title: Can senior volunteers deliver reminiscence and creative activity interventions? Results of the legacy intervention family enactment randomized controlled trial.
abstract: BACKGROUND
  Palliative care patients and their family caregivers may have a foreshortened perspective of the time left to live, or the expectation of the patient's death in the near future. Patients and caregivers may report distress in physical, psychological, or existential/spiritual realms.
  
  
  OBJECTIVE
  To conduct a randomized controlled trial examining the effectiveness of retired senior volunteers (RSVs) in delivering a reminiscence and creative activity intervention aimed at alleviating palliative care patient and caregiver distress.
  
  
  METHODS
  Of the 45 dyads that completed baseline assessments, 28 completed postintervention and 24 completed follow-up assessments. The intervention group received three home visits by RSVs; control group families received three supportive telephone calls by the research staff. Measures included symptom assessment and associated burden, depression, religiousness/spirituality, and meaning in life.
  
  
  RESULTS
  Patients in the intervention group reported a significantly greater reduction in frequency of emotional symptoms (P=0.02) and emotional symptom bother (P=0.04) than the control group, as well as improved spiritual functioning. Family caregivers in the intervention group were more likely than control caregivers to endorse items on the Meaning of Life Scale (P=0.02). Only improvement in intervention patients' emotional symptom bother maintained at follow-up after discontinuing RSV contact (P=0.024).
  
  
  CONCLUSIONS
  Delivery of the intervention by RSVs had a positive impact on palliative care patients' emotional symptoms and burden and caregivers' meaning in life. Meaningful prolonged engagement with palliative care patients and caregivers, possibly through alternative modes of treatment delivery such as continued RSV contact, may be necessary for maintenance of therapeutic effects.
authors.affiliation: Center for Mental Health and Aging, The University of Alabama, Tuscaloosa, Alabama, USA; Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA. Electronic address: rsallen@ua.edu.
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Allen
authors.affiliation: Center for Mental Health and Aging, The University of Alabama, Tuscaloosa, Alabama, USA; Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA.
authors.forename: Grant M
authors.initials: GM
authors.lastname: Harris
authors.affiliation: Center for Mental Health and Aging, The University of Alabama, Tuscaloosa, Alabama, USA; Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA.
authors.forename: Louis D
authors.initials: LD
authors.lastname: Burgio
authors.affiliation: Center for Mental Health and Aging, The University of Alabama, Tuscaloosa, Alabama, USA; Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA.
authors.forename: Casey B
authors.initials: CB
authors.lastname: Azuero
authors.affiliation: Center for Mental Health and Aging, The University of Alabama, Tuscaloosa, Alabama, USA; School of Social Work, The University of Alabama, Tuscaloosa, Alabama, USA.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Miller
authors.affiliation: Center for Mental Health and Aging, The University of Alabama, Tuscaloosa, Alabama, USA; Gwangmyeong Social Welfare Center, Gwangmyeong City, Gyeonggido, Republic of Korea.
authors.forename: Hae Jung
authors.initials: HJ
authors.lastname: Shin
authors.affiliation: Center for Mental Health and Aging, The University of Alabama, Tuscaloosa, Alabama, USA; Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA.
authors.forename: Morgan K
authors.initials: MK
authors.lastname: Eichorst
authors.affiliation: Center for Mental Health and Aging, The University of Alabama, Tuscaloosa, Alabama, USA; School of Social Work, The University of Alabama, Tuscaloosa, Alabama, USA.
authors.forename: Ellen L
authors.initials: EL
authors.lastname: Csikai
authors.affiliation: Center for Advanced Study of Teaching & Learning, University of Virginia, Charlottesville, Virginia, USA.
authors.forename: Jamie
authors.initials: J
authors.lastname: DeCoster
authors.affiliation: Center for Mental Health and Aging, The University of Alabama, Tuscaloosa, Alabama, USA; Capstone College of Nursing, The University of Alabama, Tuscaloosa, Alabama, USA.
authors.forename: Linda L
authors.initials: LL
authors.lastname: Dunn
authors.affiliation: Birmingham-Atlanta Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Medical Center, Birmingham, Alabama, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kvale
authors.affiliation: Center for Mental Health and Aging, The University of Alabama, Tuscaloosa, Alabama, USA; Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Parmelee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000517:prevention & control* / Q000523:psychology; D010166:Palliative Care / Q000523:psychology*; D011615:Psychotherapy, Group / Q000379:methods*; D012944:Social Support; D013315:Stress, Psychological / Q000517:prevention & control* / Q000523:psychology; D016896:Treatment Outcome; D014838:Volunteers
keywords: Community-based RCT; mixed methods; palliative care dyads; volunteers