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Memory and communication support strategies in dementia: Effect of a training program for informal caregivers

Published online by Cambridge University Press:  03 August 2012

Jacki Liddle ,
Erin R. Smith-Conway ,
Rosemary Baker ,
Anthony J. Angwin ,
Cindy Gallois ,
David A. Copland ,
Nancy A. Pachana ,
Michael S. Humphreys ,
Gerard J. Byrne  and
Helen J. Chenery
Jacki Liddle
Affiliation:
The University of Queensland, UQ Centre for Clinical Research, The University of Queensland, Brisbane, Australia
Erin R. Smith-Conway*
Affiliation:
The University of Queensland, UQ Centre for Clinical Research, The University of Queensland, Brisbane, Australia
Rosemary Baker
Affiliation:
The University of Queensland, UQ Centre for Clinical Research, The University of Queensland, Brisbane, Australia
Anthony J. Angwin
Affiliation:
The University of Queensland, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
Cindy Gallois
Affiliation:
The University of Queensland, School of Psychology, The University of Queensland, Brisbane, Australia
David A. Copland
Affiliation:
The University of Queensland, UQ Centre for Clinical Research, The University of Queensland, Brisbane, Australia The University of Queensland, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
Nancy A. Pachana
Affiliation:
The University of Queensland, School of Psychology, The University of Queensland, Brisbane, Australia
Michael S. Humphreys
Affiliation:
The University of Queensland, School of Psychology, The University of Queensland, Brisbane, Australia
Gerard J. Byrne
Affiliation:
The University of Queensland, School of Medicine, The University of Queensland, Brisbane, Australia
Helen J. Chenery
Affiliation:
The University of Queensland, UQ Centre for Clinical Research, The University of Queensland, Brisbane, Australia
*
Correspondence should be addressed to: Dr Erin Smith-Conway, UQ Centre for Clinical Research, The University of Queensland, Herston 4029, Australia. Phone: +61 7 3346 5583; Fax: +61 7 3346 5599. Email: [email protected].
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Abstract

Background: People with dementia have a range of needs that are met by informal caregivers. A DVD-based training program was developed using research-based strategies for memory and communication in dementia. The effectiveness of the training on the caregiver experience and the well-being of the person with dementia was evaluated.

Methods: A pre-test/post-test controlled trial was undertaken with caregiver–care-recipient dyads living in the community. Measures of the carers’ knowledge of memory and communication strategies, burden, positive perceptions of caregiving, and perceptions of problem behaviors were taken pre- and three months post-intervention. The depression and well-being of the person with dementia were also evaluated. Satisfaction with the training and feedback were measured.

Results: Twenty-nine dyads (13 training group, 16 control group) participated. Bonferroni's correction was made to adjust for multiple comparisons, setting α at 0.00385. A significant improvement was found in caregivers’ knowledge for the training group compared to the control group (p = 0.0011). The training group caregivers reported a reduction in the frequency of care recipient disruptive behaviors (p = 0.028) and increased perceptions of positive aspects of caregiving (p = 0.039), both at a level approaching significance. The training group care recipients had increased frequency of verbally communicated depressive behaviors at a level approaching significance (p = 0.0126). The frequency of observed depressive behaviors was not significantly different between groups.

Conclusions: This approach to training for caregivers of people with dementia appears promising for its impact on knowledge and the caregiving experience. Further research could monitor the impact of the training on broader measures of depression and well-being, with a larger sample.

Keywords

knowledge translationcommunity carecognitive rehabilitationcommunication skillsfamilywell-beingburdenstress
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 12 , December 2012 , pp. 1927 - 1942
Copyright
Copyright © International Psychogeriatric Association 2012

