A telephone-delivered psychosocial intervention improves dementia caregiver adjustment following nursing home placement.
OBJECTIVE
Study the preliminary efficacy of a telephone intervention, Family Intervention: Telephone Tracking-Nursing Home (FITT-NH) for improving dementia caregivers' adjustment following nursing home placement.


METHODS
Caregivers were enrolled on average 6 weeks following the care-recipients' placement in a nursing home. Baseline assessment included self-report measures of caregiver emotional functioning, staff-caregiver interactions, placement satisfaction, health-related quality of life, and social support. Caregivers were randomly assigned to FITT-NH (n = 24) or a non-contact control condition (n = 22). Caregivers were urn randomized to balance groups on caregiver gender, relationship (spouse versus other), and facility type (dementia special care versus general). The intervention was entirely telephone-delivered in 10 contacts over 3 months. Caregivers randomized to non-contact control were not prevented from using other community-based mental health or support resources, therefore reflecting standard care. Intervention strategies were based on assessment of caregiver emotional adjustment, family functioning, staff-caregiver interactions, health, and social support. Treatment strategies are based on models of stress and coping process and family functioning.


RESULTS
Groups did not differ in caregiver age, education, gender, relationship to the care recipient, length of caregiving, length of dementia diagnosis, or time since placement. Using mixed model analysis of variance, caregivers receiving FITT-NH showed a significant reduction in feelings of guilt related to placement, F(1,43) = 5.00, p < 0.05, and reported more positive perceptions of interactions with staff, F(1,43) = 4.59, p < 0.05, compared to standard care.


CONCLUSIONS
Findings provide preliminary evidence for FITT-NH as a potentially efficacious, brief, targeted psychosocial intervention for improving caregiver emotional adjustment following nursing home placement.
Davis
Jennifer Duncan
JD
Rhode Island Hospital, Alpert Medical School of Brown University, RI, USA. jdavis3@lifespan.org
Tremont
Geoffrey
G
Bishop
Duane S
DS
Fortinsky
Richard H
RH
D000223:Adaptation, Psychological; D000367:Age Factors; D000704:Analysis of Variance; D017028:Caregivers / Q000523:psychology*; D003376:Counseling / Q000379:methods; D003704:Dementia / Q000451:nursing* / Q000523:psychology; D003863:Depression / Q000517:prevention & control; D005190:Family / Q000523:psychology; D006167:Guilt; D006801:Humans; D009735:Nursing Homes; D012737:Sex Factors; D012944:Social Support; D013689:Telephone