title: Family care as collaboration: effectiveness of a multicomponent support program for elderly couples with dementia. Randomized controlled intervention study.
abstract: OBJECTIVE
  To determine whether community care of people with dementia can be prolonged with a 2-year multicomponent intervention program and to analyze effects of the intervention on total usage and expenses of social and healthcare services.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Community-dwelling couples with one spouse caring for the other spouse with dementia.
  
  
  METHODS
  Couples with dementia (N=125) were allocated at random to the intervention (n=63) or control group (n=62).
  
  
  METHODS
  Intervention couples were provided with a multicomponent intervention program with a family care coordinator, a geriatrician, support groups for caregivers, and individualized services.
  
  
  METHODS
  Time from enrollment to institutionalization of spouses with dementia and use of services and service expenditure of couples.
  
  
  RESULTS
  At 1.6 years, a larger proportion in the control group than in the intervention group was in long-term institutional care (25.8% vs 11.1%, P=.03). At 2 years, the difference was no longer statistically significant. The 2-year adjusted hazard ratio for the intervention group was 0.53 (95% confidence interval (CI)=0.23-1.19, P=.12). Intervention led to reduction in use of community services and expenditures. The difference for the benefit of intervention group was -7,985 Euro (95% CI=-16,081 to -1,499, P=.03). When the intervention costs were included, the differences between the groups were not significant.
  
  
  CONCLUSIONS
  Although the intervention did not result in a significant difference in the need for institutional care after 2 years, individualizing services in collaboration with families may lead to reduction in use of and expenditures on municipal services.
authors.affiliation: Central Union for the Welfare of the Aged, Helsinki, Finland. ulla.eloniemi-sulkava@vtkl.fi
authors.forename: Ulla
authors.initials: U
authors.lastname: Eloniemi-Sulkava
authors.forename: Marja
authors.initials: M
authors.lastname: Saarenheimo
authors.forename: Marja-Liisa
authors.initials: ML
authors.lastname: Laakkonen
authors.forename: Minna
authors.initials: M
authors.lastname: Pietilä
authors.forename: Niina
authors.initials: N
authors.lastname: Savikko
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.forename: Reijo S
authors.initials: RS
authors.lastname: Tilvis
authors.forename: Kaisu H
authors.initials: KH
authors.lastname: Pitkälä
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000628:therapy*; D005190:Family; D005260:Female; D006701:Home Nursing; D006801:Humans; D008297:Male; D008875:Middle Aged; D012944:Social Support