Primary care interventions for dementia caregivers: 2-year outcomes from the REACH study.
OBJECTIVE
This study developed and tested two 24-month primary care interventions to alleviate the psychological distress suffered by the caregivers of those with Alzheimer's disease. The interventions, using targeted educational materials, were patient behavior management only, and patient behavior management plus caregiver stress-coping management. We hypothesized that the addition of the stress-coping component would improve caregiver outcomes.


METHODS
A randomized clinical trial of 167 caregiver-care recipient dyads was run, of whom 76 completed the study without bereavement or placement.


RESULTS
During 24 months, caregivers who received the patient behavior management component only, compared with those who also received the stress-coping component, had significantly worse outcomes for general well-being and a trend toward increased risk of depression (i.e., a score of >16 on the Center for Epidemiological Studies Depression scale). There was a studywide improvement for bother associated with care recipient behaviors (according to the Revised Memory and Behavior Problems Checklist).


CONCLUSIONS
Our data suggest that brief primary care interventions may be effective in reducing caregiver distress and burden in the long-term management of the dementia patient. They further suggest that interventions that focus only on care recipient behavior, without addressing caregiving issues, may not be as adequate for reducing caregiver distress.
Burns
Robert
R
VAMC (11-H), 1030 Jefferson Avenue, Memphis, TN 38104, USA.
Nichols
Linda O
LO
Martindale-Adams
Jennifer
J
Graney
Marshall J
MJ
Lummus
Allan
A
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000628:therapy*; D017028:Caregivers / Q000523:psychology*; D003704:Dementia / Q000628:therapy; D003863:Depression / Q000209:etiology; D005260:Female; D016330:Frail Elderly; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care; D011569:Psychiatric Status Rating Scales; D013315:Stress, Psychological / Q000209:etiology / Q000628:therapy*