Feasibility and Efficacy of Life Review Delivered by Virtually-Trained Family Caregivers

Article type: Research Article

Authors: Miyawaki, Christina E.^{a; *} | McClellan, Angela^b | Bouldin, Erin D.^{c; d} | Brohard, Cheryl^e | Spencer, Helen^a | Tahija, Nina^f | Kunik, Mark E.^g

Affiliations: [a] University of Houston Graduate College of Social Work, Houston, TX, USA | [b] Baylor University Diana R. Garland School of Social Work, Waco, TX, USA | [c] Health Services Research & Development, Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA | [d] University of Utah, Department of Internal Medicine, Salt Lake City, UT, USA | [e] University of Houston College of Nursing, Sugar Land, TX, USA | [f] The Council on Recovery, Houston, TX, USA | [g] VA South Central Mental Illness Research, Education and Clinical Center & Baylor College of Medicine, Houston, TX, USA

Correspondence: [*] Correspondence to: Christina E. Miyawaki, PhD, MSW, MA, University of Houston Graduate College of Social Work, 3511 Cullen Blvd, Room 110HA, Houston, TX 77204-4013, USA.cemiyawaki@uh.edu; ORCID: 0000-0002-1234-1588

Abstract: Background:Due to the high prevalence of depressive symptoms and Alzheimer’s disease and related dementias in older Americans (≥65 years), we developed a six-week depression intervention, Caregiver-Provided Life Review (C-PLR) for care recipients (CRs) with early-stage dementia and mild depression. Objective:The objective of the study was to examine the feasibility and efficacy of C-PLR delivered by virtually-trained caregivers (CGs) on CRs who live with dementia and depression in community and long-term care settings (N = 25 CG-CR dyads). Methods:We used fidelity scores as a measure of CG’s feasibility to provide C-PLR. We collected the pre- and post-measures on CRs’ depression (primary outcome), life satisfaction, CGs’ burden, positive aspects of caregiving, and CG-CR relationship quality (secondary outcomes) and compared them using paired t-tests. We evaluated if the effect differed by race/ethnicity, residential setting, or living alone. Results:The average fidelity check-in score was 14.8±0.78 indicating high feasibility. CGs were 52 years old (mean), 88% female, 64% working, 72% college-educated, and 72% in good-excellent health. CRs were 81 years old (mean), 84% female, and 56% in poor-fair health. CRs’ depression significantly improved (p < 0.001), and this effect was found in CRs who were Asian (p = 0.017), White (p = 0.040), community-dwelling (p < 0.001), lived alone (p = 0.045), or with others (p = 0.002). Conclusion:This study demonstrated that the C-PLR can be successfully taught to CGs virtually and is effective in reducing CR’s depressive symptoms. C-PLR could be implemented more broadly to improve symptoms among CRs in community and residential settings, as well as among a diverse population of CRs.

Keywords: Alzheimer’s disease, caregiver education, dementia, depressive symptoms, internet-based intervention, program evaluation

DOI: 10.3233/JAD-230371

Journal: Journal of Alzheimer's Disease, vol. 95, no. 2, pp. 573-583, 2023