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From Beliefs to Behavior: Understanding Mechanisms of Unsafe Medication Use for Behavioral Symptom Management in Dementia Caregiving

Award Number: R03AG105037
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/01/2026
PERIOD OF PERFORMANCE END DATE: 08/31/2028

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From Beliefs to Behavior: Understanding Mechanisms of Unsafe Medication Use for Behavioral Symptom Management in Dementia Caregiving - Project Abstract Over 15 million Americans provide unpaid care to a family member with Alzheimer’s disease or a related dementia (ADRD), and more than two-thirds report performing complex medical and nursing tasks such as medication management. While medications are commonly used to manage behavioral symptoms of dementia (BSDs), little is known about how family caregivers decide when and how to administer them. Emerging data from our ongoing NIH-funded studies reveal that approximately one-third of family caregivers engage in unsafe medication practices, including the use of non-prescribed medications (e.g., over the counter or diverted drugs) and chemical restraints (medications used for caregiver convenience rather than clinical indication). Yet, there is no empirically grounded understanding of how these decisions are made. This R03 will use constructivist grounded theory methodology to generate the first theoretical model of family caregivers’ decision-making around medication administration for BSD management. We will conduct in-depth interviews (N≈35) with family caregivers of persons with ADRD, primarily drawn from participants in our ongoing R01 cohort who have already reported chemical restraint or inappropriate medication use. Guided by iterative data collection and analysis, we will pursue two specific aims: Aim 1: Create a typology characterizing caregivers’ belief systems about medication use for BSD management, comparing prescribed versus non-prescribed practices. Aim 2: Construct an empirically grounded, event-level process model describing caregivers’ situational decision-making regarding medication administration for BSDs. This study will yield a rigorous, data-driven theoretical model clarifying the motivations, contextual pressures, and decision pathways that lead to safe versus unsafe medication practices. Findings will identify actionable mechanisms that can inform caregiver education and clinical guidance to improve medication safety and strengthen non-pharmacologic management of behavioral symptoms in ADRD. By providing foundational knowledge about how caregivers make these high-stakes decisions, this project will advance dementia caregiving science and improve health outcomes for older adults living with ADRD and their families.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $156,000 )
2026	2026	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON	7000 FANNIN ST FL 9	HOUSTON	TX	77030	HARRIS	USA	Aging Research	000	1	8/14/2026	NEW	$156,000
														Subtotal = $156,000

Grand Total All Awards = $156,000

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From Beliefs to Behavior: Understanding Mechanisms of Unsafe Medication Use for Behavioral Symptom Management in Dementia Caregiving

Award Number: R03AG105037

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/01/2026

PERIOD OF PERFORMANCE END DATE: 08/31/2028

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