Alzheimer Disease, Dementia
Conditions
Keywords
Randomized control trial, Dementia caregivers, Occupational Therapy, Caregivers
Brief summary
The purpose of this study is to pilot the home Environmental Skill-Building Program (ESP) and an educational control intervention with persons with dementia and their caregivers (n=40) in preparation for a larger double-blind randomized controlled trial. Caregivers of persons with dementia often deal with difficult behaviors. The ESP is an occupational therapy intervention that helps caregivers adapt to their environment and build care-giving skills. The areas addressed include changes to the home set-up, adaptive equipment, instruction in strategies of problem-solving, energy conservation, safe task performance, and fall recovery techniques. A trial is needed with methodological rigor and to determine if the intervention is feasible in the Canadian health care system. Results will contribute to understanding how caregivers and people with dementia can be supported in their home environments.
Interventions
BEHAVIORALEducation Control
Caregiver participants are provided with information about caregiver stress and discuss it individually with an interventionist who visits the home. The control intervention involves 5 visits over 6 months.
BEHAVIORALEnvironmental Skill Building
The ESP intervention addresses home modifications and training in their use, instruction in strategies of problem-solving, energy conservation, safe task performance, fall recovery techniques, and balance and muscle strength training. Intervention is individualized for target areas identified in the initial client assessment and caregiver interview. The intervention involves using a problem solving approach and client-centred focus and the intervention assessment tools are individualized measures which determine the goals identified by the caregiver. It involves 5 visits over 6 months.
Sponsors
Alzheimer Society of Canada
McMaster University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* The caregiver must be the primary caregiver * Caregiver reports that the care recipient has at least one limitation in basic activities of daily living (ADL) or two dependencies in instrumental activities of daily living (IADLs) * The caregiver must: * provide at least 2 hours of care per day * be caregiving for at least 6 months and * be at least 21 years of age * The care recipients need to have a diagnosis of dementia
Exclusion criteria
* Caregiver: * does not live with the care recipient * has poor health (undergoing treatments for cancer, hospitalized more than three times in past year) * planning to place care recipient in long term care within the next year * Care recipients who are confined to bed most of the day or are minimally-responsive to touch or the environment are excluded
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Revised Memory and Behavior Problem Checklist | 0, 6, 9 months |
Secondary
| Measure | Time frame |
|---|---|
| Disability Assessment for Dementia | 0, 6, 9 months |
| Number of caregiving assistance hours | 0, 6, 9 months |
| Short Zarit Burden Interview | 0, 6, 9 months |
| Task Management Strategy Index | 0, 6, 9 months |
| Perceived Change Scale | 0, 6, 9 months |
Countries
Canada
Outcome results
None listed