Abstract
With loss of mobility in Multiple Sclerosis (MS) comes increase in caregiver assistance, burden, stress, and depression. This 6-month feasibility study used a pre-post design to test integration of a validated, behavioral, caregiving intervention into an ongoing MS clinic. Because the program focused on caregivers, there were no additional services provided to the persons living with MS other than usual medical care. Twenty-five MS caregivers received REACH VA (Resources for Enhancing All Caregivers’ Health in the VA), a six-session behavior-focused intervention during two to three months designed to increase caregiver skills in managing their own stress and burden and MS related issues and concerns, with a focus on mobility. Caregivers were assessed at baseline, three, and six months. Caregivers’ expectations of the program were to receive education on MS, caregiving and stress management skills, and support. The major benefits caregivers reported were understanding their loved one’s condition and how to better provide care. At six months, caregivers reported statistically and clinically significant improvements in depressive symptoms and bother with challenging MS behaviors. Persons with MS reported benefit for their caregivers and for themselves; 71% reported that their caregivers had helped them with mobility and function. Study results suggest that the addition of the brief REACH caregiver intervention into an MS clinic would benefit both caregivers and persons with MS. Although the intervention was six sessions over three months, benefit persisted at six months, suggesting durability of effects. This trial is registered with ClinicalTrials.gov NCT02835677.
Highlights
It is estimated that around one million people in the United States are living with Multiple Sclerosis (MS) [1]
Recruitment occurred through the clinic via brochures and clinician referrals. e study was conducted under the oversight of the Memphis Veterans Affairs Medical Center (VAMC) Institutional Review Board (IRB)
A major concern for caregivers is always to understand their loved one’s condition and its effects on them, and this was the most common benefit reported by these caregivers
Summary
It is estimated that around one million people in the United States are living with Multiple Sclerosis (MS) [1]. Between 80% and 90% of informal care for people with MS occurs in the home, typically by a spouse who spends from 4 to 12 hours per day caring for their loved one [2, 3]. MS caregivers report greater stress-related symptoms and lower life satisfaction than noncaregivers, have higher needs for mental health services, and report a wide range of problems related to caregiving [4, 5]. Caregiver burden in MS is a multidimensional response to physical, psychological, emotional, social, and financial stressors associated with caregiving, o en leading to higher risk of depression and lower quality of life [6]. Caregiver depression is associated with less perceived social support, higher MS disease severity, and greater
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