Sponsor. Administration on Aging.
Purpose. This demonstration program, based in Philadelphia, Pennsylvania, is designed to assess the efficacy of a short-term nursing intervention in meeting the diverse needs of female African American and Caucasian caregivers. The goal is to enhance the services that caregivers receive through the Family Caregiver Support Program.19
Description. This program is designed to enhance the service strategy of the Philadelphia Corporation on Aging's (PCA's) existing Family Caregiver Support Program. It offers an intensive nursing intervention designed to maintain caregiver health, strengthen caregiver skills, and reduce caregiver stress. The intervention targets female African-American caregivers 65 years of age or older who provide care to a spouse or parent. Caregivers who meet the target criteria (identified through the PCA's automated client data system) are randomly assigned to the intervention or the control group condition. The goal is to enroll 200 caregivers (100 African American and 100 Caucasian) to complete the intervention by the end of Year 3.
The intervention consists of four in-home visits by a master's prepared nurse over a 3-month period, followed in some cases by more extensive intervention (i.e., in cases where the complexity of the caregiving situation or special needs of the caregiver require additional visits). During the first visit, the caregiver receives a thorough physical examination, completes the Caregiver Health Interview tool, develops a plan for health care (including both preventive health care and medical care services), and receives health education materials. During the second through fourth visits, individualized health care plans are reviewed, referrals are made to other health care providers, and additional caregiver training is provided. In addition, during the final (fourth) in-home visit, the nurse reevaluates the caregiver's health (repeating the assessment conducted at the time of the initial visit) and asks additional questions about the caregiver's perception of the intervention. Changes in health status and well-being are tracked from baseline through 3-month follow-up.20
A second intervention, known as the telemedicine component, has been offered as an add-on to those caregivers who are considered at risk of deterioration in their own health (due to advanced age; the presence of two or more chronic conditions or unstable management of chronic disease; limited informal resources and social isolation, depression and/or anxiety; and medically complex or physically demanding caregiving tasks). Those who agree to participate in this intervention, have on-going contact with the nurse (via telemedicine) over an additional 3-month period, both to reinforce their original care plan and to monitor the health status of the caregiver over time.
The control group for the second intervention receives two in-home visits by a nurse over the same 3-month period. The same evaluation tool is used for both the intervention and control group at both points in time.
Results to Date. Individuals are still being recruited into the program. Interim results should be available by fall 2003.
Next Steps. Baseline and follow-up data on caregivers in both the intervention and control group will be collected and analyzed. Changes in the following outcomes will be examined at 3- and 6-month follow-up: caregiver health, performance of caregiver tasks, caregiver stress, and caregiver quality of life.
Joan Klein, MSW, LSW
Director, Family Caregiver Support Program
Philadelphia Corporation for Aging
642 North Broad Street
Philadelphia, PA 19130-3409
Phone: (215) 765-9000, extension 4356
Fax: (215) 765-9066