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Evaluation of a problem-solving (PS) techniques-based intervention for informal carers of patients with dementia receiving in-home care

Published online by Cambridge University Press:  23 January 2015

Mary Chiu ,
Tim Pauley ,
Virginia Wesson ,
Dunstan Pushpakumar  and
Joel Sadavoy
Mary Chiu*
Affiliation:
The Cyril and Dorothy, Joel and Jill Reitman Centre for Alzheimer's Support and Training, Mount Sinai Hospital, Toronto, Ontario, M5G 1X5, Canada Department of Geriatric and General Psychiatry, Mount Sinai Hospital, Toronto, Ontario, M5G 1X5, Canada Department of Psychiatry, University of Toronto, Toronto, Ontario, M5T 3L9, Canada
Tim Pauley
Affiliation:
Department of Research and Evaluation, Toronto Central Community Care Access Centre, Toronto, Ontario, M5T 2Z5, Canada Department of Research and Evaluation, West Park Healthcare Centre, Toronto, Ontario, M6M 2J5, Canada
Virginia Wesson
Affiliation:
The Cyril and Dorothy, Joel and Jill Reitman Centre for Alzheimer's Support and Training, Mount Sinai Hospital, Toronto, Ontario, M5G 1X5, Canada Department of Geriatric and General Psychiatry, Mount Sinai Hospital, Toronto, Ontario, M5G 1X5, Canada Department of Psychiatry, University of Toronto, Toronto, Ontario, M5T 3L9, Canada
Dunstan Pushpakumar
Affiliation:
The Cyril and Dorothy, Joel and Jill Reitman Centre for Alzheimer's Support and Training, Mount Sinai Hospital, Toronto, Ontario, M5G 1X5, Canada
Joel Sadavoy
Affiliation:
The Cyril and Dorothy, Joel and Jill Reitman Centre for Alzheimer's Support and Training, Mount Sinai Hospital, Toronto, Ontario, M5G 1X5, Canada Department of Geriatric and General Psychiatry, Mount Sinai Hospital, Toronto, Ontario, M5G 1X5, Canada Department of Psychiatry, University of Toronto, Toronto, Ontario, M5T 3L9, Canada
*
Correspondence should be addressed to: Mary Chiu, Department of Psychiatry, The Cyril and Dorothy, Joel and Jill Reitman Centre for Alzheimer's Support and Training, Mount Sinai Hospital, 60 Murray Street, Room L1-012, Toronto, Ontario, M5G 1X5, Canada. Phone: +1-416-586-4800 x4104; Fax: +1-416-586-3231. Email: mchiu@mtsinai.on.ca.
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Abstract

Background:

The value of care provided by informal carers in Canada is estimated at $26 billion annually (Hollander et al., 2009). However, carers’ needs are often overlooked, limiting their capacity to provide care. Problem-solving therapy (PST), a structured approach to problem solving (PS) and a core principle of the Reitman Centre CARERS Program, has been shown to alleviate emotional distress and improve carers’ competence (Chiu et al., 2013). This study evaluated the effectiveness of problem-solving techniques-based intervention based on adapted PST methods, in enhancing carers’ physical and emotional capacity to care for relatives with dementia living in the community.

Methods:

56 carers were equally allocated to a problem-solving techniques-based intervention group or a control arm. Carers in the intervention group received three 1 hr visits by a care coordinator (CC) who had been given advanced training in PS techniques-based intervention. Coping, mastery, competence, burden, and perceived stress of the carers were evaluated at baseline and post-intervention using standardized assessment tools. An intention-to-treat analysis utilizing repeated measures ANOVA was performed on the data.

Results:

Post-intervention measures completion rate was 82% and 92% for the intervention and control groups, respectively. Carers in the intervention group showed significantly improved task-oriented coping, mastery, and competence and significantly reduced emotion-oriented coping, burden and stress (p < 0.01–0.001). Control carers showed no change.

Conclusion:

PS techniques, when learned and delivered by CCs as a tool to coach carers in their day-to-day caregiving, improves carers’ caregiving competence, coping, burden, and perceived stress. This may reduce dependence on primary, psychiatric, and institutional care. Results provide evidence that establishing effective partnerships between inter-professional clinicians in academic clinical health science centers, and community agencies can extend the reach of the expertise of specialized health care institutions.

Keywords

carersbehavioral and psychological symptoms of dementiacommunity caretrainingcognitive behavioral therapy
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 6 , June 2015 , pp. 937 - 948
Copyright
Copyright © International Psychogeriatric Association 2015 

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