Preparedness for Caregiving in Experienced Caregivers of Persons Living with Dementia - Candidate: Dr. Emily Mroz is a postdoctoral fellow in Geriatrics at Yale School of Medicine. Having observed unmet needs of family caregivers of persons living with dementia (PLWD) through her scholarship, training, and lived experiences, her career goal is to develop resources to bolster psychological and behavioral outcomes of family caregivers of PLWD. She plans to do this in an academic research setting, where she can use her expertise to support a new generation of researchers and public health workers. Through her training to date, Dr. Mroz has identified a uniquely underserved group of caregivers, has led multiple small research studies with caregivers of PLWD, and has employed techniques to examine narratives of lived experiences. Additional training will provide her with skills in a) psychometrics and measure validation, b) translating Stage 0 findings to design user-centered interventions, and c) leading larger, clinical trial research in collaboration with engaged community partners. This training, combined with completion of the proposed research, will provide critical support for Dr. Mroz’s junior faculty career transition. Project: Half of US family caregivers (> 11 million adults) support PLWD, and many care for more than one PLWD across their adulthood. Promoting caregiver preparedness improves psychological, behavioral, and quality-of-life outcomes for caregivers and PLWD and reduced PLWD institutionalization. Current caregivers who have also previously provided care for a PLWD (i.e., experienced caregivers) have developed skills that critically prepare them to navigate current care roles. However, many experienced caregivers report low confidence in their caregiving abilities, as well as poor psychological health, undermining their skills-based preparedness and thus their capacity to provide quality care. Existing interventions have focused on caregiving skills, creating a resource gap for the growing subgroup of experienced caregivers for which skills-based training is insufficient. This project will provide Stage 0 evidence for development of an intervention to improve preparedness (primary outcome) and psychological health (secondary outcomes) in experienced caregivers. The central hypothesis is that experienced caregivers’ recall of subjective accounts from their earlier caregiving roles (i.e., caregiving narration) influences their current preparedness, indicating the utility of a narrative-based intervention. To test this hypothesis, Dr. Mroz will address three aims in a samples of experienced caregivers of PLWD: 1) validate a multidimensional, questionnaire-based self-report measure of dementia-caregiver preparedness for identifying intervention end-users, 2) characterize caregiving narration patterns according to salient narrative variables, indicating potent and malleable mechanisms to engage during intervention development, and 3) identify associations between narration variables and preparedness, exploring mediating effects of psychological health. On completion of these aims, Dr. Mroz will have made necessary Stage 0 discoveries to support Stage 1 development of a user-centered, narrative-based intervention, which she will pursue through an R01 proposal.
