REDUCING AND PREVENTING CAREGIVERS’ BURDEN: THE EFFICACY OF DEMENTIA CARE MANAGEMENT FOR INFORMAL DEMENTIA CAREGIVERS

Abstract

The provision of appropriate support for informal caregivers is a major challenge for the healthcare system in Germany. To provide an optimal support for informal dementia caregivers, we conducted a cluster-randomized controlled trial of a comprehensive Dementia Care Management (DCM) for persons with dementia (PWD) and their informal caregivers in a primary care setting. The analyses are based on longitudinal data of the general practitioner-based, cluster-randomized DCM intervention trial DelpHi-MV (Dementia: life- and person-centered help) with baseline and 12-month follow-up assessment as well as two arms (intervention group versus care as usual). A sample of n = 317 community dwelling PWD screened positive for dementia (DemTect < 9) and their caregivers provided written informed consent to participate. Intervention caregivers reported significant improvements in caregiver burden, especially in caregivers’ subjective burden due to behavioral change and caregivers’ subjective burden due to perceived conflicts between needs and responsibilities to care. Post-hoc subgroup analyses revealed that especially caregivers living together with PWD benefit from DCM compared to caregivers not living together with PWD. DCM provided by specifically trained nurses at patients’ domesticity using an IMS resulted in significant improvement in caregivers’ burden. These improvements were achieved by reducing caregivers’ subjective burden due to behavioral change and perceived conflicts between needs and responsibilities to care.