Coaching Dementia Caregivers to Master Care-Resistant Behavior

Coaching Dementia Caregivers to Master Care-Resistant Behavior and Improve Coping Strategies

266 family caregivers will be randomly assigned to either immediate intervention or delayed intervention groups. All caregivers will complete baseline surveys and 3 weeks of daily diaries. The immediate intervention group will receive 12 weeks of CuRB-IT. They will complete 3 rounds of 3-week daily diaries followed by an intermittent survey at 12 week intervals for the next 33 weeks. The delayed intervention group will receive 12 weeks of attention, complete 1 round of 3-week daily diaries followed by an intermittent survey, then complete 12 weeks of CuRB-IT, and complete 2 rounds of 3--week daily diaries followed by an intermittent survey at 12-week intervals for the next 18 weeks.

The purposes of the delayed-intervention randomized clinical trial (N=266) are to:

Care-Resistant Behavior Internet Training (CuRB-IT).

1. examine the efficacy of CuRB-IT in increasing the self-efficacy of family caregivers of persons living with dementia to handle care-resistant behaviors (CRB);
2. further test the efficacy of CuRB-IT in improving caregivers coping strategies (a) among the experimental (immediate-intervention group) as compared to the control (delayed-intervention group) (between groups) and (b) within-person from pre- to post- intervention;
3. examine intervention decay at 3- and 6-months post intervention to determine performance of intervention and inform scheduling of booster sessions;
4. assess the efficacy of the CuRB-IT intervention in preventing onset of poor coping strategies by family caregivers;
5. test the hypothesized mechanism of action that increased CRB self-efficacy and use of CuRB-IT problem-focused coping strategies mediate the relationship between CRB stress appraisal and caregiving activities.

Inclusion Criteria:

• 1)Caregiver of any race or gender who is aged >18 years
• 2) provides unpaid care,
• 3) cares for a spouse/common-law, sibling, parent or grandparent (or in-law, aged 60+ years),
• 4) lives with or shares cooking facilities with the care recipient,
• 5) Care recipient has mild cognitive impairment or dementia as identified using the Quick Dementia Rating System instrument,
• 6) the care provided consists of help with at least 2 Instrumental Activities of Daily Living or one Activity of Daily Living,
• 7) the care recipient is resistant to receiving assistance with, or refuses to do, at least one instrumental or activity of daily living

Exclusion Criteria:

• 1) persons who cannot speak/read English
• 2) who do not have reliable access to a smart phone or internet