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The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Advance Access originally published online on April 6, 2009
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2009 64A(7):785-791; doi:10.1093/gerona/glp030
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© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Caregiving and Chronic Care: The Guided Care Program for Families and Friends

Jennifer L. Wolff1,2, Erin Rand-Giovannetti1, Sara Palmer3, Stephen Wegener1,3, Lisa Reider1, Katherine Frey1, Daniel Scharfstein1,2 and Chad Boult1,2

1 Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
2 Division of Geriatric Medicine and Gerontology
3 Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland

Address correspondence to Jennifer L. Wolff, PhD, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 692, Baltimore, MD 21205. Email: jwolff{at}jhsph.edu


  Abstract

Background: The Guided Care Program for Families and Friends (GCPFF) is one component of "Guided Care" (GC), a model of primary care for chronically ill older adults that is facilitated by a registered nurse who has completed a supplemental educational curriculum.

Methods: The GCPFF melds support for family caregivers with the delivery of coordinated and comprehensive chronic care and seeks to improve the health and well-being of both patients and their family caregivers. The GCPFF encompasses (a) an initial meeting between the nurse and the patient's primary caregiver, (b) education and referral to community resources, (c) ongoing "coaching," (d) a six-session group Caregiver Workshop, and (e) monthly Support Group meetings, all facilitated by the patient's GC nurse.

Results: A cluster-randomized controlled trial of GC is underway in 14 primary care physician teams. Of 904 consented patients, 450 (49.8%) identified a primary caregiver; 308 caregivers met eligibility criteria, consented to participate, and completed a baseline interview. At 6-month follow-up, intervention group caregivers’ mean Center for Epidemiological Studies Depression (CESD) and Caregiver Strain Index (CSI) scores were respectively 0.97 points (p = .14) and 1.14 points (p = .06) lower than control group caregivers’. Among caregivers who provided more than 14 hours of weekly assistance at baseline, intervention group caregivers’ mean CESD and CSI scores were respectively 1.23 points (p = .20) and 1.83 points (p = .04) lower than control group caregivers’.

Conclusions: The GCPFF may benefit family caregivers of chronically ill older adults. Outcomes will continue to be monitored at 18-months follow-up.

Keywords Caregiving; Chronic disease; Nursing; Primary care

Received: June 1, 2008; Accepted: January 7, 2009

Decision Editor: Darryl Wieland, PhD, MPH


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