# The Living Memory Home: Reducing Grief and Improving Relationships between Home-based Patients with ADRD and Their Family Caregivers

> **NIH NIH R21** · WEILL MEDICAL COLL OF CORNELL UNIV · 2024 · $211,682

## Abstract

Project Summary
With over 6 million people in the United States diagnosed with Alzheimer’s disease (AD) in 2021, dementia and
dementia caregiving are now major public health concerns. As dementia advances, it becomes increasingly
difficult for the person with dementia (PwD) to recall past events and for these “care pairs” to enjoy activities and
time together. AD caregivers also experience “ambiguous loss”– when the PwD is still physically present but
mentally absent. Research has shown that such losses can exacerbate caregiver pre-loss grief – a painful
yearning for the PwD as s/he used to be, loneliness, and role confusion. Caregiver pre-loss grief is associated
with depression, poor quality of life, impaired medical decision-making on the PwD’s behalf. Caregivers grieve
not just the PwD’s loss of memory and identity, but also the loss of the relationship that they shared. Our micro-
sociological theory of adaptation to loss suggests that caregivers’ well-being benefits from filling the
psychosocial voids created by significant interpersonal loss. In the context of AD, such voids might be filled by
activities enabling caregivers to share memories with the PwD of their common past, reminding them of happy
times, proud moments, feelings of belonging, and of former roles and relationships, while providing an
opportunity to show affection, appreciation, respect, and “play”. Reminiscence Therapy (RT), which uses cues
to trigger recall of significant life events, may address such psychosocial deprivations. Our Living Memory Home
(LMH) web application is an online bereavement resource that we propose to adapt to address AD caregiver
psychosocial deprivations and, thereby, reduce caregiver pre-loss grief while improving the caregiver-PwD
relationship. Aim 1: We propose to adapt LMH for caregivers of patients with early-stage dementia. The LMH
will be adapted to include RT activities led by caregivers. Input from 30 stakeholders (e.g., current/ bereaved AD
caregivers, PwD, dementia experts) will inform the creation of the LMH-4-Dementia Care Pairs (LMH-4-DCP).
Aim 2: To evaluate LMH-4-DCP feasibility, acceptability, and explore effects on outcomes. Care pairs (n=70)
will be randomized to LMH-4-DCP (n=35) or an attention control condition (LMH excluding reminiscence
activities; n=35). User interaction (e.g., logins, feature usage) and satisfaction will be assessed as will primary
outcomes. Hypothesis: >70% of caregivers will find it acceptable, and its use associated with lower caregiver
pre-loss grief and improved relationship quality (primary outcomes) at 1-month follow-up. Effects on caregiver
psychosocial deprivations (e.g., sense of belonging) (mediators) at 2-weeks will be explored. Impact: LMH-4-
DCP will prove acceptable and associated with reduced caregiver pre-loss grief and improved quality of the care-
pair relationship via targeting the reduction of psychosocial deprivations. Results will be used to seek NIH R01
funding of a larger randomize...

## Key facts

- **NIH application ID:** 10836503
- **Project number:** 5R21AG077144-02
- **Recipient organization:** WEILL MEDICAL COLL OF CORNELL UNIV
- **Principal Investigator:** Francesca Falzarano
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $211,682
- **Award type:** 5
- **Project period:** 2023-05-15 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10836503

## Citation

> US National Institutes of Health, RePORTER application 10836503, The Living Memory Home: Reducing Grief and Improving Relationships between Home-based Patients with ADRD and Their Family Caregivers (5R21AG077144-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10836503. Licensed CC0.

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