Self- Care TALK Study - Promoting Alzheimer's Disease (AD) Spousal Caregiver Health

Informal caregiving, or providing non-paid assistance for a family member or friend who is unable to care for self, is challenging and stressful. Caregivers commonly experience negative psychological, emotional, physical, and social outcomes, including depression, strain and other disruptions in health and well-being. The overall aim of the study is to test the effectiveness of a health-promoting self-care education and support partnership between advanced practice nurses (APNs) and older spouse caregivers, in reducing perceived caregiving strain and in promoting health. The theory-based, multi-dimensional Self-Care TALK intervention is provided using a telephone-based approach to facilitate participation among carers, considering their concurrent responsibilities in the caregiving role. A randomized, treatment/comparison, repeated-measures experimental design is used to test the effectiveness of the health-promoting treatment (Self-Care TALK) compared to usual care, for spouse caregivers age 60 and older. Subjects must be living with and caring for the person with dementia and the dementia diagnosis must have been within 2 years of enrollment. Subjects complete questionnaires at baseline (Time 1) before randomization to the treatment or comparison group. Treatment group subjects receive written materials related to self-care and health promotion for use during the TALK sessions. Self-Care TALK is implemented through 6 weekly telephone sessions with advanced practice nurses. Sessions focus on several self-care topics, including: healthy habits, building self-esteem, focusing on the positive, avoiding role overload, communicating, and building meaning. Basic content is structured, but conversations are individualized with regard to each person's environment, abilities, and activities. All subjects complete questionnaires again at 8 weeks (Time 2), and 24 weeks (Time 3) after baseline. Treatment group subjects are hypothesized to have lower caregiving strain, higher perceived health, well-being, and self-efficacy related to health, and less depressive symptomatology than comparison group subjects. Promoting healthy outcomes for caregivers of persons with dementia is essential to fostering ability for continued home-based care. Comparison group subjects receive written materials related to self-care and health promotion post Time 3.