The New Hampshire Family Caregiver Support Program (NHECSP)

Primary Practice

Multi-faceted family support program based on combination of evidence-based programs


The NHFCSP is a nationally recognized family caregiver support program that was informed by the work of Dr. Mary Mittelman and colleagues (2006), who developed an evidenced-based caregiver support program at New York University (NYU).  Their work provided evidence that a combination of individual counseling and additional support interventions improved overall caregiver well-being, delaying the necessity for nursing home placement.  Effective interventions developed at NYU were instrumental in informing the design of the NHFCSP.

The NHFCSP is a family-directed program that is managed at the local level through the Service Link Resource Center (SLRC) network. The SLRC network is NH’s single entry point for all NH residents; regardless of age, disability or income levels, to receive information and assistance in navigating the spectrum of long-term services and supports. The NHFCSP incorporates a number of components and is available to anyone caring for a person over the age of 60. Program components include information and referral; a comprehensive caregiver assessment; one-on-one counseling and support; ad-hoc telephone assistance; funding for respite care; flexible funding for caregiving related goods and services; caregiver support programs and training; and an evidence-based caregiver education program (Powerful Tools for Caregivers). Participants in the program may choose to receive any or all of the above services and supports, although financial support for respite care and caregiver supports are limited to those who meet program eligibility criteria.

Upon entry into the program a caregiver specialist meets with the caregiver and conducts an assessment of both caregiver and care recipient needs. From this assessment, a plan of support is developed with the family caregiver, utilizing a person- centered approach. Those individuals who are eligible for respite and/or supplemental services have the opportunity to develop a budget for services with assistance from the Caregiver Specialist.  The Caregiver Specialist’s role is more of a coach or guide in this process, but the family caregiver ultimately chooses what services they want and how they want to utilize their allotted funds. An Agency with Choice fiscal agent model is utilized to assist caregivers to manage their budget, pay invoices, and manage payroll responsibilities.

Target Population(s)

Caregivers of older adults, and caregivers of individuals with dementia or Alzheimer’s


The program is located in every community in NH, local and state level. The NH Family Caregiver Support Program (NHFCSP) is funded under the Older Americans Act, Title IIIE and administered by the New Hampshire Bureau of Elderly and Adult Services (BEAS)


To improve, or at minimum maintain, the family caregiver’s ability to continue to provide care without sacrificing their health and well-being

Evidence of Outcomes

Emerging Practice/Model
This program is a combination of various programs into an overall program delivered at the state level. The University of NH conducted research to assess the effectiveness of the program. Assessments of both the caregiver and care receiver were conducted upon entry into the program and again at six months. Researchers found that levels of caregiver burden, depressive symptoms, and mental and physical well-being remained stable even as care recipient functional levels, as measured by activities of daily living (ADLs), showed significant declines. These findings provide promising evidence to support the effectiveness of providing even a short period of organized caregivers supports.

Additional Information



Vidyalakshmi, S., Fox, S.W., Phillips, K.G. (2014). Transitions in caregiving: Evaluating a person-centered approach to supporting family caregivers in the community. Journal of Gerontological Social Work, 57(6-7), 750-765.