Telephone-Delivered Psychosocial Intervention Reduces Burden in Dementia Caregivers.

Warren Alpert Medical School of Brown University.
Dementia 11/2008; 7(4):503-520. DOI: 10.1177/1471301208096632
Source: PubMed

ABSTRACT OBJECTIVES: To examine the preliminary efficacy of Family Intervention: Telephone Tracking-Dementia (FITT-D), a multi-component intervention that is delivered in 23 telephone contacts over 12 months. METHOD: Thirty-three dementia caregivers were randomly assigned to receive either FITT-D (n =16) or standard care (n =17) using urn randomization to balance the groups on dementia severity, caregiver gender, and relationship type (spouse versus other). Inclusion criteria included formal dementia diagnosis, caregiving for at least 6 months, residing with the care recipient, and providing at least 4 hours of direct supervision per day. Master's-level therapists contacted caregivers by telephone over 12 months. Each contact followed a standardized treatment manual, involving assessment and individualized application of interventions to address mood, family functioning, social support, and health. Outcomes included Zarit Burden Interview, Revised Memory and Behavior Problem Checklist, and the Geriatric Depression Scale at baseline and 12 months (end of treatment). RESULTS: Caregivers receiving FITT-D exhibited significantly lower burden scores and less severe reactions to memory and behavior problems than caregivers in the standard care condition. CONCLUSION: Findings provide preliminary evidence for the efficacy of FITT-D, a potentially highly accessible, low-cost intervention for dementia caregivers.

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    ABSTRACT: We conducted a systematic review of studies employing telehealth interventions which focused on family caregivers' outcomes. The Embase, CINHAL, Cochrane and PubMed databases were searched using combinations of keywords including "telehealth," "telemedicine," "telecare," "telemonitoring," "caregiver" and "family." The initial search produced 4205 articles, of which 65 articles met the inclusion criteria. The articles included 52 experimental studies, 11 evaluation studies, one case study and one secondary analysis. Thirty-three articles focused on family caregivers of adult and older patients, while 32 articles focused on parental caregivers of paediatric patients. The technologies included video, web-based, telephone-based and telemetry/remote monitoring. Six main categories of interventions were delivered via technology: education, consultation (including decision support), psychosocial/cognitive behavioural therapy (including problem solving training), social support, data collection and monitoring, and clinical care delivery. More than 95% of the studies reported significant improvements in the caregivers' outcomes and that caregivers were satisfied and comfortable with telehealth. The review showed that telehealth can positively affect chronic disease care, home and hospice care. © The Author(s) 2014 Reprints and permissions:
    Journal of Telemedicine and Telecare 12/2014; 21(1). DOI:10.1177/1357633X14562734 · 1.74 Impact Factor
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    ABSTRACT: Dementia caregiving is often associated with increase in depressive symptoms and strained relationships. This study tested whether telephone-delivered psychoeducation combined with an enhanced behavioral activation (BA) module had a better effect on the well-being of Alzheimer's caregivers than psychoeducation alone. The focus is on enhancing the competent use of coping skills via BA. The program is delivered by telephone to increase accessibility and sustainability for caregivers. Senior citizens are trained as paraprofessionals to deliver the BA module to increase the potential for sustainability of the program. The study compared two telephone interventions using a 4-month longitudinal randomized controlled trial. For the first 4 weeks, all participants received the same psychoeducation program via telephone. Then for the following 4 months, eight biweekly telephone follow-up calls were carried out. For these eight follow-up calls, participants were randomized into either one of the two following groups with different conditions. For the psychoeducation with BA (PsyED-BA) group, participants received eight biweekly sessions of BA practice focused on pleasant event scheduling and improving communications. For the psychoeducation only (PsyED only) group, participants received eight biweekly sessions of general discussion of psychoeducation and related information. A total of 62 family caregivers of persons living with dementia were recruited and 59 (29 in the PsyED-BA group and 30 in the PsyED only group) completed the whole study. As compared to the group with psychoeducation and discussion, the group with enhanced BA had decreased levels of depressive symptoms. The study had a low attrition rate. Results suggested that competence-based training could be effectively administered through the telephone with the help of senior citizens trained and engaged as paraprofessionals. Results contribute to the present literature by offering some framework for developing effective, accessible, sustainable, and less costly interventions.
    Clinical Interventions in Aging 01/2015; 10:611-9. DOI:10.2147/CIA.S72348 · 1.82 Impact Factor


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