The Rural Family Dementia Caregivers (RFD Caregivers) Program: Developing Caregiving Knowledge and Skills for a Disproportionately Burdened Caregiver Population

About This Grant

The Rural Family Dementia Caregivers (RFD Caregivers) Program: Developing Caregiving Knowledge and Skills for a Disproportionately Burdened Caregiver Population Abstract. Americans living in rural areas, compared to their urban and suburban counterparts, are disproportionately affected by shortages of health care resources, resulting in poorer health status and health outcomes. The prevalence and impact of dementia and other chronic illnesses is and will continue to be higher in rural America. Rural-dwelling persons living with dementia illnesses (PLWD) and the friends and family (caregivers) who support them are adversely affected by the scarcity of primary care health providers and competent diagnostic and coordinated dementia-sensitive care and support services, the distance to and unavailability of specialty care and effective education, and the ongoing closure of rural hospitals. This project seeks to ameliorate the challenges faced by rural dementia families by embedding an evidence-based online dementia caregiver psychoeducation program (Tele-Savvy) into a statewide dementia diagnostic and care planning entity (Georgia Memory Net (GMN)). GMN, established by the State of Georgia in 2018 to expand dementia diagnostic capacity statewide, supports seven Memory Assessment Clinics (MACs) that provide in-person and virtual comprehensive dementia and dementia caregiver assessments and care management recommendations (but not care coordination), especially to residents in rural counties. Tele- Savvy, a 43-day synchronous/asynchronous program, employs a Social Cognitive Theory-based mechanism to strengthen dementia family caregivers’ competence and confidence (mastery) for enacting solution-focused coping behaviors in their day-to-day caregiving. Tele-Savvy has been shown to be efficacious in improving caregivers’ emotional well-being and improving PLWD quality of life, improvements mediated by demonstrated enhancements in caregiving mastery. Tele-Savvy will be augmented to incorporate curriculum elements aimed at developing rural caregivers’ competence and confidence for identifying, accessing, and coordinating the formal and informal healthcare and support services needed to help maintain community living for PLWD. Employing a cohort-based wait-list design, we will recruit 10 groups of 24 families (N=240) to participate in a 12-month study to evaluate Tele-Savvy’s impact on caregiver and PLWD well-being. The study will pursue two principal aims and an exploratory aim: Aim 1. Evaluate the efficacy of RFD Tele-Savvy to enhance the sense of mastery and emotional well-being of GMN family caregivers and document ways RFD Tele-Savvy enhanced caregivers’ capacities to carry out care plans and master the particular challenges of rural caregiving. Aim 2. Establish the efficacy of RFD Tele-Savvy in promoting improvements in the quality of life of PLWD whose caregivers are trained in the RFD Tele-Savvy program. Exploratory Aim: Gather information to assess the feasibility of and to estimate power needs for a future examination of the effect of GMN caregiver participation in RFD Tele-Savvy on PLWD healthcare utilization (ED visits and preventable hospitalizations).