Robert Glueckauf, Ph.D.

Alzheimer's Caregiver Community Education and Support System

The number of persons with progressive dementia is predicted to expand substantially as the proportion of older adults increases.. The vast majority of adults with progressive dementia (75%) are cared for at home by family members. Most caregivers are middle-aged daughters and daughters-in-law, as well as older spouses. Intensive home care activities are performed at high cost to those family members in terms of psychological, physical, and financial resources. Several studies have shown that caregivers of persons with dementia are at substantial risk for the development of emotional disorders, particularly depression and anxiety. There continues to be a substantial gap between caregiver needs and available services especially for rural families. While exciting successes of tele-health-caregiver-interventions based on telephone or internet communication (Alzheimer's Caregiver Community Education and Support System (ACCESS)) were reported, they were performed exclusively in large metropolitan areas with urban-residing caregivers. Rural individuals instead tend to rely more on local community providers and are rather reluctant to enter into relationships with non-rural providers unless they are specifically recommended by their trusted family physician, pastor, and/or pharmacist. To solicit the support and direct involvement of those frontline providers we propose to

1. develop culturally sensitive and appropriate educational materials for diverse ethnic groups of dementia caregivers and their rural primary care providers such as primary care physicians, pharmacists and pastors.
2. We will compare the effects of a rural provider outreach program with routine dementia education and the combined telephone- and Web-based Alzheimer's Caregiver Community Education and Support System (ACCESS) and
3. compare their effects on caregivers' psychological distress, perceived self-efficacy, and role strain from pre- to post treatment;
4. Differences in individual ethnic groups will be assessed and evaluated
5. evaluate differences in referral patterns, utilization rates and satisfaction with ACCESS among rural non-Hispanic White, African-American, and Hispanic Latino dementia caregivers;