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References

Alexopoulos, G. S., Abrams, R. C., Young, R. C. and Shamoian, C. A. (1988). Cornell scale for depression in dementia. Biological Psychiatry, 23, 271–284.CrossRefGoogle ScholarPubMed
Australian Institute of Health and Welfare (2007a). Dementia in Australia: National Data Analysis and Development. Canberra: AIHW.Google Scholar
Australian Institute of Health and Welfare (2007b). Older Australia at a Glance, 4th edn. Canberra: AIHW.Google Scholar
Bedard, M., Molloy, D. W., Squire, L., Dubois, S., Lever, J. A. and O'Donnell, M. (2001). The Zarit Burden Interview: a new short version and screening version. The Gerontologist, 41, 652–657.CrossRefGoogle ScholarPubMed
Bourgeois, M. S., Dijkstra, K., Burgio, L. and Allen-Burge, R. (2001). Memory aids as an augmentative and alternative communication strategy for nursing home residents with dementia. AAC: Augmentative and Alternative Communication, 17, 196–210.Google Scholar
Bourgeois, M. S., Schulz, R. and Burgio, L. (1996). Interventions for caregivers of patients with Alzheimers's disease: a review and analysis of content, process and outcomes. International Journal of Aging and Human Development, 43, 35–92.CrossRefGoogle ScholarPubMed
Bowling, A. (2005). Measuring Health: A Review of Quality of Life Measurement Scales, 3rd edn. Maidenhead, Berkshire: Open University Press.Google Scholar
Braun, M., Mura, K., Peter-Wight, M., Hornung, R. and Scholz, U. (2010). Toward a better understanding of psychological well-being in dementia caregivers: the link between marital communication and depression. Family Process, 49, 185–203.CrossRefGoogle Scholar
Brodaty, H., Green, A. and Koschera, A. (2003). Meta-analysis of psychosocial interventions for caregivers of people with dementia. Journal of the American Geriatrics Society, 51, 657–664.CrossRefGoogle ScholarPubMed
Broughton, M., et al. (2011). Evaluation of a caregiver education program to support memory and communication in dementia: a controlled pretest-posttest study with nursing home staff. International Journal of Nursing Studies, 48, 1436–1444.CrossRefGoogle ScholarPubMed
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159.CrossRefGoogle ScholarPubMed
Cooke, D., McNally, L., Mulligan, K., Harrison, J. and Newman, P. (2001). Psychosocial interventions for caregivers of people with dementia: a systematic review. Aging & Mental Health, 5, 120–135.CrossRefGoogle ScholarPubMed
Cross, S. M. B., Broomfield, N. M., Davies, R. and Evans, J. J. (2008). Awareness, knowledge and application of memory rehabilitation among community psychiatric nurses working with dementia. Dementia: The International Journal of Social Research and Practice, 7, 383–395.CrossRefGoogle Scholar
de Vugt, M. E., et al. (2004). Do caregiver management strategies influence patient behaviour in dementia? International Journal of Geriatric Psychiatry, 19, 85–92.CrossRefGoogle ScholarPubMed
Done, D. J. and Thomas, J. A. (2001). Training in communication skills for informal carers of people suffering with dementia: a cluster randomized clinical trial comparing a therapist led workshop and a booklet. International Journal of Geriatric Psychiatry, 16, 816–821.CrossRefGoogle ScholarPubMed
Draper, B., Low, L. F., Withall, A., Vickland, V. and Ward, T. (2009). Translating dementia research into practice. International Psychogeriatrics, 21, S72–80.CrossRefGoogle ScholarPubMed
Droes, R.-M., Van der Roest, H., Van Mierlo, L. D. and Meiland, F. (2011). Memory problems in dementia: adaptation and coping strategies and psychosocial treatments. Expert Review of Neurotherapeutics, 11, 1769–1782.CrossRefGoogle ScholarPubMed
Elo, S. and Kyngas, H. (2008). The qualitative content analysis process. Journal of Advanced Nursing, 62, 107–115.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-Mental State”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle Scholar
Gallagher, D., et al. (2011). Self-efficacy for managing dementia may protect against burden and depression in Alzheimer's caregivers. Aging & Mental Health, 15, 663–670.CrossRefGoogle ScholarPubMed
Gataric, G., Kinsel, B., Currie, B. G. and Lawhorne, L. W. (2010). Reflections on the under-researched topic of grief in persons with dementia: a report from a symposium on grief and dementia. American Journal of Hospice and Palliative Medicine, 27, 567–574.CrossRefGoogle ScholarPubMed
Haberstroh, J., Neumeyer, K., Krause, K., Franzmann, J. and Pantel, J. (2011). TANDEM: communication training for informal caregivers of people with dementia. Aging & Mental Health, 15, 405–413.CrossRefGoogle ScholarPubMed
Hebert, R., Bravo, G. and Preville, M. (2000). Reliability, validity and reference values of the Zarit Burden Interview for assessing informal caregivers of community dwelling older persons with dementia. Canadian Journal on Aging, 19, 494–507.CrossRefGoogle Scholar
Hoffman, T. and McKenna, K. (2006). Evaluation of client education. In McKenna, K. and L., T. (eds.) Client Education: A Partnership Approach (pp. 159–182). Sydney, Australia: UNSW Press.Google Scholar
Juul, S. and Frydenberg, M. (2010). An Introduction to Stata for Health Researchers, 3rd edn. College Station, Texas: Stata Press.Google Scholar
Lawlor, B. A. (2002). Managing behavioral and psychological symptoms in dementia. British Journal of Psychiatry, 181, 463–465.CrossRefGoogle Scholar
