surveys by study arm.

We will report completion rates by study arm at the end of the trial. Completion will be defined as completing 2 home-based visits, 1 phone-based visit and sending at least one secure message to a social worker in the baseline to 8-week period and one message in weeks 9 through 24.

Measured as the total number of inpatient visits had by patients with dementia within the study 6-month period.

Measured as the total number of primary care visits had by the patients with dementia within the study 6-month period.

Measured as the total number of emergency department visits had by patients with dementia within the study 6-month period.

Average number of prescription fills for the patient with dementia after 8 weeks enrolled in the study. This data comes from the automated system pharmacy data.

Refill rates after initial medication dispensing, using automated system pharmacy data

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Memory subscale ranges from 0-6 and measures issues with memory. A higher subscale score indicates worse memory symptoms.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Speech and Language subscale ranges from 0-6 and measures issues with speech and language. A higher subscale score indicates worse ability to speak and converse with others.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Recognition of Family Members subscale ranges from 0-5 and measures issues with recognition of family members. A higher subscale score indicates worse recognition of family members.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Orientation to Time subscale ranges from 0-4 and measures issues with the patient with dementia's ability to orient themselves in time. A higher subscale score indicates worse ability to orient themselves in time.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Orientation to Place subscale ranges from 0-4 and measures issues with the patient with dementia's ability to orient themselves. A higher subscale score indicates worse disorientation.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Ability to Make Decisions subscale ranges from 0-4 and measures issues with the patient with dementia's ability to make decisions for themselves. A higher subscale score indicates worse ability to make decisions for themselves.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Social & Community Activity subscale ranges from 0-5 and measures issues with the patient with dementia's ability to interact with those around them. A higher subscale score indicates worse ability to interact with others.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Home Activities & Responsibilities subscale ranges from 0-4 and measures issues with the patient with dementia's ability to do their usual things around the house. A higher subscale score indicates worse ability to complete home activities and responsibilities.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Personal Care - Cleanliness subscale ranges from 0-3 and measures issues with the patient with dementia's ability to take care of their personal hygiene independently. A higher subscale score indicates worse ability to maintain their cleanliness independently.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Eating subscale ranges from 0-3 and measures issues with the patient with dementia's ability to eat independently. A higher subscale score indicates worse ability to eat independently.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Control of Urination and Bowels subscale ranges from 0-4 and measures issues with the patient with dementia's ability to control their urination and bowels. A higher subscale score indicates worse ability to control their urination and bowels.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Ability to Get From Place to Place subscale ranges from 0-6 and measures issues with the patient with dementia's ability to get around on their own. A higher subscale score indicates worse ability to get around independently.

Randomized Caregivers are offered:

• A telephone orientation visit with a study coach to acquaint the caregiver to the 6-session STAR-VTF program and online learning environment.
• A paper-based and electronic manual to identify priority behaviors, develop plans for addressing behaviors, and make plans for pleasant events.
• 6 weekly telephone coaching visits lasting 30 minutes and corresponding to each of the 6 training modules.
• Secure message (email) support within the patient portal, as needed, with the coach to help with personalizing the STAR-VTF curriculum for up to 6 months, as initiated by the caregiver.

Patients with dementia randomized to the STAR-C VTF condition will be asked for consent to have their caregiver participate in the study and for the use of their medical record data.

Total of all reporting groups

Demographic data was collected from the patient with dementia's medical record and the caregiver demographic data was collected at a later date; we were not able to record all caregiver demographic data.

We collected the caregiver's demographic data at a later date for both arms; we have missing data for 10 caregivers in usual care and 8 caregivers in STAR-C VTF. The later collection date made it harder to reach participants that already completed the intervention, had withdrawn, or had completed the study. There is not a row to display missing data in this table.

Demographic data was collected from the patient with dementia's medical record and the caregiver demographic data was collected at a later date; we were not able to record all caregiver demographic data.

