Project Summary/Abstract In March, 2020, the San Francisco Bay area imposed the first shelter-in-place orders in the U.S. during the Coronavirus Disease 2019 (COVID-19) pandemic. Combined with federally recommended social distancing requirements (i.e. remaining six feet apart, avoiding crowded spaces and group gatherings), shelter-in-place had profound, isolating impacts on people living with Alzheimer’s Disease and Related Dementias and their caregivers (dementia caregiving dyads). Social distancing increased stressors within the home and shuttered Long-Term Services and Supports (LTSS) critical to keeping people with dementia safely in their homes. The overarching goal of the research agenda is to improve quality of life for dementia caregiving dyads through in- home social interventions, including music and other meaningful activities. The objectives of this proposal are twofold: to understand the impact of COVID-19 social distancing requirements upon and creative responses of dementia caregiving dyads; and to engage LTSS professionals in identifying targets for interventions to improve social isolation and well-being for people living with Alzheimer’s Disease and Related Dementias and their caregivers. Using community-engaged research methods, this study engages dementia caregiving dyads in semi-structured interviews, standardized assessments and validated measures of dementia severity and caregiver burden in order to identify both unmet needs and creative responses to social distancing, including music and meaningful activities. Using concurrent thematic analysis, we will identify possible targets for intervention. These will be brought to LTSS professionals for examination within COVID-19 social distancing- related changes in services and service delivery. The knowledge gained from this study will be used to identify targets for the development of in-home multilevel social interventions to reduce social isolation and improve well-being for dementia caregiving dyads, that can be tested through R21 exploratory or R61/R22 phased innovation. Targets will be disseminated to dementia caregiving dyads for use in creative caregiving activities and to LTSS organizations to inform ongoing service innovations.

Project Narrative This administrative supplement studies the extreme impact of COVID-19 social distancing requirements upon people living with dementia and caregivers at two levels of engagement: community (in the home) and organizational (Long-Term Services and Supports). Through participant-engaged methods, it will identify targets for development of interventions, including music and meaningful activities, to reduce social isolation and improve well-being for people living with dementia and their caregivers. These targets will be 1) disseminated to the organizations for use in real-time adaptations of services and service delivery, 2) for development of an in-home, multilevel social intervention for dementia caregiving dyads to reduce social isolation and improve well-being that can be tested through R21 exploratory or R61/R33 phased innovation trials.