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P3‐485: Telephone Group Education: A strategy for caregivers of veterans with dementia
Author(s) -
Shulan Mollie D.,
Wray Laura,
Toseland Ronald,
Freeman Kurt,
Vasquez Bob,
Gao Jian
Publication year - 2008
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2008.05.2056
Subject(s) - dementia , psychosocial , medicine , psychological intervention , spouse , coping (psychology) , gerontology , clinical psychology , nursing , psychiatry , disease , pathology , sociology , anthropology
Background: This study was designed to evaluate the impact of a Telehealth Education Program (TEP) on veterans with moderate to severe dementia and their spouse caregivers. The TEP is a program of education, coping skills, problem solving and support presented to caregivers of veterans with dementia by teleconference in ten weekly, one-hour sessions. The TEP was based on a stress and coping model aimed to enhance the knowledge, skills and feelings of support of the caregivers who participated. Methods: This study employed a randomized controlled design of 2 interventions, 3 times of measurement, 2 sites and 4 leaders. Veterans with moderate to severe dementia and their spouses were recruited and randomly assigned to TEP or usual care (UC). They were assessed at baseline, three and twelve months after baseline. Psychosocial outcome data and health care cost and utilization data were collected to examine three hypotheses: 1) whether TEP veterans would experience significant reduction in behavior problems, agitation and symptoms of depression; 2) whether TEP caregivers would experience a significant increase in dementia management skills; 3) whether TEP veterans would experience significant more days in the community, fewer hospital admissions, and nursing home admissions.. Outcome variables were analyzed using mixed effects regression models. Healthcare cost and utilization data were abstracted from VISTA databases within the VA. Results: There were 158 caregiverveteran dyads, 83 in TEP and 75 in UC. There were no significant baseline differences in demographic variables across groups. Results show that TEP caregivers perceived significant changes in some outcome variables as compared to UC caregivers. Healthcare cost data showed a significant (p 0.039) cost savings of $2768 at six months for TEP as compared to UC, but were not significant at one year. Inpatient, outpatient and nursing home costs were assessed but only TEP nursing home costs reached significance(p 0.009) with a savings of $1057 at six months. Conclusions: TEP resulted in short term cost savings and perceived improvements in some psychosocial variables for TEP caregivers.