Peer Support for Family Caregivers of Older Adults Living With Dementia

Family care partners (FCP) of older adults living with Alzheimer's disease and Alzheimer's disease-related dementias (AD/ADRD) are at high risk of adverse health effects of caregiving. AD/ADRD prevalence can be as high as 18.6% in some high-risk populations versus 10% in the general public overall. Combined with late or missed diagnosis, this leads to neuropsychological symptom management, healthcare planning, physical, spiritual, and psychosocial challenges for FCPs. Support interventions are needed to assist high-risk AD/ADRD FCP populations. Peer Support for Family Caregivers of Older Adults Living with Dementia (Pair 2 Care) is a peer support intervention that is delivered virtually. Our team, in collaboration with current and former FCPs, community leaders, and healthcare providers, developed Pair 2 Care. Pair 2 Care© leverages the experiential expertise of former AD/ADRD FCPs (care recipient is deceased) who serve as trained mentors to current FCP mentees. Pair 2 Care was found to be feasible and acceptable based on completion of total participant enrollment (N=26), mentor training, and FCP mentee-mentor pairing in only 10 weeks. Mentors were retained at 90% and FCP mentees at 93% for this 6-month intervention. Participants rated their overall Pair 2 Care satisfaction as very high (4.6/5.0). The study team hypothesize that Pair 2 Care will result in better FCP mentee outcomes (reduced depressive symptoms, anxiety, and loneliness and greater social support, quality of life, and self-efficacy) compared to controls. The study team will conduct a two-arm randomized controlled trial (n=172 FCP mentees; n=86 intervention group; n=86 enhanced usual care control group). The specific aims of this study are to (1) determine Pair 2 Care intervention efficacy on FCP mentee depressive symptoms (primary outcome), anxiety, social support, loneliness, quality of life, and self-efficacy for surrogate decision making; (2) examine the associations between FCP mentee and mentor individual characteristics and variations in engagement quality (i.e., frequency and mode of connection, program satisfaction) with Pair 2 Care©; and (3) determine the impact on the mentor's well-being, identity restoration, meaning in life, and loneliness following Pair 2 Care intervention participation using mixed-methods analyses. This study will provide important intervention efficacy data for this innovative, simple, evidence-based, potentially scalable approach to addressing the needs of FCPs providing support to people living with AD/ADRD. Pair 2 Care has the potential to inform important AD/ADRD caregiving-related policy.