Caregiving, Dementia, Elder Abuse, Elder Mistreatment, Quality of Care
Conditions
Brief summary
The Knowledge and Interpersonal Skills to Develop Enhanced Relationships (KINDER) intervention was developed to prevent psychological elder abuse (EA) and promote high-quality caregiving by lowering relationship strain and developing CG resourcefulness. The goal of this two-arm, randomized control trial is to determine the efficacy of KINDER at mitigating psychological EA by family caregivers to persons living with dementia and to describe how the intervention may work to reduce psychological EA.
Interventions
BEHAVIORALKnowledge and Interpersonal Skills to Develop Enhanced Relationships
KINDER is an 8-week intervention that consists of three facilitated group discussion sessions conducted over Zoom with a small group of caregivers, in addition to self-paced lessons delivered using a printed or PDF workbook, depending on participant preference. Throughout KINDER, caregivers reflect on their relationship, including how their behavior toward the care recipient may need to change considering new vulnerabilities with dementia, and how to communicate about topics that often contribute to conflict, such as balancing safety and independence (e.g., driving).
BEHAVIORALHealthy Living for the Caregiver
Caregivers in the control arm will receive a workbook that covers 8 weeks of content focused on healthy living (e.g., nutrition).
Sponsors
Case Western Reserve University
National Institute on Aging (NIA)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Age range: from 18 to No upper limit; * Be a family member to an individual living with AD/ADRD; * Provide assistance with at least two instrumental activities of daily living or one activity of daily living; * Provides at least 4 hours of caregiving per day and sees the care recipient in-person at least 2 times per week on average * The care recipient is at least age 65 or older * Report an AD8 Dementia Screening score for care recipients of at least 2; * Commit to attending at three discussion sessions; * Have reliable access to internet and email, and to be able to attend synchronous sessions using the Zoom videoconferencing platform. * Caregiver lives in any of the following states, which may require mandetory reporting of elder mistreatment when responding to survey questions: Delaware, Florida, Indiana, Kentucky, Louisiana, Mississippi, Montana, New Hampshire, New Mexico, North Carolina, Oklahoma, Rhode Island, South Carolina, Tennessee, Texas, Utah, Wyoming
Exclusion criteria
* Are unable to read or speak English; * Previously participated in Learning Skills Together (NCT05846984) or KINDER pilot study; * Have plans to place the care recipient in a skilled nursing facility within the next 8 months (i.e., study duration)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Psychological Elder Abuse | Baseline, 2 weeks post-intervention, 12 weeks post-intervention, 24 weeks post-intervention | The investigators will use a modified version of the Conflict Tactics Scale 2 to measure psychological EA (MCTS 2). This scale includes five psychological EA behaviors, such as insulting, swearing at, or yelling at the care recipient, as well as threatening to stop taking care of the care recipient, placing them in a nursing home, threatening physical harm, and stomping out of the room. Participants will be asked to describe the frequency of each behavior in the last 2 months, such that response options will include: None, Once, Twice, 3 to 5 times, 6 to 10 times, and More than 10 times. Scores range from 0 to 30. Higher scores indicate greater frequency of mistreatment. Higher scores indicate greater frequency of abuse. The outcome measure will use the average change score from baseline scores until each post-intervention survey. |
| Quality of Caregiving | Baseline, 2 weeks post-intervention, 12 weeks post-intervention, 24 weeks post-intervention | To measure quality of care, the investigators will use the 11-item Exemplary Caregiving Scale, which focuses on providing care that meets the care recipient's needs (α=0.73) and is respectful (α=0.76). Response options include Never, Sometimes, Often, and Always (range: 11 to 44). Higher scores indicate higher quality of caregiving. The outcome measure will use the average change score from baseline scores until each post-intervention survey. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Resourcefulness | Baseline, 2 weeks post-intervention, 12 weeks post-intervention, 24 weeks post-intervention | Resourcefulness is measured using the 28-item Caregiver Resourcefulness Scale (α=0.85). This scale has two factors: one focused on help-seeking and another on self-help. Caregivers are asked the frequency at which they use different strategies to manage challenges, and may respond: Not at all like me (0), Pretty much not like me (1), A little bit not like me (2), A little bit like me (3), Pretty much like much like me (4), or Very much like me (5). Items are added together to create a total score. Scores range from 0 to 140, where higher scores indicate higher levels of resourcefulness. The outcome measure will use the average change score from baseline scores until each post-intervention survey. |
| Caregiving Relationship Strain | Baseline, 2 weeks post-intervention, 12 weeks post-intervention, 24 weeks post-intervention | Relationship strain will be measured using the 5-item Strain Scale of the Dyadic Relationship Scale (α=0.69). Respondents are asked to indicate agreement with statements such as, "The patient made too many requests," and may indicate Strongly Disagree, Disagree, Agree, or Strongly Agree. The scale has a range of scores from 4 to 20, where higher scores indicate greater levels of relationship strain. The outcome measure will use the average change score from baseline scores until each post-intervention survey. |
Countries
United States
Contacts
CONTACTKylie Meyer, PhD
CONTACTLauren Project Manager
Outcome results
None listed