Measuring Self-Appraised Changes following Participation in an Intervention for Caregivers of Individuals with Dementia.

This study examined the psychometric properties of the Self-Appraisal of Change Scale, a measure designed to capture domains that are subjectively relevant to caregivers, associated with overall well-being, and amenable to change upon engaging in an intervention. Data from 107 caregivers of veterans with dementia enrolled in a randomized controlled trial of a telephone-delivered caregiver psychoeducation and support group program (the Telehealth Education Program (TEP)) were analyzed. The TEP, which was delivered by master's prepared social workers and a nurse dementia care manager, targeted caregivers' dementia-related knowledge, attitudes, and self-management skills.

The effect of telephone support groups on costs of care for veterans with dementia.

Purpose: Few studies have addressed the effects of caregiver interventions on the costs of care for the care recipient. This study evaluated the effects of a caregiver education and support group delivered via the telephone on care recipient health care utilization and cost.

Design And Methods: The Telehealth Education Program (TEP) is a manualized program of education and support designed for caregivers of veterans with moderate-to-severe dementia.

Effectiveness of advanced illness care teams for nursing home residents with dementia.

This study evaluated the effectiveness of advanced illness care teams (AICTs) for nursing home residents with advanced dementia. The AICTs used a holistic approach that focused on four domains: (1) medical, (2) meaningful activities, (3) psychological, and (4) behavioral. The authors recruited 118 residents in two nursing homes for this study and randomly assigned them to AICT or to usual care (UC).

Human subjects protection in a study of caregivers of community-residing persons with dementia.

This article describes the processes and methods used to protect human subjects during a joint research project undertaken by a state health department and a university-based research team. The use of a statewide registry to obtain a sample of primary caregivers of persons with dementia provided a unique opportunity for the research team to interview a large and representative sample of caregivers. At the same time, it raised complex issues regarding the privacy of the primary caregivers and the confidentiality of the patient data that were drawn from the state-operated mandatory dementia registry.

The effectiveness of a telephone support program for caregivers of frail older adults.

Purpose: The purpose of this study was to evaluate the effectiveness of a telephone support group program on spouses and adult child caregivers of frail older adults.

Design And Methods: The Telephone Support Group (TSG) model is a multicomponent group program offered in 12 weekly, 90-minute group sessions. It includes emotion-focused and problem-focused coping strategies, education, and support.

Effects of a program for coordinated care of advanced illness on patients, surrogates, and healthcare costs: a randomized trial.

Objective: To evaluate the Advanced Illness Coordinated Care Program (AICCP), delivered by allied health personnel to improve care for patients coping with advanced illness and in need of preparation for end-of-life (EOL) care.

Study Design: Clinical trial involving 275 patients and 143 surrogates in 6 settings who were randomly assigned to the AICCP or usual care (UC).

Methods: The AICCP participants met with a care coordinator for assistance with provider communication, care coordination, and support.

Supporting caregivers of frail older adults in an HMO setting.

The long-term effectiveness of a structured health education program (HEP) for spouses and frail older adults was evaluated in a staff model health maintenance organization (HMO). HEP is a multicomponent group program that includes emotion-focused and problem-focused coping strategies, education, and support. For caregivers, HEP was more effective than usual care (UC) in reducing depression, increasing knowledge of community services and how to access them, and changing caregivers' feelings of competence and the way they respond to the caregiving situation.

Increasing the use of formal services by caregivers of people with dementia.

This study evaluated the impact of an information and referral intervention designed to help family caregivers of people with dementia obtain needed health and human services. Caregivers (N = 608) of community-residing people with dementia were surveyed about their need for and use of community services. Of the 608 caregivers, 203 agreed to be referred to a staff member of an Alzheimer's Association chapter to get help finding needed health and community services.

Predictors of health and human services use by persons with dementia and their family caregivers.

The aim of this study was to identify predictors of the use of health and human services by community residing persons with dementia and their family caregivers. Telephone interviews were conducted with a sample of 608 primary caregivers of community residing persons with dementia who were randomly selected from a state-wide dementia registry. The Anderson Behavioral Model of Health Care Use was used as the analytic framework.

Health education groups for caregivers in an HMO.

The short-term effectiveness of a Health Education Group (HEP) intervention program for spouses of frail older adults was compared to the usual care (UC) offered to the spouses of frail older persons in a staff model health maintenance organization. HEP is a multicomponent group program offered in eight weekly, two-hour group sessions, and ten monthly, two-hour follow-up group sessions. It includes emotion-focused and problem-focused coping strategies, education, and support.

Educating nursing assistants to communicate more effectively with nursing home residents with dementia.

This article describes the development and evaluation of a Nursing Assistant Communication Skills Program (NACSP). NACSP was designed to help nursing assistants (NAs) interact more effectively with nursing home residents with moderate and severe dementia. In two skilled-care nursing homes, NAs in four units were randomly assigned by unit to NACSP or to a wait-list control condition (UC) and were assessed at baseline, 3 months, and 6 months.

