# Development of a Reliable and Accessible Caregiving Language Model (CaLM)

arXiv: https://arxiv.org/abs/2403.06857 · HTML: https://mlsanity.com/paper/2403.06857/

## Key facts

- Cited by 5 papers in the map (data through 14 Oct 2026).
- Builds on 20 of its 58 references that are in the map.
- First posted on arXiv 11 Mar 2024.

## Builds on (most cited first, 20 of 20)

- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [LLaMA: Open and Efficient Foundation Language Models](https://mlsanity.com/paper/2302.13971/) (2023)
- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [Sentence-BERT: Sentence Embeddings using Siamese BERT-Networks](https://mlsanity.com/paper/1908.10084/) (2019)
- [On the Opportunities and Risks of Foundation Models](https://mlsanity.com/paper/2108.07258/) (2021)
- [Dense Passage Retrieval for Open-Domain Question Answering](https://mlsanity.com/paper/2004.04906/) (2020)
- [Lost in the Middle: How Language Models Use Long Contexts](https://mlsanity.com/paper/2307.03172/) (2023)
- [QLoRA: Efficient Finetuning of Quantized LLMs](https://mlsanity.com/paper/2305.14314/) (2023)
- [Improving language models by retrieving from trillions of tokens](https://mlsanity.com/paper/2112.04426/) (2021)
- [Atlas: Few-shot Learning with Retrieval Augmented Language Models](https://mlsanity.com/paper/2208.03299/) (2022)
- [The RefinedWeb Dataset for Falcon LLM: Outperforming Curated Corpora with Web Data, and Web Data Only](https://mlsanity.com/paper/2306.01116/) (2023)
- [Deduplicating Training Data Makes Language Models Better](https://mlsanity.com/paper/2107.06499/) (2021)
- [An Empirical Study of Catastrophic Forgetting in Large Language Models During Continual Fine-tuning](https://mlsanity.com/paper/2308.08747/) (2023)
- [The Curse of Recursion: Training on Generated Data Makes Models Forget](https://mlsanity.com/paper/2305.17493/) (2023)
- [LLM-Adapters: An Adapter Family for Parameter-Efficient Fine-Tuning of Large Language Models](https://mlsanity.com/paper/2304.01933/) (2023)
- [Deduplicating Training Data Mitigates Privacy Risks in Language Models](https://mlsanity.com/paper/2202.06539/) (2022)
- [LLM Lies: Hallucinations are not Bugs, but Features as Adversarial Examples](https://mlsanity.com/paper/2310.01469/) (2023)
- [Almanac: Retrieval-Augmented Language Models for Clinical Medicine](https://mlsanity.com/paper/2303.01229/) (2023)
- [Transformer models: an introduction and catalog](https://mlsanity.com/paper/2302.07730/) (2023)
- [Integrating UMLS Knowledge into Large Language Models for Medical Question Answering](https://mlsanity.com/paper/2310.02778/) (2023)

## Built on by (most cited first, 5 of 5)

- [Reflections and New Directions for Human-Centered Large Language Models](https://mlsanity.com/paper/2605.06901/) (2026)
- [Large Language Model-Powered Conversational Agent Delivering Problem-Solving Therapy (PST) for Family Caregivers: Enhancing Empathy and Therapeutic Alliance Using In-Context Learning](https://mlsanity.com/paper/2506.11376/) (2025)
- [Empathy by Design: Aligning Large Language Models for Healthcare Dialogue](https://mlsanity.com/paper/2512.06097/) (2025)
- [InvisibleBench: A Deployment Gate for Caregiving Relationship AI](https://mlsanity.com/paper/2511.20733/) (2025)
- [DementiaCare-Bench: A Modality-Validated Video Benchmark](https://mlsanity.com/paper/2609.12929/) (2026)

## Abstract (arXiv)

Unlike professional caregivers, family caregivers often assume this role without formal preparation or training. Because of this, there is an urgent need to enhance the capacity of family caregivers to provide quality care. Large language models can potentially be used as a foundation technology for supporting caregivers as educational tools or as adjunct to care. This study aimed to develop a reliable Caregiving Language Model (CaLM) by using FMs and a caregiving knowledge base, develop an accessible CaLM using a small FM that requires fewer computing resources, and evaluate the performance of the model compared to a large FM. We developed CaLM using the Retrieval Augmented Generation (RAG) framework combined with FM fine-tuning for improving the quality of FM answers by grounding the model on a caregiving knowledge base. We used two small FMs as candidates for the FM of CaLM (LLaMA-2 and Falcon with 7B parameters) and larger FM GPT-3.5 as a benchmark. We developed the caregiving knowledge base by gathering various types of documents from the Internet. In this study, we focused on caregivers of individuals with Alzheimer's Disease Related Dementias. We evaluated the models' performance using the benchmark metrics commonly used in evaluating language models and their reliability to provide accurate references with the answers. The RAG framework improved the performance of all FMs used in this study across all measures. As expected, the large FM performed better than small FMs across all metrics. The most interesting result is that small fine-tuned FMs with RAG performed significantly better than GPT 3.5 across all metrics. The fine-tuned LLaMA-2 small FM performed better than GPT 3.5 (even with RAG) in returning references with the answers. The study shows that reliable and accessible CaLM can be developed by using small FMs with a knowledge base specific to the caregiving domain.