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Alzheimer's disease ASF-F ASF-F instrument ASF-S tool Assessment of Strategies behaviors Cafferata caregiver responses caregiver sample caregivers reported caregiving experience caregiving families caregiving role change and individuation chronic illness community health nurses coping diagnosis of PDD dimensions of family environment Family APGAR family caregivers family functioning family growth family member family processes family satisfaction family stability family system family therapy family types family's four process dimensions Friedemann 1989 Gerontologist identified interventions interview Likert Scale lournal maintenance and togetherness maximum possible score measured by items member with PDD minimum possible moderately low needs Nursing research patient patterns of family Personal communication positive correlation primary caregivers quality of relationship recent diagnosis Sangl satisfaction with family significant signifies high signifies low Situational Data Questionnaire Smilkstein social span development specific Strategies in Families stress subject's name summative score system change system maintenance target subjects variables Wayne State University Zarit