Using technology to provide individualized respite for caregivers in rural communities.

Introduction: Caregiving for older adults-by family and friends-is an essential component of the U.S. health and long-term care systems. Though often rewarding, caregiving is associated with higher rates of poor health. Respite is valued by caregivers and associated with positive outcomes; however, access is limited. Exhale-The Family Caregiver Initiative, known as Exhale, was established to support the development of respite programming consistent with local priorities. Methods: Exhale respite programs participate in an evaluation, which includes caregiver assessments. This paper focuses on results from one Exhale-supported program, Caregiver Tech Solutions (CTS). CTS provides digital technology and coaching to caregivers in rural New York, offering an alternative to place-based respite and allowing caregivers to achieve short breaks from tasks or worries within their homes, on their terms. Results: Evaluation findings show that most CTS caregivers were children of the care recipients and cared for someone age 75+. Most had not participated in a respite program previously. Significant increases in respite were reported at follow-up: 25% of participants reported respite "every day or almost every day" at follow-up, compared to 12% at baseline. There were also significant declines in caregiver burden. Conclusions: CTS is not unique in use of electronic resources; however, literature remains sparse. Furthermore, pairing technology with coaching is uncommon. Finally, the outcomes demonstrated by CTS counter perceptions that technology-based solutions are not appropriate for older adults or in rural communities. Rather, flexible programs such as CTS represent a promising approach to addressing the needs of rural caregivers.