Evaluation of a problem-solving (PS) techniques-based intervention for informal carers of patients with dementia receiving in-home care. (23rd January 2015)

• Record Type: Journal Article
• Authors: Chiu, Mary; Pauley, Tim; Wesson, Virginia; Pushpakumar, Dunstan; Sadavoy, Joel
• Is Part Of: International psychogeriatrics. Volume 27:Number 6(2015:Jun.)
• Page Start: 937
• Page End: 948
• Publication Date: 2015-01-23
• Subjects: carers, -- behavioral and psychological symptoms of dementia, -- community care, -- training, -- cognitive behavioral therapy; Geriatric psychiatry -- Periodicals; 618.9768905
• DOI: 10.1017/S1041610214002798
• Languages: English
• ISSNs: 1041-6102

Abstract

ABSTRACT: Background: The value of care provided by informal carers in Canada is estimated at $26 billion annually (Hollander et al., 2009). However, carers' needs are often overlooked, limiting their capacity to provide care. Problem-solving therapy (PST), a structured approach to problem solving (PS) and a core principle of the Reitman Centre CARERS Program, has been shown to alleviate emotional distress and improve carers' competence (Chiu et al., 2013). This study evaluated the effectiveness of problem-solving techniques-based intervention based on adapted PST methods, in enhancing carers' physical and emotional capacity to care for relatives with dementia living in the community. Methods: 56 carers were equally allocated to a problem-solving techniques-based intervention group or a control arm. Carers in the intervention group received three 1 hr visits by a care coordinator (CC) who had been given advanced training in PS techniques-based intervention. Coping, mastery, competence, burden, and perceived stress of the carers were evaluated at baseline and post-intervention using standardized assessment tools. An intention-to-treat analysis utilizing repeated measures ANOVA was performed on the data. Results: Post-intervention measures completion rate was 82% and 92% for the intervention and control groups, respectively. Carers in the intervention group showed significantly improved task-oriented coping, mastery, and competence and significantly reduced emotion-oriented coping, burden and stress ( p < 0.01–0.001). Control carers showed no change. Conclusion: PS techniques, when learned and delivered by CCs as a tool to coach carers in their day-to-day caregiving, improves carers' caregiving competence, coping, burden, and perceived stress. This may reduce dependence on primary, psychiatric, and institutional care. Results provide evidence that establishing effective partnerships between inter-professional clinicians in academic clinical health science centers, and community agencies can extend the reach of the expertise of specialized health care institutions.