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Effectiveness of Powerful Tools for Caregivers on Caregiver Burden and on Care Recipient Behavioral and Psychological Symptoms of Dementia: A Randomized Controlled Trial
Institution:1. Department of Neurology, University of California (DT), Davis, Sacramento, CA;2. School of Nursing, University of Minnesota (HN), Minneapolis, MN;3. National Geriatric Hospital (TP, ATN, HTN, NBN), Hanoi, Vietnam;4. Hanoi Medical University (TP, ATN, HTN), Hanoi, Vietnam;5. Department of Public Health Sciences, University of California (DH), Davis, Davis, CA;6. Department of Psychiatry and Behavioral Sciences, University of California (LH), Davis, Sacramento, CA
Abstract:ObjectiveThe aim of this study was to evaluate the effectiveness of a psychoeducational intervention, Powerful Tools for Caregivers (PTC), for family caregivers of individuals with dementia.DesignA pragmatic, 2-arm randomized controlled trial compared the PTC intervention, as delivered in practice, to usual care. Participants randomized to usual care functioned as a control group and then received the PTC intervention.InterventionPTC is a 6-week manualized program that includes weekly 2-hour classes in a group setting facilitated by 2 trained and certified leaders. The educational program helps caregivers to enhance self-care practices and manage emotional distress.Setting and participantsTwo stakeholder organizations delivered the intervention in community settings. Participants were family caregivers of individuals with dementia recruited from the community in Florida.MethodsPrimary outcomes were caregiver burden and behavioral and psychological symptoms of dementia of the care recipient. Secondary outcomes included caregiver depressive symptoms, self-efficacy, self-rated health, and life satisfaction. Measures were collected at baseline (n = 60 participants), postintervention (n = 55), and at 6-week follow-up (n = 44).ResultsIntent-to-treat analyses found PTC reduced caregiver burden (d = ?0.48) and depressive symptoms (d = ?0.53), and increased self-confidence (d = 0.68), but found no significant benefit for behavioral and psychological symptoms of dementia in care recipients. PTC was rated highly by participants and program attrition was low, with 94% of caregivers completing at least 4 of the 6 classes.Conclusions and implicationsAlthough no significant effects were found for behavioral and psychological symptoms of dementia, this trial supports the effectiveness of PTC to improve caregiver outcomes as delivered in the community.
Keywords:Caregiver  dementia  Alzheimer's disease  burden  depressive symptoms  behavioral and psychological symptoms of dementia
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