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Due to advances made in medicine and health care, older adults (OAs) are living longer but enduring problems with physical functioning and health for longer periods of time. Also, the percentage of OAs with cognitive impairments is increasing. Caregiving duties which decades ago lasted months now last for years. The long-term stress of caring for an OA who is physically and/or cognitively impaired leads many caregivers (CGs) to feel frustrated, angry, overwhelmed and isolated. As a result of this stress many CGs resort to nursing home placement. The COPE Project was undertaken in a social service agency in northeastern Ohio in order to provide service options to participating CGs. It was hypothesized that these optional services would alleviate some of the debilitating stress associated with caregiving and postpone institutionalization. This program was geared to assist CGs of low income OAs (n=127) who had physical/cognitive disabilities. CGs were allotted $1200 in unrestricted vouchers to be used within a six month period to purchase new or additional services. This presentation will discuss baseline data obtained from the initial CG interview (e.g., physical and behavioral problems, activities of daily living and CG well-being) that predicted subsequent placement. Analyses revealed the predictors of placement to be: whether the OA had a problem with household tasks (b= -2.260, p=.006), whether the OA woke up the CG or other family members during the night (b= -1.522, p=.046,) and whether the CG felt she/he had been a good CG (b=. 1.465, p=.035). The implications of these findings for evaluation of service programs and the distribution of agency resources will be discussed.

This paper reports on the development and use of a scale that assesses values and preferences for everyday care of both family caregivers (CGs) and persons with cognitive impairments (PWCIs). Sample for the study included community-dwelling African American (n=66) and non African-American adults (n=45) with physical and/or cognitive impairments and their family caregivers. Results of factor analysis indicated that the 37-item Values and Preferences Scale (VPS) was best divided into four conceptual domains: autonomy (9 items, a=.76), burden (4 items a=.76), self-identity (10 items, a=.77), and family/social interactions (14 items, a=.81). Although no major differences were found across these four domains for African American vs. non African American CGs and PWCIs, differences were found at the item level. For example, PWCIs generally agreed on the importance of care values and preferences, while CGs were more likely to disagree on the importance of specific items. These and other findings will be discussed with an emphasis on how these differences are more likely attributable to SES or caregiver characteristics (e.g., daughters vs. wives) than to culture or ethnicity.

In this aging world, understanding the relationship between caregivers (CG) and care receivers (CR) becomes ever more important. For societies to meet the needs of this aging population, they must develop an understanding of the values and preferences for care of the people delivering and utilizing that care within informal caregiving networks. A sample of 111 dyads residing within the community was interviewed to examine the values and preferences of CRs and the CG's perceptions of the CR's values and preferences in a care-partnering situation. Correlations between CR Mini Mental State Examination and the Value and Preferences Scale domains (autonomy, burden, self-identity, and family/social interactions) indicated a statistically significant relationship for autonomy (r = .32, p < .01), self-identity (r = .19, p < .05), and family social/interactions (r = .22, p < .05) for care receivers. Autonomy (r = .44, p < .01) and self-identity (r = .21, p < .05) were reported by CGs as being more important for CRs who were more cognitively intact. Thus, impairment level is a good predictor of CR's care values and preferences as well as CG's perceptions of these values and preferences.

Many family caregivers (CGs) of person's with cognitive impairment (PWCIs) face the critical task of arranging for their relative's living arrangements, services, and activities. The potential stress CGs face surrounding decision-making for the PWCI centers on: 1) the CG's perceptions of the PWCI's preferences for care, and 2) how congruent the CG's perceptions are with the PWCI's preferences for care. This presentation examines dyadic congruence and its effect on CG strain in 111 CG-PWCI dyads. PWCIs were asked about their own preferences while CGs were asked about their perceptions of their relative's preferences on topics including decision-making, personal care, living arrangements, and use of f0t'tnal services. Dyadic congruence was measured using CG-PWCI difference scores for each question. Significant correlations between congruence and measures of CG strain indicate that as awareness of relative's care preferences increases, CGs' Quality of Life improves (r=.26, p=.010) and Financial Strain (r=-.30, p=.003) and Relationship Strain decrease (r=-.21, p=.025). These results suggest that increasing discussion of care preferences among dyads may be one method of alleviating caregiver strain.