Use of health and human services by community-residing people with dementia.

This article reports on the use of and need for health and human services by community-residing people with dementia. Telephone interviews were conducted with a sample of 608 caregivers of such individuals who were randomly selected from a dementia registry. Caregivers reported using an average of 3.

Gerontological social work and the UN International Year of Older Persons. Interview by Stanley L. Witkin.

To highlight the United Nations International Year of Older Persons and to increase awareness of social work issues related to older people, the editor of Social Work conducted an interview with four distinguished social workers involved in gerontological social work. The interviewees identified professional needs and various policy and practice issues for social work education and practice.

An evaluation of a family visit education program.

Objectives: This study was designed to examine the impact of the Family Visit Education Program (FVEP) on family members, nursing staff, and nursing home residents with dementia.

Design: The study employed a 2 x 3 single-blind, randomized control group design with two study conditions, FVEP or usual care (UC), and three times of measurement, baseline, 3-months, and 6-months.

Setting: The study was conducted in five skilled-care nursing homes that ranged in size from 120 to 300 beds.

Does geriatric evaluation and management improve the health behavior of older veterans in psychological distress?

A randomized, controlled trial compared prospective 16-month health service use among 160 frail, elderly veterans receiving outpatient geriatric evaluation and management (GEM) or usual primary care (UPC). In this secondary analysis, multivariable regression was used to determine if the psychosocial assessment and support provided by the GEM team moderated the use of medical services by patients in psychological distress. The results indicate that GEM reduced outpatient use among patients who scored higher on a measure of somatization (p less than or equal to .

Outpatient geriatric evaluation and management: is there an investment effect?

The effectiveness and efficiency of outpatient geriatric evaluation and management (GEM) was compared to usual outpatient primary care (UPC). Although GEM had no overall impact on health care utilization or cost of care for the entire study period, significant reductions were found during the sixteen- to twenty-four-month study period, suggesting a possible investment effect. In the first eight months of the study, GEM patients incurred 34.

The effectiveness and efficiency of outpatient geriatric evaluation and management.

Objective: To compare the effectiveness of geriatric evaluation and management (GEM) with usual primary care (UPC).

Design: A 2 x 3 randomized controlled group design.

Setting: A 450-bed Department of Veterans Affairs Medical Center (VAMC) that provides general medical and surgical care to eligible veterans.

Outpatient geriatric evaluation and management. Results of a randomized trial.

The effectiveness and efficiency of outpatient geriatric evaluation and management (GEM) was compared with usual outpatient primary care (UPC). One hundred sixty frail elderly outpatients were assigned randomly to GEM or UPC and assessed at baseline and at 8 months on measures of (1) health and functional status, (2) psychosocial well-being, (3) quality of health and social care, (4) use of inpatient and outpatient services, and (5) cost of care. The results indicate that GEM was significantly more effective than UPC in reducing mortality, increasing patient satisfaction, and improving the quality of health and social care.

The impact of a spouse-caregiver support group on care recipient health care costs.

Frail elderly veterans who received care at a Department of Veterans Affairs medical center and whose spouse-caregivers participated in support groups to which they had been randomly assigned had lower health care costs over a 1-year period than did control participants. The greatest impact was observed for participants perceived by their spouse-caregivers to be in the poorest health. What is important to consider about this result in terms of health care policymaking is that support groups targeted for spouse-caregivers of elderly veterans in poor health produced significant outpatient, inpatient, and total cost savings for the care recipients, and were cost effective.

A problem solving intervention for caregivers of cancer patients.

Effects of a psychosocial intervention program on spouses of cancer patients, and on the cancer patients themselves, will be described. A six session intervention program, which included support, problem-solving and coping skills, was designed to help spouses to cope with the stress of caring for their partner. Forty male and forty female spouses of cancer patients of a regional oncology center were randomly assigned to intervention or usual treatment conditions.

Long-term effectiveness of a group program for caregivers of frail elderly veterans.

Long-term results of an evaluation of a multicomponent support-group program for spouses caring for frail elderly veterans indicated that participants experienced significant reductions in subjective burden. As compared to those of the control group, caregivers' perceptions of their husbands' health improved significantly from pretest to one year, while perceptions of their husbands' functioning on measures of instrumental daily activities showed significantly less deterioration in the period from pretest to posttest.

An evaluation of a group program for spouses of frail elderly veterans.

We examined the effectiveness of a multicomponent group program for spouses of frail aging veterans that included support, education, problem solving, and stress reduction. Compared with caregivers who received no intervention, those in the group program showed significant increases in use of active behavioral coping strategies, knowledge of community resources, perceived independence in the marital relationship, and personal changes in the caregiving relationship. They also experienced significant decreases in subjective burden and the stress and severity of caregiving problems.