Lewis, M. L., Hobday, J. V. and Hepburn, K. W. (2010). Internet-based program for dementia caregivers. American Journal of Alzheimer's Disease and Other Dementias, 25, 674–679.CrossRefGoogle ScholarPubMed
Lorish, C. D. and Maisiak, R. (1986). The face scale: a brief, nonverbal method for assessing patient mood. Arthritis and Rheumatism, 29, 906–909.CrossRefGoogle Scholar
Parker, D., Mills, S. and Abbey, J. (2008). Effectiveness of interventions that assist caregivers to support people with dementia living in the community: a systematic review. International Journal of Evidence Based Healthcare, 6, 137–172.Google ScholarPubMed
Pauteux, S., Herrmann, F., Le Lous, P., Fabjan, M., Michel, J. P. and Gold, G. (2005). Feasibility and reliability of four pain self-assessment scales and correlation with an observational rating scale in hospitalized elderly demented patients. Journal of Gerontology: Medical Sciences, 60A, 524–529.Google Scholar
Perneczky, R., Wagenpfeil, S., Komossa, K., Grimmer, T., Diehl, J. and Kurz, A. (2006). Mapping scores onto stages: Mini-Mental State Exam and clinical dementia rating. American Journal of Geriatric Psychiatry, 14, 139–144.CrossRefGoogle Scholar
Pinquart, M. and Sörensen, S. (2006). Helping caregivers of persons with dementia: which interventions work and how large are their effects? International Psychogeriatrics, 18, 577–595.CrossRefGoogle ScholarPubMed
Portney, L. G. and Watkins, M. P. (2009). Foundations of Clinical Research. Applications to Practice, 3rd edn. Upper Saddle River, New Jersey: Pearson Prentice Hall.Google Scholar
Ready, R. E. and Ott, B. R. (2003). Quality of life measures for dementia. Health and Quality of Life Outcomes., 1, 1–9.CrossRefGoogle ScholarPubMed
Rentz, C., Krikorian, R. and Keys, M. (2005). Grief and mourning from the perspective of the person with a dementia illness: beginning the dialogue. Omega, 50, 165–179.CrossRefGoogle Scholar
Rosa, E., et al. (2010). Needs of caregivers of the patients with dementia. Archives of Gerontology and Geriatrics, 51, 54–58.CrossRefGoogle ScholarPubMed
Roth, D. L., et al. (2003). Psychometric analysis of the revised memory and behavior problems checklist: factor structure of occurrence and reaction ratings. Psychology and Aging, 18, 906–915.CrossRefGoogle ScholarPubMed
Royal Australian College of General Practitioners (2006). Medical Care of Older Person in Residential Aged Care Facilitites, 4th edn. South Melbourne, Victoria, Australia: RACGP.Google Scholar
Schulz, R. and Martire, L. (2004). Family caregiving of persons with dementia: prevalence, health effects and support strategies. American Journal of Geriatric Psychiatry, 12, 240–249.CrossRefGoogle ScholarPubMed
Semiatin, A. M. and O'Connor, M. K. (2012). The relationship between self-efficacy and positive aspects of caregiving in Alzheimer's disease caregivers. Aging & Mental Health, 16, 683–688.CrossRefGoogle ScholarPubMed
Smith, E. R., et al. (2011). Memory and communication support in dementia: research-based strategies for caregivers. International Psychogeriatrics, 23, 256–263.CrossRefGoogle ScholarPubMed
Smits, C. H. M., de Lange, J., Droes, R.-M., Meiland, F., Vernooij-Dassen, M. and Pot, A. M. (2007). Effects of a combined intervention programmes for people with dementia living at home and their caregivers: a systematic review. International Journal of Geriatric Psychiatry, 22, 1181–1193.CrossRefGoogle ScholarPubMed
Snowdon, J. and Fleming, R. (2008). Recognising depression in residential facilities: an Australian challenge. International Journal of Geriatric Psychiatry, 23, 295–300.CrossRefGoogle ScholarPubMed
Spijker, A., et al. (2008). Effectiveness of nonpharmacological interventions in delaying the instituationalization of patients with dementia: a meta-analysis. Journal of the American Geriatrics Society, 56, 1116–1128.CrossRefGoogle ScholarPubMed
StataCorp (2007). Stata Statistical Software: Release 10. College Station, TX: StataCorp LP.Google Scholar
Tarlow, B. J., Wisniewski, S. R., Belle, S. H., Rubert, M., Ory, M. G. and Gallagher-Thompson, D. (2004). Positive aspects of caregiving: contributions of the REACH project to the development of new measures for Alzheimer's caregiving. Research on Aging, 26, 429–453.CrossRefGoogle Scholar
Teri, L., McCurry, S. M., Logsdon, R. and Gibbons, L. E. (2005). Training community consultants to help family members improve dementia care: a randomized controlled trial. The Gerontologist, 45, 802–811.CrossRefGoogle ScholarPubMed
Teri, L., Truax, P., Logsdon, R., Uomoto, J., Zarit, S. and Vitaliano, P. P. (1992). Assessment of behavioral problems in dementia: the revised memory and behaviour problems checklist. Psychology and Aging, 7, 622–631.CrossRefGoogle ScholarPubMed
Van Mierlo, L. D., Meiland, F., Van der Roest, H. and Droes, R.-M. (2011). Personalised caregiver support: effectiveness of psychosocial interventions in subgroups of caregivers of people with dementia. International Journal of Geriatric Psychiatry, 27, 1–14.CrossRefGoogle ScholarPubMed
Vernooij-Dassen, M., Draskovic, I., McCleery, J. and Downs, M., Issue 11. (2011). Cognitive reframing for carers of people with dementia. Cochrane Database of Systematic Reviews Art. No.: CD005318.Google Scholar
Zarit, S. H., Reever, K. E. and Bach-Peterson, J. (1980). Relatives of the impaired elderly: correlates of feelings of burden. The Gerontologist, 20, 649–655.CrossRefGoogle ScholarPubMed