We collected the caregiver's demographic data at a later date for both arms; we have missing data for 10 caregivers in usual care and 8 caregivers in STAR-C. The later collection date made it harder to reach participants that already completed the intervention, had withdrawn, or had completed the study.

Demographic data was collected from the patient with dementia's medical record and the caregiver demographic data was collected at a later date; we were not able to record all caregiver demographic data.

We collected the caregiver's demographic data at a later date for both arms; we have missing data for 10 caregivers in usual care and 8 caregivers in STAR-C. The later collection date made it harder to reach participants that already completed the intervention, had withdrawn, or had completed the study.

Demographic data was collected from the patient with dementia's medical record and the caregiver demographic data was collected at a later date. Although we were not able to collect all demographic data from the caregivers, all resided in the same region.

The Caregiver Mastery Scale is a 7-item self-report scale, indicating the extent to which respondents agree (5) or disagree (1) with each item. Three items with negative statements are reverse-scored. Total scores can range from 7 to 35, with higher scores reflecting greater caregiver mastery. This scale was only used with caregivers and were reported as the total score.

The Caregiver Mastery Scale is only completed by the caregiver.

Scale used to measure caregiver's observation of any memory or behavior issues over the past week. The potential range of the scale is 0-96 with higher scores reflecting more problems with memory or behaviors observed in the patient with dementia. This scale was only used with caregivers and were reported as the total score.

The Revised Memory and Problem Behavioral Checklist is only completed by the caregiver.

This measure captures the caregiver's self-reported level of stress. Potential range of 10-50, with higher values indicating higher stress in the caregiver. This scale was only used with caregivers and were reported as the total score.

The Kingston Caregiver Stress is only completed by the caregiver.

The Revised Memory and Behavior Problems Checklist, Depression subscale measure depression symptoms of the patient with dementia as reported by the caregiver. The sub scale range is 0-36; with a higher score indicating worse depression symptoms.

The RMBPC, Depression subscale is only completed by the caregiver.

The Functional Activities Questionnaire measures the patient with dementia's dependency on their caregiver for daily activities as reported by the caregiver. Total range is 0-30; with a higher score indicating a higher dependence on the caregiver by the patient with dementia.

The Functional Activities Questionnaire is only completed by the caregiver.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The subscale ranges are:

A higher subscale score indicates worse dementia symptom.

• Memory, Speech and Language, Ability to Get From Place to Place: range of 0-6
• Recognition of Family Members, Social & Community Activity: range of 0-5
• Orientation to Time, Place, Ability to Make Decisions, Home Activities & Responsibilities, Control of Urination and Bowels: range of 0-4
• Personal Care - Cleanliness, Eating: range of 0-3

The Dementia Severity Rating Scale is completed by the caregiver to report the patient with dementia's severity rating for each subscale.

Self-reported caregiver depression assessed by the RMBPC, Depression subscale on the Revised Memory and Behavior Problem Checklist (RMBPC) questionnaire. The range in subscale scores is 0 to 36 with higher scores representing a worse outcome.

We used multiple imputation on our entire sample of 67 caregivers, including baseline survey response, 8 week survey response, and 6 month survey response. As such, all individuals contributed information to the analyses.

Self-reported caregiver self-efficacy assessed by the Caregiver Mastery Scale. Total scores can range from 7 to 35, with higher scores reflecting greater caregiver mastery.

The Caregiver Mastery Scale is a 7-item measure of self-efficacy. is a 7-item self-report scale, indicating the extent to which respondents agree (5) or disagree (1) with each item. Three items with negative statements are reverse-scored. Total scores can range from 7 to 35, with higher scores reflecting greater caregiver mastery.

We used multiple imputation on our entire sample of 67 caregivers, including baseline survey response, 8 week survey response, and 6 month survey response. As such, all individuals contributed information to the analyses.

