A non-pharmacological intervention to manage behavioral and psychological symptoms of dementia and reduce caregiver distress: Design and methods of project ACT³

Figures & data

Figure 1 Project ACT study design with additional arm.

Abbreviations: CG, caregiver; OT, occupational therapist; NU, nurse; PCP, primary care physician.

Table 1 Overview of intervention protocol

Session #	Week #	Type of contact	Interventionist	Overview of session content
Active phase – Step 1 – Assessment of patient, caregiver and environment
1	1	Home visit	OT	Rapport building Provide/review education material Evaluate management techniques, home environment, target behavior and treatment goal
2	2	Home visit	NU	Rapport building Provide information about medical contributors to behaviors Review patient medication Obtain urine and blood samples
3	3–4	Tele-contact	NU	Provide medical test results; physician referral if necessary.
Active phase – Step 2 – Introduction of prevention and management techniques
4	4	Home visit	OT	Reinforce/facilitate physician referral if necessary Use problem solving and brainstorming (1st target behavior) Identify potential strategies Introduce stress management technique
5	5–6	Home visit	OT	Introduce action plan and demonstrate, role play each strategy
6	7–8	Home visit	OT	Review strategies and treatment goal Modify action plan if necessary Work on 2nd target behavior as above if 1st behavior resolved Introduce stress management technique
7	9–10	Tele-contact	OT	Review progress and use of strategies Reinforce use and practice of techniques
8	11–12	Home visit or tele-contact	OT	Review progress Reinforce use of strategies. Work on 3rd target behavior as above.
9	12–13	Home visit or tele-contact	OT	Review progress Target 4th behavior if appropriate as above.
10	14–15	Home visit or tele-contact	OT	Review progress/reinforce strategy use
11	16	Home visit	OT	Review progress and strategy use Review problem solving steps.
Maintenance – Step 3 – Closure and generalization to new problem areas
12	18	Tele-contact	OT	Review progress/reinforce strategy use Generalize strategies to new areas
13	21	Tele-contact	OT	Review progress/reinforce use Validate caregivers skill
14	24	Tele-contact	OT	Review progress and obtain closure.

Abbreviations: OT, occupational therapist; NU, nurse.