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Purpose: Few empirical studies have compared the efficacy between psychoeducational (skill-building) approaches for reducing caregivers' psychological distress and interventions modeled after typical community-based support groups. We compare the impact of two distinct interventions on Anglo and Latino caregivers of elderly relatives with dementia. Design and Methods: The change from preassessment to postassessment (baseline to 3 months) for 213 female caregivers (122 Anglo and 91 Latino) is presented. They were seen weekly for 10 weeks in either the Coping With Caregiving psychoeducational program (instruction and practice in small groups to learn specific cognitive and behavioral skills) or in the Enhanced Support Group condition (guided discussion and empathic listening to develop reciprocal support within the group). Both programs were tailored to be sensitive to the cultural concerns of Anglo and Latino caregivers, and they were delivered in either English or Spanish by trained interventionists. Results: Overall, participants in the Coping With Caregiving condition reported a significant reduction in depressive symptoms, increased use of adaptive coping strategies, and a trend toward decreased use of negative coping strategies when compared with those in the Enhanced Support Group condition. Results were similar for both ethnic groups: there were no main effects for ethnicity, and no significant ethnicity by treatment interaction effects. Implications: This study provides empirical support that female caregivers benefit more from a skill-building approach to managing their distress than from support group membership alone. We find it very encouraging that the Latino caregivers responded well on key outcome variables, suggesting that Latinos will participate in clinical research and will benefit from their involvement when services are provided to meet their specific needs.

Investigated whether the coping framework developed with younger adults with schizophrenia could be applied to people over 50 with schizophrenia. Results indicated that coping strategies used by older people were similar to those of younger populations. However, it was reported that efficacy of coping strategies had increased as participants had grown older and accepted their illness. (BF)

Purpose: Few empirical studies have compared the efficacy between psychoeducational (skill-building) approaches for reducing caregivers' psychological distress and interventions modeled after typical community-based support groups. We compare the impact of two distinct interventions on Anglo and Latino caregivers of elderly relatives with dementia. Design and Methods: The change from preassessment to postassessment (baseline to 3 months) for 213 female caregivers (122 Anglo and 91 Latino) is presented. They were seen weekly for 10 weeks in either the Coping With Caregiving psychoeducational program (instruction and practice in small groups to learn specific cognitive and behavioral skills) or in the Enhanced Support Group condition (guided discussion and empathic listening to develop reciprocal support within the group). Both programs were tailored to be sensitive to the cultural concerns of Anglo and Latino caregivers, and they were delivered in either English or Spanish by trained interventionists. Results: Overall, participants in the Coping With Caregiving condition reported a significant reduction in depressive symptoms, increased use of adaptive coping strategies, and a trend toward decreased use of negative coping strategies when compared with those in the Enhanced Support Group condition. Results were similar for both ethnic groups: there were no main effects for ethnicity, and no significant ethnicity by treatment interaction effects. Implications: This study provides empirical support that female caregivers benefit more from a skill-building approach to managing their distress than from support group membership alone. We find it very encouraging that the Latino caregivers responded well on key outcome variables, suggesting that Latinos will participate in clinical research and will benefit from their involvement when services are provided to meet their specific needs. Key Words: Alzheimer's caregiving, Interventions, Latino issues, Coping

Purpose: This article reviews and critiques several issues of importance to those whose goal is to make intervention research with Latino caregivers more 'user-friendly.' Issues range from current demographic trends showing the ever-increasing number of Latino caregivers to discussion of cultural values that influence their help-seeking behavior. Design and Methods: This article presents a review of current published information on this topic. The gerontological literature was searched for the past decade for relevant material; in addition, the authors' own experience in this area is described. Results: Although limited information was found that derived from actual empirical studies, a number of articles describe potential barriers to research involvement and provide suggestions for making participation more attractive and culturally appropriate for Latinos. Implications: Clinical researchers need to increase their sensitivity to such issues as cultural values and language preference and develop effective collaborations with the Latino community so that intervention research programs can be designed and implemented successfully with Latinos caring for cognitively impaired elderly family members at home. Key Words: Caregiving, Stress, Hispanic, Women, Aging

By exploring the subjective experience of older people, this study investigated whether the coping framework developed with younger adults with schizophrenia could be applied to people with schizophrenia over the age of 50 years. Fifteen participants diagnosed with schizophrenia, over the age of 50, were recruited from clubhouses and given a semi-structured interview to identify what, if any, coping strategies were used to manage persistent symptoms. The results indicated that the coping strategies used by this older sample were similar to those reported by earlier studies with younger populations. However, it was reported that the efficacy of the coping strategies had increased as the participants had grown older and accepted their illness. Older adults with schizophrenia are capable of employing strategies to manage their illness and should be considered an important source of knowledge for younger individuals who struggle with the illness and for mental health professionals who work with the chronically mentally ill.

This paper (Part II) further illustrates how a staff needs assessment can serve as the foundation for ongoing collaborations between extended care unit staff and consulting clinical researchers. The first phase of the process involved gathering data via a series of semi-structured interviews with staff of a long-term care unit at the Veterans Affair Palo Alto Health Care System. This paper describes the second phase that involved the implementation of a series of interventions aimed at supporting staff in dealing with disruptive and aggressive behavior. The final phase, which is ongoing, is monitoring and refining the interventions based on staff feedback and the results of program evaluation. Such an approach allows interventions to target the concerns and needs of a particular setting. Continuation of initiated interventions and collaboration between researchers and unit staff are two of the indicators that this model has worked. [ABSTRACT FROM AUTHOR]