The Kingston Caregiver Stress Scale (KCSS) is designed to allow a family member (or other) caregiver to express his/her level of perceived stress, as it relates to caregiving. It can also be used to monitor changes in stress levels over time, as the caregiver's situation changes. Scores range from 10-50; a higher scores indicates higher levels of stress.

We used multiple imputation on our entire sample of 67 caregivers, including baseline survey response, 8 week survey response, and 6 month survey response. As such, all individuals contributed information to the analyses.

We report the number of caregivers who completed their 8 week surveys by study arm.

We report the number of caregivers who completed their 6-month surveys by study arm.

We will report completion rates by study arm at the end of the trial. Completion will be defined as completing 2 home-based visits, 1 phone-based visit and sending at least one secure message to a social worker in the baseline to 8-week period and one message in weeks 9 through 24.

We reviewed how many caregiver - patient with dementia dyads completed the 8 weeks of online STAR-C VTF separate from those that completed the week 8 follow-up surveys. We report on the number of dyads that completed the online training from the total number enrolled. The number differs from the participant flow form because some dyads did not complete the week 8 follow-up survey but did complete the online training.

Measured as the total number of inpatient visits had by patients with dementia within the study 6-month period.

We analyzed our entire sample of 67 patients with dementia to understand how many touches they had with our care delivery system throughout the entire study. The total number differs from the participant flow as that is a reflection of completed follow-up surveys and not care delivery system touches.

Measured as the total number of primary care visits had by the patients with dementia within the study 6-month period.

We analyzed our entire sample of 67 patients with dementia to understand how many touches they had with our care delivery system throughout the entire study. The total number differs from the participant flow as that is a reflection of completed follow-up surveys and not care delivery system touches.

Measured as the total number of emergency department visits had by patients with dementia within the study 6-month period.

We analyzed our entire sample of 67 patients with dementia to understand how many touches they had with our care delivery system throughout the entire study. The total number differs from the participant flow as that is a reflection of completed follow-up surveys and not care delivery system touches.

Average number of prescription fills for the patient with dementia after 8 weeks enrolled in the study. This data comes from the automated system pharmacy data.

We analyzed our entire sample of 67 patients with dementia to understand how many prescriptions were filled for the patient with dementia after 8 weeks in the study. The total number differs from the participant flow as that is a reflection of completed follow-up surveys and not prescription fills.

Refill rates after initial medication dispensing, using automated system pharmacy data

We analyzed our entire sample of 67 patients with dementia to understand how many prescriptions were filled for the patient with dementia after 8 weeks in the study. The total number differs from the participant flow as that is a reflection of completed follow-up surveys and not prescription refills.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Memory subscale ranges from 0-6 and measures issues with memory. A higher subscale score indicates worse memory symptoms.

We used multiple imputation on our entire sample of 67 caregivers, including baseline survey response, 8 week survey response, and 6 month survey response. As such, all individuals contributed information to the analyses.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Speech and Language subscale ranges from 0-6 and measures issues with speech and language. A higher subscale score indicates worse ability to speak and converse with others.

We used multiple imputation on our entire sample of 67 caregivers, including baseline survey response, 8 week survey response, and 6 month survey response. As such, all individuals contributed information to the analyses.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Recognition of Family Members subscale ranges from 0-5 and measures issues with recognition of family members. A higher subscale score indicates worse recognition of family members.

We used multiple imputation on our entire sample of 67 caregivers, including baseline survey response, 8 week survey response, and 6 month survey response. As such, all individuals contributed information to the analyses.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Orientation to Time subscale ranges from 0-4 and measures issues with the patient with dementia's ability to orient themselves in time. A higher subscale score indicates worse ability to orient themselves in time.

We used multiple imputation on our entire sample of 67 caregivers, including baseline survey response, 8 week survey response, and 6 month survey response. As such, all individuals contributed information to the analyses.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Orientation to Place subscale ranges from 0-4 and measures issues with the patient with dementia's ability to orient themselves. A higher subscale score indicates worse disorientation.

