Abstract
AbstractBackgroundInformal caregivers of Alzheimer’s disease and other dementia (ADOD) have higher burden compared to caregivers of other illnesses, and caregivers’ well‐being affects their care recipients (CR). We hypothesized that with tangible support for caregivers' challenges related to daily activities, CR’s functional levels in the intervention group will be maintained while that in the control group will be declined.MethodThis randomized controlled trial involved a 3‐month intervention taking place in Caregiver's homes. Participants (21 intervention and 15 control) were caregivers of community‐dwelling older adults with ADOD who are members of the Programs of All‐inclusive Care for the Elderly (PACE). Challenges were described by caregivers, and solutions were derived from literature reviews, experiences and brain storming among geriatric occupational theorists, and delivered after a discussion with caregivers. Outcome measures were CR’s Activities of Daily Living (ADLs) and Instrumental ADLs, and caregivers’ burden, depression, physical fatigue, and confidence to continue care. T‐tests compared these group differences at baseline and 3 months due to much lower cognition of CR in the intervention group. All scores for the intervention group was much worse than those of the control group.ResultThe intervention group improved in confidence, depression, and physical fatigue, in contrast to the control group’s decline in all these measures. At baseline, CR’s functional levels of the intervention groups were much lower than those of the control group, and both groups declined further over 3 months. However, the decline of care recipients of the control group was much larger: 2.8 times for ADLs and 5.3 times for IADLs more than the intervention group.ConclusionEffective tangible support including working with caregivers to organize life and make schedules, training for transfer of CRs, use of a gait belt, and effective a communication method, and reviewing educational material with them improved their confidence, resulting in delaying CR's function decline. Even with CR's very low cognition, this type of support was effective to improve informal caregivers' confidence for continued care; therefore, we have to find a way to translate exiting knowledge of ADOD care to a practical support system.
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