CAN TRAINED IMPROVISATION TECHNIQUES HELP REDUCE CAREGIVER BURDEN AND DEPRESSION?

Abstract

Caregiving for a loved one with dementia is associated with increased stress, depression, and health problems (e.g., Fonareva & Oken, 2014). Recognizing the need for interventions to support caregivers through this challenging role, a novel approach was developed to teach communication and build community through improvisational skills. In partnership with Second City and Caring Across Generations the Improv for Care course was implemented at the Cleveland Clinic Lou Ruvo Center for Brain Health. The present study aimed to measure preliminary outcomes for this program. Caregivers for individuals with neurodegenerative disorders were recruited to participate in the Improv for Care program through flyers and provider referrals. A total of 9 caregivers completed measures both before and after the course. Depression symptoms, caregiver burden, and patient neuropsychiatric symptoms were captured with the Beck Depression Inventory-II (Beck, Steer, & Brown, 1996), Zarit Burden Interview (Zarit, Todd, & Zarit, 1986), and the Neuropsychiatric Inventory Questionnaire (Kaufer et al., 2000). A qualitative measure examined caregivers’ perception of their level of support, confidence, and other qualities related to caregiving. Caregivers were predominantly female (77.8%), caring for a spouse (66.7%), well educated (66.6% had completed college or an advanced degree), and ranged in age from 45 to 78 (M = 65.5). Most were full-time caregivers (77.8%). Caregiver ratings of loneliness significantly decreased after course completion (Z = -2.23, p = 0.026) as did ratings of severity (Z = -2.12, p = 0.034) and distress (Z = -2.00, p = 0.046) associated with their loved ones’ neuropsychiatric symptoms. Decrease in caregiver burden was approaching significance (Z = -1.84, p = 0.066). Outcomes from this pilot project revealed a significant effect in reducing loneliness as well as severity and distress associated with neuropsychiatric symptoms. Contributing to reduced loneliness may have implications for caregiver health and wellbeing given the negative health risks associated with isolation (Perissinotto, Cenzer, & Covinsky, 2012). Neuropsychiatric symptoms are predictive of institutionalization (Afram et al., 2014) and thus a reduction in the severity and distress may delay nursing facility placement. Improv for Care represents a promising intervention for dementia caregivers.