We used multiple imputation on our entire sample of 67 caregivers, including baseline survey response, 8 week survey response, and 6 month survey response. As such, all individuals contributed information to the analyses.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Ability to Make Decisions subscale ranges from 0-4 and measures issues with the patient with dementia's ability to make decisions for themselves. A higher subscale score indicates worse ability to make decisions for themselves.

We used multiple imputation on our entire sample of 67 caregivers, including baseline survey response, 8 week survey response, and 6 month survey response. As such, all individuals contributed information to the analyses.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Social & Community Activity subscale ranges from 0-5 and measures issues with the patient with dementia's ability to interact with those around them. A higher subscale score indicates worse ability to interact with others.

We used multiple imputation on our entire sample of 67 caregivers, including baseline survey response, 8 week survey response, and 6 month survey response. As such, all individuals contributed information to the analyses.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Home Activities & Responsibilities subscale ranges from 0-4 and measures issues with the patient with dementia's ability to do their usual things around the house. A higher subscale score indicates worse ability to complete home activities and responsibilities.

We used multiple imputation on our entire sample of 67 caregivers, including baseline survey response, 8 week survey response, and 6 month survey response. As such, all individuals contributed information to the analyses.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Personal Care - Cleanliness subscale ranges from 0-3 and measures issues with the patient with dementia's ability to take care of their personal hygiene independently. A higher subscale score indicates worse ability to maintain their cleanliness independently.

We used multiple imputation on our entire sample of 67 caregivers, including baseline survey response, 8 week survey response, and 6 month survey response. As such, all individuals contributed information to the analyses.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Eating subscale ranges from 0-3 and measures issues with the patient with dementia's ability to eat independently. A higher subscale score indicates worse ability to eat independently.

We used multiple imputation on our entire sample of 67 caregivers, including baseline survey response, 8 week survey response, and 6 month survey response. As such, all individuals contributed information to the analyses.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Control of Urination and Bowels subscale ranges from 0-4 and measures issues with the patient with dementia's ability to control their urination and bowels. A higher subscale score indicates worse ability to control their urination and bowels.

We used multiple imputation on our entire sample of 67 caregivers, including baseline survey response, 8 week survey response, and 6 month survey response. As such, all individuals contributed information to the analyses.

The Dementia Severity Rating Scale measures the severity of dementia as observed by a caregiver in the patient with dementia. The Ability to Get From Place to Place subscale ranges from 0-6 and measures issues with the patient with dementia's ability to get around on their own. A higher subscale score indicates worse ability to get around independently.

We used multiple imputation on our entire sample of 67 caregivers, including baseline survey response, 8 week survey response, and 6 month survey response. As such, all individuals contributed information to the analyses.

The FAQ measures instrumental activities of daily living, such as preparing balanced meals and managing personal finances as observed by the caregiver in the patient with dementia. The tool consists of 10 questions with total scores ranging from 0-30. A minimum score of 9 indicates impaired functioning, and as the score increases from 9 indicating a greater reduction in functioning.

We used multiple imputation on our entire sample of 67 caregivers, including baseline survey response, 8 week survey response, and 6 month survey response. As such, all individuals contributed information to the analyses.

Patients with dementia randomized to the usual care control condition will be asked for consent to have their caregiver participate in the study and for the use of their medical record data.

Randomized Caregivers are offered:

• A telephone orientation visit with a study coach to acquaint the caregiver to the 6-session STAR-VTF program and online learning environment.
• A paper-based and electronic manual to identify priority behaviors, develop plans for addressing behaviors, and make plans for pleasant events.
• 6 weekly telephone coaching visits lasting 30 minutes and corresponding to each of the 6 training modules.
• Secure message (email) support within the patient portal, as needed, with the coach to help with personalizing the STAR-VTF curriculum for up to 6 months, as initiated by the caregiver.

Patients with dementia randomized to the STAR-C VTF condition will be asked for consent to have their caregiver participate in the study and for the use of their medical record data.