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1 Center for Applied Research on Aging and Health (CARAH)
2 Biostatistics Section, Division of Clinical Pharmacology, Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania.
Address correspondence to Dr. Laura N. Gitlin,130 S. 9th Street, Suite 513, Philadelphia, PA 19107. E-mail: laura.gitlin{at}jefferson.edu
Background. Few studies evaluate whether short-term intervention effects are maintained over time for families caring for persons with dementia. This article examines whether treatment effects found at 6 months following active treatment were sustained at 12 months for 127 family caregivers who participated in an occupational therapy intervention tested as part of the National Institutes of Health Resources for Enhancing Alzheimer's Caregiver Health (REACH) initiative.
Methods. A randomized two-group design was implemented with three assessment points: baseline, 6 months, and 12 months. Caregivers were randomly assigned to a usual care control group or intervention that consisted of six occupational therapy sessions to help families modify the environment to support daily function of the person with dementia and reduce caregiver burden. Following 6-month active treatment, a maintenance phase consisted of one home and three brief telephone sessions to reinforce strategy use and obtain closure. Noninferiority statistical analysis was used to evaluate whether intervention caregivers maintained treatment benefits from 6 to 12 months in comparison to controls.
Results. For the sample of 127 at 6 months, caregivers in intervention reported improved skills (p =.028), less need for help providing assistance (p =.043), and fewer behavioral occurrences (p =.019) compared to caregivers in control. At 12 months, caregiver affect improved (p =.033), and there was a trend for maintenance of skills and reduced behavioral occurrences, but not for other outcome measures.
Conclusion. An in-home skills training program helps sustain caregiver affect for those enrolled for more than 1 year. More frequent professional contact and ongoing skills training may be necessary to maintain other clinically important outcomes such as reduced upset with behaviors.
This article has been cited by other articles:
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  M. Devor and M. Renvall An Educational Intervention to Support Caregivers of Elders With Dementia American Journal of Alzheimer's Disease and Other Dementias, June 1, 2008; 23(3): 233 - 241. [Abstract] [PDF]
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 M. J L Graff, E. M M Adang, M. J M Vernooij-Dassen, J. Dekker, L Jonsson, M. Thijssen, W. H L Hoefnagels, and M. G M O. Rikkert Community occupational therapy for older patients with dementia and their care givers: cost effectiveness study BMJ, January 19, 2008; 336(7636): 134 - 138. [Abstract] [Full Text] [PDF]
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 M. J. L. Graff, M. J. M. Vernooij-Dassen, M. Thijssen, J. Dekker, W. H. L. Hoefnagels, and M. G. M. OldeRikkert Effects of Community Occupational Therapy on Quality of Life, Mood, and Health Status in Dementia Patients and Their Caregivers: A Randomized Controlled Trial J. Gerontol. A Biol. Sci. Med. Sci., September 1, 2007; 62(9): 1002 - 1009. [Abstract] [Full Text] [PDF]
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