# "Safety in Dementia": An Online Caregiver Intervention.

> **NIH NIH R01** · UNIVERSITY OF COLORADO DENVER · 2021 · $1,718,886

## Abstract

PROJECT SUMMARY
Cognitive and behavioral changes that come with Alzheimer's Disease and related dementias (ADRD) can
increase the risk of injury or death, including from firearms. Suicide is the primary injury risk from firearms for
people with ADRD, but ADRD-related confusion or paranoia can put others at risk. In the United States, an
estimated 33-60% of people with ADRD have a firearm in the home, and 38% of ADRD caregivers identify
firearms as an issue to address. Yet firearm safety is rarely discussed with ADRD patients or caregivers,
leaving some ADRD caregivers without guidance about when and how to address the sensitive topic. To
address this gap, we developed “Safety in Dementia” (SiD) for informal caregivers to address firearm safety
(R34MH113539-NIA suppl). Based on theory and international standards for development, SiD is an online
decision aid that helps caregivers clarify values and preferences and then commit to implementing their
preferred options. SiD had high acceptability in a small pilot trial, and we hypothesize SiD will increase informal
caregivers' preparation and self-efficacy to make and implement decisions that effectively address firearm
access, thereby reducing injury risk. Overa three-year period,our multi-disciplinary, established study team
will conduct an online randomized trial of SiD with national recruitment and longitudinal follow-up, with
recruitment of informal caregivers of community-dwelling adults with ADRD who have firearm access. Through
this trial and qualitative interviews with stakeholders, we aim to: (1) test the efficacy of SiD on firearm safety
decision quality and behaviors among a national sample of informal caregivers; (2) compare varied methods
(social media/internet versus via relevant organizations) in reaching informal caregivers; and (3) explore
stakeholder longitudinal experiences with SiD and firearm-related decisions, including recommendations for
optimal SiD use. Our underlying hypotheses are that SiD will be significantly associated with higher immediate
decision quality and subsequent action to reduce firearm access, and that caregiver populations will vary by
method of contact (social media/internet versus relevant organizations). The proposed research will meet a
critical need for effective, acceptable tools to help caregivers address firearm access in the context of ADRD,
thereby helping reduce firearm injuries and deaths while respecting and promoting older adult independence,
autonomy, and rights. The aging of the U.S. population underscores the urgency of these issues, and our
proposed work will provide the scientific foundation for future implementation and evaluation of person-
centered tools in real-world settings, including through enhanced understanding of methods for reaching and
engaging caregivers.

## Key facts

- **NIH application ID:** 10398633
- **Project number:** 1R01AG076364-01
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Marian Elizabeth Betz
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $1,718,886
- **Award type:** 1
- **Project period:** 2021-09-17 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10398633

## Citation

> US National Institutes of Health, RePORTER application 10398633, "Safety in Dementia": An Online Caregiver Intervention. (1R01AG076364-01). Retrieved via AI Analytics 2026-06-01 from https://api.ai-analytics.org/grant/nih/10398633. Licensed CC0.

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