Resource need and use of multiethnic caregivers of elders in their homes.

Aims: The aim of this study was to predict South Florida family caregivers' need for and use of informal help or formal services, specifically, to explore the predictive power of variables suggested by the Caregiver Identity Theory and the literature and develop and test a structural model.

Background: In the USA, most of the care to older adults is given by family members. Caregivers make economic and social sacrifices that endanger their health.

Is gerontology ready for accreditation?

The authors review widely accepted criteria for program accreditation and compare gerontology with well-established accredited fields including clinical psychology and social work. At present gerontology lacks many necessary elements for credible professional accreditation, including defined scope of practice, applied curriculum, faculty with applied professional credentials, and resources necessary to support professional credentialing review. Accreditation with weak requirements will be dismissed as "vanity" accreditation, and strict requirements will be impossible for many resource-poor programs to achieve, putting unaccredited programs at increased risk for elimination.

Effects of the TCARE® intervention on caregiver burden and depressive symptoms: preliminary findings from a randomized controlled study.

Objectives: We examined the effects of a manualized care management protocol specifically designed for care managers working with caregivers, the Tailored Caregiver Assessment and Referral® (TCARE®) protocol, on caregiver identity discrepancy, burden, and depressive symptoms.

Methods: Preliminary data from a longitudinal, randomized, controlled intervention study with 266 family caregivers served by 52 care managers in 4 states were analyzed using repeated measures random effects regression procedures. Caregivers in the intervention and control groups were repeatedly assessed for up to 9 months on caregiver identity discrepancy, 3 areas of caregiving burden-objective, relationship, and stress burdens; depression; and intention for nursing home placement.

The impact of TCARE® on service recommendation, use, and caregiver well-being.

Purpose Of The Study: Findings are reported from a study that examined the effects of the Tailored Caregiver Assessment and Referral (TCARE®) protocol, a care management process designed to help family caregivers, on care planning and caregiver outcomes.

Design And Methods: A longitudinal, randomized controlled trial was conducted with 97 caregivers enrolled in a demonstration project in Georgia. Data included on care plans pertaining to service recommendations, compliance, and use were reviewed.

A dimensional analysis of caregiver burden among spouses and adult children.

Purpose Of The Study: Caregiver burden is a multidimensional construct, addressing tension and anxiety (stress burden), changes in dyadic relationships (relationship burden), and time infringements (objective burden) resulting from caregiving. The study aims were to assess (a) whether the dimensions of burden were the same for caregiving spouses and adult children, (b) the role of assisting with problem behaviors (PBs) and activities of daily living (ADLs) on each dimension of burden, and (c) the role of each dimension of burden on self-rated health and intention to institutionalize the care receiver.

Design And Methods: This study included 280 spouse/partner and 243 adult child caregivers of persons with chronic illnesses.

Impact of a psychoeducational program on three types of caregiver burden among spouses.

Purpose: The purpose of this study was to investigate the extent to which a psychoeducational intervention called "Powerful Tools for Caregivers" (PTC) influences burden of spouse caregivers. Specifically, this study examined whether spouse caregivers who attended PTC exhibited reductions in stress burden, relationship burden, and objective burden compared to a comparison group.

Design And Methods: The 6 -week intervention used a self-efficacy framework to train caregivers to focus on self-care, communicate effectively, and manage emotions.

Weighing the success of a national Alzheimer's disease service demonstration.

As the need for long-term care services within the United States has grown dramatically, Congress has consistently deflected the primary responsibility for such care to state governments, local organizations, and, ultimately, the family. This paper examines the impact of the Alzheimer's Disease Demonstration Grants to States (ADDGS) program, a small federally funded initiative within the context of this trend. Although the demonstration can be deemed a huge success relative to the goals of creating new services for an underserved target population, questions are raised about the merits of the program relative to the exploding need for an effective network of long-term care services.

A profile of home care workers from the 2000 census: how it changes what we know.

Purpose: The goal of our study was to identify a representative sample of direct care aides to generate an accurate profile of the long-term-care workforce, with a special focus on home care workers.

Design And Methods: Data were taken from the 5% Public Use Microdata Sample (PUMS) of the 2000 Census.

Results: Variable coding in the 2000 Census data allowed for a more detailed identification of long-term-care workers than was available in previous studies.

Investigating the effects of communication problems on caregiver burden.

Objective: The goal of this study was to explore the relationship between communication problems associated with dementia and caregiver burden, within the context of problem behaviors and cognitive and functional abilities of the care recipient.

Methods: A scale on communication problems associated with dementia was developed and administered to 89 family caregivers. Participants also completed measures of care-recipient cognitive and functional status, problem behavior, and caregiver burden (demand, stress, and objective burden).

Evaluating a practice-oriented service model to increase the use of respite services among minorities and rural caregivers.

Purpose: The goal of this study was to evaluate the practice-oriented model of service use (Yeatts, Crow, & Folts, 1992) relative to the more widely used behavioral model ( Andersen, 1968) in its ability to explain the use of respite services by caregivers of Alzheimer's patients. Unlike the behavioral model, which focuses primarily on characteristics of the service user, the practice-oriented model focuses primarily on characteristics of the service.

Design And Methods: Interview data from 1,158 caregivers participating in the Alzheimer's Disease Demonstration Grants to States program ( Montgomery, Kosloski, Karner, & Schaefer, 2002) were analyzed.

Exemplars of successful Alzheimer's demonstration projects.

The Alzheimer's Demonstration program was established in 1991 to develop models of home and community-based care for persons with Alzheimer's disease and their families. After more than ten years of program experience and evaluation, the Alzheimer's Demonstration program has generated significant information about how to work successfully with families coping with Alzheimer's disease. In particular, the Demonstration program has been very successful in developing innovative program models and approaches to serving traditionally underserved populations such as ethnic minorities, low income, and rural families.

The role of cultural factors on clients' attitudes toward caregiving, perceptions of service delivery, and service utilization.

The purpose of the present study was to gain a better understanding of the role of culture in the use of respite services. Culture was defined in three different ways: (1) ethnicity (African-American, Hispanic/Latino, or White); (2) relationship of the caregiver to the care receiver (spouse, adult-child, or other); and (3) geographic location (urban or rural). All three of these classifications were significantly related to the use of respite services, even after controlling for elders' income.

Profiles of respite use.

Profiles of long-term respite use are reported for a diverse sample of 4,369 families from seven states who participated in the Alzheimer's Disease Demonstration Grant to States program. Data from service records spanning a period of seven years were analyzed using hierarchical linear modeling techniques. Respite use was examined in both day care and in-home settings using three different measures of use.

Initial findings from the evaluation of the Alzheimer's Disease Demonstration Grants to States Program.

This article describes the initial development and implementation of the Alzheimer's Disease Demonstration Grants to States (ADDGS) program in 15 states. In addition to describing the services delivered and the client populations served, key elements of program development are discussed. Development strategies common to the programs that most successfully used the demonstration as a catalyst for developing services that are likely to continue are identified.