EFFECT OF A TELEPHONE-BASED DEMENTIA CAREGIVER INTERVENTION ON USE OF COMMUNITY SUPPORT SERVICES AND HEALTH CARE RESOURCES

Abstract

Project Description: Dementia caregivers tend to underutilize community support services (e.g., support groups, respite care) and may overuse healthcare resources (e.g., physician and hospital visits). We developed a telephone-delivered intervention, Family Intervention: Telephone Tracking - Caregiver (FITT-C), which has been shown to reduce caregivers' depressive symptoms and reactions to care recipients' behavioral problems. This study examined the effects of FITT-C on community support and healthcare use. Participants were 250 (M age = 62.72, SD = 12.99; 78% female; 95% Caucasian) distressed informal dementia caregivers who were randomly assigned to receive the FITT-C or Telephone Support (TS). Participants in both interventions received a resource packet containing educational materials about dementia and local services/resources. Both groups received 16 telephone contacts from a trained master's level therapist over 6 months. The FITT-C intervention provided psychoeducation, problem-solving, and other directive therapeutic approaches based on assessment of key areas. TS provided supportive therapeutic strategies (e.g., venting, reflective listening). Outcome measures were caregivers' report of community support service use, total number of visits to the emergency department, and total hospital stays for themselves and care recipients during the interventions. Intervention groups did not differ in demographic characteristics, use of support services, or use of healthcare resources at baseline. Caregivers who received the FITT-C showed significantly greater use of community support services at end of treatment compared to those receiving TS (FITT-C M = 8.95, SD = 12.05 vs. TS M =6.13 SD =8.33, p =.046). FITT-C caregivers also showed fewer total emergency department visits (FITT-C M =.13, SD =.39 vs. TS M =.32 SD =.78, p=.030) and number of hospital stays (FITT-C M =.09, SD =.33 vs. TS M =.26 SD = .64, p=.025) over the 6-month course of the intervention compared to TS caregivers. Care recipients' use of community or medical resources did not differ by group. An entirely telephone delivered intervention shows efficacy for increasing caregivers' engagement in community resources and for reducing caregivers' use of healthcare resources. In conjunction with previous findings showing positive mental health effects of FITT-C, these results highlight FITT-C's potential impact on healthcare utilization.