title: Teaching Caregivers of Persons with Dementia to Address Pain.
abstract: OBJECTIVE
  To compare the efficacy of Preventing Aggression in Veterans with Dementia (PAVeD) with that of usual care in decreasing incidence of aggression (primary outcome) and pain and improving depression, pleasant events, caregiver burden, and patient-caregiver relationship quality (secondary outcomes).
  
  
  METHODS
  Randomized controlled trial with assessments at baseline and 3, 6, 9, and 12 months SETTING: Houston, TX.
  
  
  METHODS
  A total of 203 community-dwelling veterans with pain and dementia and their caregivers.
  
  
  METHODS
  PAVeD, 6 to 8 weekly sessions of 45-minute home visits with masters-level clinicians providing instruction to caregivers on recognizing pain, enhancing communication, and making daily activities pleasant and enjoyable, and at least two elective sessions.
  
  
  METHODS
  Cohen-Mansfield Agitation Inventory (primary outcome), Philadelphia Geriatric Pain Intensity Scale, Geriatric Depression Scale, Pleasant Events Schedule-AD, Burden Interview, Mutuality Scale (secondary outcomes), Client Satisfaction Questionnaire.
  
  
  RESULTS
  There were no significant differences in aggression incidence between intervention and control groups, although the PAVeD group had significantly better mutuality than controls.
  
  
  CONCLUSIONS
  PAVeD may need to address a broader range and more in-depth coverage of aggression risk factors with person-centered tailoring to target certain types of distress. Interventions to prevent aggression may also need to address medical providers in addition to caregivers.
authors.affiliation: Houston VA HSR&D Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX; Baylor College of Medicine, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center, United States. Electronic address: mkunik@bcm.edu.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Kunik
authors.affiliation: The University of Alabama and Tuscaloosa Veterans Affairs Medical Center, Tuscaloosa, AL.
authors.forename: A Lynn
authors.initials: AL
authors.lastname: Snow
authors.affiliation: Houston VA HSR&D Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX; Baylor College of Medicine, Houston, TX.
authors.forename: Nancy
authors.initials: N
authors.lastname: Wilson
authors.affiliation: Houston VA HSR&D Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX; Baylor College of Medicine, Houston, TX.
authors.forename: Amber B
authors.initials: AB
authors.lastname: Amspoker
authors.affiliation: Houston VA HSR&D Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX; Baylor College of Medicine, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center, United States.
authors.forename: Shubhada
authors.initials: S
authors.lastname: Sansgiry
authors.affiliation: Department of Management, Policy and Community Health, The University of Texas School of Public Health-Houston, Houston, TX.
authors.forename: Robert O
authors.initials: RO
authors.lastname: Morgan
authors.affiliation: Houston VA HSR&D Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX; Baylor College of Medicine, Houston, TX.
authors.forename: Jun
authors.initials: J
authors.lastname: Ying
authors.affiliation: Texas Woman's University, Houston, TX.
authors.forename: Gayle
authors.initials: G
authors.lastname: Hersch
authors.affiliation: Houston VA HSR&D Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX; Baylor College of Medicine, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center, United States.
authors.forename: Melinda A
authors.initials: MA
authors.lastname: Stanley
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression / Q000523:psychology*; D017028:Caregivers / Q000193:education*; D016208:Databases, Factual; D003704:Dementia / Q000150:complications*; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D057187:Independent Living; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology; D014728:Veterans / Q000523:psychology*
keywords: aggression; caregiving; dementia; pain; veterans