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Principal Investigator: JOSEPH E. GAUGLER
Organization: UNIVERSITY OF MINNESOTA
Fiscal Year: 2024
Award: $235,264
Funding agency: National Institute on Aging
Project Abstract
Descriptive research suggests that living alone with cognitive impairment (CI) is associated with many
complex challenges, such as a lack of available and accessible services to facilitate living independently, and
an elevated risk of hospitalization and institutionalization. Additionally, almost half of older adults who live alone
with CI experience difficulty with a basic or instrumental activity of daily living. However, there are few
interventions designed to assist older adults with CI who live alone to help them remain socially engaged in
their existing living environment. We propose to develop a novel home-based intervention, called Home Alone,
for persons living alone with CI (defined here as someone diagnosed with mild cognitive impairment/MCI or as
someone with cognitive impairment without dementia as established on a validated telephone-based
screener). Home Alone is a seven-module home-based program that is adapted from established, evidence-
based mental health and dementia care interventions (behavioral activation, Skills2Care®, and the Tailored
Activities Program). This proposed R21 will examine the feasibility, acceptability, and usefulness of Home
Alone to assist persons living alone with CI or AD/ADRD to successfully navigate the challenges of living
independently with dementia. The Specific Aims are: to 1) develop and adapt Home Alone for pilot testing
among 15 persons with CI who live alone over a 3-month period. A convergent parallel mixed methods design
will be utilized to determine whether various elements of Home Alone (e.g., delivery mode, length, and other
intervention characteristics) require adaptation; and 2) pilot-test a revised version of Home Alone over a 6-
month period among 50 participants living alone with CI. A sequential explanatory mixed methods design will
be utilized to do so. We will determine whether Home Alone is carried out as intended and is deemed feasible,
acceptable, and useful. The development of this theory- and evidence-informed intervention will directly
address the need for further understanding of how to support people living alone with CI. If successful, the
proposed R21 will position Home Alone for a subsequent randomized controlled evaluation and later as a
flexible, much-needed evidence-based resource that is scalable for healthcare systems and dementia support
programs.
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