Inclusion Criteria:  People with ADRD Inclusion Criteria:  aged 55 or older hospitalized have a physician-confirmed diagnosis of ADRD staged GDS 6 or 7; or GDS 5 with additional co-morbidity defined by Charlson Comorbidity Index scored 5 or higher  Caregiver Inclusion Criteria:  the adult (aged 18 or older) legally authorized representative (LAR) for healthcare and have capacity to serve in this role support the person with ADRD ( -can complete interviews in English.  Exclusion Criteria:  Dyads will be excluded if  the LAR is not a family caregiver the patient currently receives palliative care or hospice patient or caregiver would be unduly stressed dyad is not successfully randomized.