CGs typically provide care without formal support, have significant unmet needs, and limited access to the knowledge and skills needed to care for older adults with complex conditions. To date, most tested CG interventions have: a) focused on one disease state (e.g., dementia); b) delivered interventions outside existing service settings/payment structures; c) required extensive training of interventionists, d) had less reach to a mix of CGs/older persons; e) required retooling of the intervention to enhance its implementation potential in real world settings; and f) not been translated for delivery in community-settings nor sustained. The study potentially overcomes these shortcomings by embedding an evidence-based approach in a service and payment structure (adult day services [ADS]), addressing core needs of diverse CGs of older adults with a mix of conditions, and evaluating outcomes of high relevance to CGs (well-being, depression), older adults (behavioral symptoms), ADS (more days spent in ADS) and society (reduction of nursing home placement).