Enhancing Caregiver Health: Findings from the Resources for Enhancing Alzheimer's Caregiver Health II Intervention

Authors

  • Amanda F. Elliott PhD, MSN,

    1. From the *Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama; Center for Mental Health and Aging and §Institute for Social Science Research, University of Alabama, Tuscaloosa, Alabama; and School of Social Work and Institute of Gerontology, University of Michigan, Ann Arbor, Michigan.
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  • Louis D. Burgio PhD,

    1. From the *Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama; Center for Mental Health and Aging and §Institute for Social Science Research, University of Alabama, Tuscaloosa, Alabama; and School of Social Work and Institute of Gerontology, University of Michigan, Ann Arbor, Michigan.
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  • Jamie DeCoster PhD

    1. From the *Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama; Center for Mental Health and Aging and §Institute for Social Science Research, University of Alabama, Tuscaloosa, Alabama; and School of Social Work and Institute of Gerontology, University of Michigan, Ann Arbor, Michigan.
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  • Trial Registration: clinicaltrials.gov Identifier: NCT00177489

Address correspondence to Louis D. Burgio, School of Social Work, Institute of Gerontology, University of Michigan, 1080 S. University, 2772 SSWB, Ann Arbor, MI 48109-1106. E-mail: lburgio@umich.edu

Abstract

OBJECTIVES: To examine the relationships between changes from baseline to post-Resources for Enhancing Alzheimer's Caregiver Health (REACH) intervention in caregiver (CG) self-reported health, burden, and bother.

DESIGN: Randomized, multisite clinical trial.

SETTING: CG and care recipient (CR) homes in five U.S. cities.

PARTICIPANTS: Four hundred ninety-five dementia CG and CR dyads (169 Hispanic, 160 white, and 166 African American) receiving intervention and their controls.

INTERVENTION: CGs were assigned to the REACH intervention or a no-treatment control group. Intervention subjects received individual risk profiles and the REACH intervention through nine in-home and three telephone sessions over 6 months. Control subjects received two brief “check-in” telephone calls during this 6-month period.

MEASUREMENTS: The primary outcome was change in CG health status from baseline to after the intervention. Secondary outcomes were CG burden and bother after the intervention.

RESULTS: After the intervention, CGs reported better self-rated health, sleep quality, physical health, and emotional health, which was related to less burden and bother with their caregiving role than for CGs not receiving the intervention. Changes in depression appeared to mediate these relationships. Several racial and ethnic group differences existed in physical and emotional health, as well as in total frustration with caregiving, emotional burden, and CG-rated bother with CR's activities of daily living and instrumental activities of daily living at baseline and at follow-up, although differences between baseline and posttest did not vary according to race.

CONCLUSION: A structured, multicomponent skills training intervention that targeted CG self-care behaviors as one of five target areas, improved self-reported health status, and decreased burden and bother in racially and ethnically diverse CGs of people with dementia.

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