The Savvy Caregiver program: The demonstrated effectiveness of a transportable dementia caregiver psychoeducation program

Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia 30322, USA.
Journal of Gerontological Nursing (Impact Factor: 1.02). 04/2007; 33(3):30-6.
Source: PubMed


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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Available from: Kenneth Hepburn, Sep 08, 2014
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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 [20] and family conflicts [21]. Social dysfunction, such as avoiding social situations [22] and social integration of the caregiver in the community [23], were measured in one study each. "
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    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.
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    • "It is beneficial when carers are able to enter the frame of reference of the individual and understand the world from their point of view, which can only be done if the carer has an understanding of dementia (Downs and Bowers, 2008). Psycho-education is the transmission of specific, relevant information tailored to the needs of the person and his/her carer, to improve insight and enable more informed decisionmaking at all stages of illness (Hepburn et al, 2007). The benefits of applying psycho-education are outlined in Box 1. "
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    • "Quality improvement findings indicate that the program significantly reduced a number of key indicators of caregiving distress in a sample of stressed and burdened caregivers of persons with dementia. Furthermore, the medium effect sizes are consistent with those obtained in traditional Savvy (Hepburn et al., 2007;Lewis, Hepburn, Narayan, & Kirk, 2005) as well as those reported by other face-toface programs (Coon et al., 2003;Gallagher-Thompson et al., 2003;Glueckauf et al., 2012;Llanque et al., 2015;Pinquart & Sörensen, 2006). Caregiver self-assessments were very positive upon completion of VA Tele-Savvy: the caregivers reported feeling more confident and skilled. "
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