Caregiving and chronic care: the guided care program for families and friends.
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.
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. jwolff@jhsph.edu
Jennifer L
JL
Wolff
Erin
E
Rand-Giovannetti
Sara
S
Palmer
Stephen
S
Wegener
Lisa
L
Reider
Katherine
K
Frey
Daniel
D
Scharfstein
Chad
C
Boult
D015142:Baltimore; D017028:Caregivers / Q000193:education*; D002908:Chronic Disease / Q000451:nursing*; D005190:Family; D005260:Female; D017144:Focus Groups / Q000379:methods; D033062:Friends; D006306:Health Surveys; D006801:Humans; D008134:Long-Term Care / Q000592:standards*; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D024802:Nurse's Role; D010348:Patient Care Team; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care; D012107:Research Design; D011795:Surveys and Questionnaires