Applying CSNAT in HBPC as an Approach to Elder Mistreatment Risk Reduction

Summary

This study will evaluate the feasibility, acceptability, and preliminary effects of the Carer Support Needs Assessment Tool (CSNAT) intervention for family caregivers of older adults receiving home-based primary care. The CSNAT is a structured, caregiver-centered approach designed to identify caregiver support needs and facilitate supportive problem-solving conversations between clinicians and family caregivers. Family caregivers will be assigned to either the CSNAT intervention or a comparison group receiving usual care. Feasibility will be evaluated through participant recruitment, retention, and intervention adherence. Acceptability will be assessed through qualitative interviews with caregivers who participate in the intervention. The study will also examine the preliminary effects of the CSNAT intervention on caregiver outcomes, including caregiver strain, physical well-being, mental well-being, and emotional management. In addition, the study will explore whether improvements in caregiver well-being are associated with a reduced risk of situations that may contribute to harm or neglect of the older adult receiving care. This pilot study will provide information on the practicality of implementing the CSNAT intervention in home-based primary care and will inform the design of future larger-scale studies.

Detailed Description

Family caregivers play a crucial role in the care of older adults with health and daily living needs at home. At the same time, caregiving in this context can be stressful and demanding, and family members can experience strain, poor health, and unmet support needs. These circumstances can further impact the older adults they care for, including creating unwanted risks to their health and safety. Caregivers of patients receiving home-based primary care may be especially likely to experience these challenges because many patients have multiple health conditions and require extensive support. The Carer Support Needs Assessment Tool (CSNAT) is a structured approach where caregivers identify and prioritize areas where they need support by responding to the CSNAT questionnaire (i.e., tool). The tool covers 15 areas related to both caregiving responsibilities and caregivers' own well-being. After completing the questionnaire/tool, caregivers use their responses to the CSNAT to shape discussions about their care needs with a healthcare provider. Together, the caregiver and clinician create a plan to address identified support needs and later review progress and any additional needs. This study will evaluate whether the CSNAT approach can be successfully used with family caregivers of older adults receiving home-based primary care. Eighty caregivers will be randomly assigned to either a CSNAT intervention group or a usual-care control group. Caregivers in the intervention group will complete the CSNAT, participate in a support planning discussion with a nurse practitioner, and take part in a follow-up discussion approximately one month later. Caregivers in the control group will receive usual care, which may include informal conversations with their healthcare provider about caregiving needs. Researchers will assess the practicality and acceptability of the CSNAT approach by examining recruitment, participation, retention, and completion of study activities. The study will also collect information on caregiver strain, caregiver physical and mental well-being, and factors related to risk of elder mistreatment before and after the study period. In addition, interviews with a subset of caregivers in the intervention group will be conducted to better understand their experiences with the CSNAT approach.

Eligibility Criteria

Interventions