Embedding Caregiver Support Within Adult Day Services: Outcomes of a Multisite Trial.
Gerontologist
; 64(4)2024 Apr 01.
Article
em En
| MEDLINE
| ID: mdl-37549428
ABSTRACT
BACKGROUND AND OBJECTIVES:
Adult day services (ADS) provide quality-of-life benefits to people with dementia, but few provide systematic caregiver support. We report outcomes of a multisite, national trial testing a staff-delivered caregiver program, ADS Plus. RESEARCH DESIGN ANDMETHODS:
Cluster-randomized trial involving 34 ADS 18 sites provided ADS (controls) and 16 provided ADS and ADS Plus (intervention). Trained staff met with caregivers to provide dementia education, support/validation, referrals/linkages, and strategies for care challenges and self-care over 12 months. Main outcomes included depressive symptoms (Center for Epidemiological Studies Depression Scale [CES-D]) and well-being at 6 and 12 months, and client attendance over 12 months.RESULTS:
Of 203 caregivers (Interventionâ =â 102; Controlâ =â 101), 5.9% at 3 months, 12.8% at 6 months, and 22.7% at 12 months were lost to follow-up. Caregivers were predominantly female (80.3%), with 76.4% identifying as White/Caucasian, 14.8% Black/African American, and 12.3% Hispanic/Latino. Most (88.2%) had ≥college education and were 65.0 years old (SDâ =â 13.46). For those with 6-month data, 40.4% control and 40.2% ADS Plus caregivers had depressed symptoms (≥16 CES-D) at baseline. By 6 months, 43.6% control versus 34.2% ADS Plus caregivers had ≥16 scores (odds ratioâ =â 0.38, pâ =â .072). By 12 months, after covariate adjustments, ADS Plus caregivers reported reduced total depression scores versus controls (pâ =â .013) and lower depressed affect scores (pâ =â .015). Of 18 sites providing 12-month client attendance data, 9 intervention sites reported 126.05 days attended versus 78.49 days for 9 control sites (pâ =â .079). DISCUSSION AND IMPLICATIONS Compared with ADS alone, by 12 months, ADS Plus improved caregiver mood and increased ADS utilization by 60.6%. Results support ADS staff delivering evidence-based caregiver support to enhance ADS benefits. CLINICAL TRIAL REGISTRATION NCT02927821.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cuidadores
/
Demência
Tipo de estudo:
Clinical_trials
/
Prognostic_studies
Aspecto:
Implementation_research
/
Patient_preference
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Gerontologist
Ano de publicação:
2024
Tipo de documento:
Article