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Background characteristics and treatment-related factors associated with treatment success or failure in a non-pharmacological intervention for dementia caregivers

Published online by Cambridge University Press:  06 March 2017

Karen C. Rose  and
Laura N. Gitlin
Karen C. Rose*
Affiliation:
Department of Psychology, Widener University, 1 University Place, Chester, PA 19013, USA
Laura N. Gitlin
Affiliation:
Department of Community Public Health, School of Nursing, Joint appointments, Department of Psychiatry, Director, Center for Innovative Care in Aging, Johns Hopkins University, 525 Wolfe Street, Suite 316, Baltimore, MD, 21205, USA
*
Correspondence should be addressed to: Dr Karen C. Rose, Professor, Department of Psychology, Widener University, One University Place, Chester, PA 19013, USA. Phone: 610-499-4526; Fax: 610-499-5792. Email: kcrose@widener.edu.
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Abstract

Background:

Non-pharmacological interventions for persons with dementia often rely on family caregivers for implementation. However, caregivers differ in their readiness to use strategies. This study examines dyadic characteristics and treatment-related mechanisms associated with treatment success (high readiness to use strategies) and failure (low readiness to use strategies) at the conclusion of the Advancing Caregiver Training (ACT) intervention.

Methods:

Caregiver and person with dementia characteristics and treatment-related variables (treatment participation, number and type of strategies introduced and enacted) were examined in 110 caregivers in intervention. Interventionists rated readiness (1=precontemplation; 2=contemplation; 3=preparation; 4=action) of caregivers to use strategies at the final ACT session. Univariate analyses examined dyadic characteristics, and Multiple Analysis of Covariance (MANCOVA) and Analyses of Covariance (ANCOVA) examined treatment-related factors associated with readiness to use strategies at treatment completion.

Results:

At treatment completion, 28.2% (N=31) scored in pre-action and 71.8% (N=79) at action. Caregivers at pre-action readiness levels were more likely than those at action to be a spouse, report greater financial difficulties and be managing fewer problem behaviors. Although both groups were introduced an equivalent number of non-pharmacological strategies, caregivers at pre-action were less likely than those at action to report enacting strategies.

Conclusions:

Certain dyadic characteristics and treatment-related factors were associated with treatment failure including financial strain and lack of strategy integration. Findings suggest that developing intervention components to address financial concerns and increase opportunities for practicing strategies and then using them between treatment sessions may be important for caregivers at risk of treatment failure.

Keywords

caregivingdementianon-pharmacological interventionsreadiness
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 6 , June 2017 , pp. 1005 - 1014
Copyright
Copyright © International Psychogeriatric Association 2017 

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