This article is about the trial of a transportable psychoeducation program for family caregivers of older adults with Alzheimer's disease and other dementias that was based on a program developed and previously tested in an academic setting. Family caregivers were recruited by agencies in three states and invited to participate in a randomized trial of this six-session program. Questionnaires were administered prior to randomization and again 5 to 6 months later to assess program effect. A total of 52 caregivers completed both questionnaires (22 were in the wait-list control group). Experimental participants' scores on measures of mastery and distress were significantly better than control participants' scores at follow-up (Time 2 Results for this transported program showed benefits to caregivers com parable to those in the previous trials. The program demonstrated that it could be offered in a variety of settings and that it had benefit for caregivers.
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"Another aspect of psychological function, family role function, was examined in five studies. Examples include the caregiver's perception of loss of self and of the relationship with the care recipient due to the disease  and family conflicts . Social dysfunction, such as avoiding social situations  and social integration of the caregiver in the community , were measured in one study each. "
[Show abstract][Hide abstract] ABSTRACT: Caregiver interventions may help improve the quality of informal care. Yet the lack of a systematic framework specifying the targets and outcomes of caregiver interventions hampers our ability to understand what has been studied, to evaluate existing programs, and to inform the design of future programs. Our goal was to develop an organizing framework detailing the components of the caregiving activities and the caregiver and care recipient outcomes that should be affected by an intervention. In so doing, we characterize what has been measured in the published literature to date and what should be measured in future studies to enable comparisons across interventions and across time.
Our data set comprises 121 reports of caregiver interventions conducted in the United States and published between 2000 and 2009. We extracted information on variables that have been examined as primary and secondary outcomes. These variables were grouped into categories, which then informed the organizing framework. We calculated the frequency with which the interventions examined each framework component to identify areas about which we have the most knowledge and under-studied areas that deserve attention in future research.
The framework stipulates that caregiver interventions seek to change caregiving activities, which in turn affect caregiver and care recipient outcomes. The most frequently assessed variables have been caregiver psychological outcomes (especially depression and burden) and care recipient physical and health care use outcomes.
Based on the organizing framework, we make three key recommendations to guide interventions and inform research and policy. First, all intervention studies should assess quality and/or quantity of caregiving activities to help understand to what extent and how well the intervention worked. Second, intervention studies should assess a broad range of caregiver and care recipient outcomes, including considering whether expanding to economic status and health care use of the caregiver can be accommodated, to ease subsequent economic evaluations of caregiving. Third, intervention studies should measure a common set of outcomes to facilitate cross-time and cross-study comparisons of effectiveness.
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to translate the evidence-based Resources for Enhancing Alzheimer's Caregiver Health (REACH) II intervention for use in 4 Area Agencies on Aging (AAAs). A secondary aim was to examine possible moderators of treatment outcome.
We used a quasi-experimental pre-post treatment design with no control group. A partnership was formed between the Alabama Department of Senior Services and the University of Alabama. The partnership trimmed the REACH II intervention used in the clinical trial for feasible use in a social service agency. The condensed REACH intervention, termed REACH OUT, was delivered to 272 dementia caregivers during 4 home visits and 3 phone calls for a period of 4 months. The assessment examined pre-post treatment effects on a number of outcomes, including care recipient risk, mood, memory, and behavior problems; caregiver stress and emotional well-being; caregiver health; and program satisfaction. All aspects of the program except for training, periodic consultation, and data analysis were controlled by the AAA staff.
Analyses were conducted on the 236 dyads that completed at least 3 of the 4 planned sessions. Significant positive pre-post effects were found on caregiver subjective burden, social support, caregiver frustration, depression, caregiver health, care recipient behavior problems and mood, and 2 of 4 care recipient risk behaviors. Site of intervention and certain participant characteristics (e.g., caregiver relationship) moderated several pre-post differences. A caregiver survey and interventionist focus group reported high acceptability of the program
This project suggests that the REACH II intervention can be modified for feasible and effective use in AAAs. The next step is to integrate the intervention into usual service delivery to achieve sustainability.
The Gerontologist 03/2009; 49(1):103-16. DOI:10.1093/geront/gnp012 · 3.21 Impact Factor