FAMILIES: an effective healthcare intervention for caregivers of community dwelling people living with dementia

Abstract

Objectives: Caregiving for a person with dementia (PWD) carries increased risk of poorer health and quality of life. Non-pharmacological interventions improve outcomes for caregivers of PWDs. We evaluated the efficacy of a modified New York University Caregiver Intervention (NYUCI), named FAMILIES, delivered to spousal and non-spousal caregivers of PWDs from diverse etiologies in a reduced number of sessions.

Methods: Participants were 122 primary caregivers for community dwelling PWDs in Virginia. The intervention included two individual and four family/group counseling sessions that integrated dementia education, coping skills and behavioral management training, emotional support, and identification of family and community resources. Assessment of depression, caregiver well-being and burden, and caregiver reactions to the behavioral symptoms of dementia (BSD) were completed at baseline, the sixth session, and 6-month follow-up.

Results: Symptoms of depression (p < .001) and caregiver burden (p = .001) and caregivers’ capacity to effectively manage their reactions to BSD (p = .003), significantly improved at the sixth session. Benefits were maintained at 6-month follow-up. Being married and female predicted improvement in caregiver burden; being male and living in a rural area predicted reduced risk of depression. Caregivers reported that the intervention was helpful and had a positive impact on the PWD.

Conclusions: Modifications to the NYUCI did not diminish its efficacy. Caregivers in FAMILIES experienced improvements in depressive symptoms, caregiver burden, and their ability to effectively manage their reactions to BSD. Systemic support for implementing FAMILIES could have a broad impact on caregivers, PWDs, and the healthcare system.

Keywords:

• Psychological and behavioural symptoms
• stress/burden
• caregiving and interventions
• evaluation/effectiveness
• dementia and cognitive disorders

Acknowledgments

We would like to thank the U.S. Department of Health and Human Services, Administration for Community Living, for funding this intervention. We would like to acknowledge Devin M. Bowers, MPH, former Dementia Services Coordinator with the Virginia Department for Aging and Rehabilitative Services, for her leadership in securing funding for this grant. We would also like to thank the Alzheimer’s Association for their support and services. We would like recognize that the success of caregiver interventions, such as FAMILIES, depends in large part on the clinicians providing the direct clinical services. To this end, we thank the clinicians who delivered the intervention with caregivers and their families. Lastly, we would like to extend our utmost gratitude to the many caregivers and their families for participating in this intervention.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by a cooperative agreement (No. 90DS2010-01-00) from the Administration on Aging (AoA), Administration for Community Living (ACL), U.S. Department of Health and Human Services (DHHS). Grantees carrying out projects under government sponsorship are encouraged to express freely their findings and conclusions. Therefore, points of view or opinions do not necessarily represent official AoA, ACL, or DHHS policy. This publication has been created or produced by the University of Virginia Memory and Aging Care Clinic with financial assistance, in whole or in part, from the Virginia Department of Aging and Rehabilitative Services.