Translation of a Dementia Caregiver Support Program in a Health Care System—REACH VA
Abstract
BACKGROUND: Based on the National Institute on Aging/National Institute of Nursing Research Resources for Enhancing Alzheimer's Caregiver Health (REACH) randomized controlled trial (REACH II), REACH VA (Department of Veterans Affairs) was the first national clinical translation of a proven behavioral intervention for dementia caregivers, running from September 2007 through August 2009. This article describes the population and outcomes of the REACH VA translation of REACH II into the VA. METHODS: Clinical staff members from 24 VA Medical Center Home-Based Primary Care programs in 15 states delivered the intervention to stressed caregivers of patients with dementia. Like REACH II, the 6-month REACH VA intervention, structured through a protocol and individualized through a risk assessment, targeted education, support, and skills training to address caregiving risk areas of safety, social support, problem behaviors, depression, and health through 12 individual in-home and telephone sessions and 5 telephone support group sessions. Staff members of the Memphis VA Medical Center, Memphis, Tennessee, collected data on burden, depression, health and healthy behaviors, caregiving frustrations, social support, dementia-related behaviors, and time spent providing care and on duty. RESULTS: From baseline to 6 months, caregivers reported significantly decreased burden, depression, impact of depression on daily life, caregiving frustrations, and number of troubling dementia-related behaviors. A 2-hour decrease in hours per day on duty approached significance. Caregivers (96%) believed that the program should be provided by the VA to caregivers. CONCLUSIONS: This clinical translation achieved outcomes similar to the REACH II randomized controlled trial, providing clinically significant benefits for caregivers of a veteran with a progressive dementing disease. This model of caregiver support can inform public policy in providing assistance to caregivers.
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Current evidence suggests that non-pharmacologic strategies, such as family care giver interventions, show greater effect than most drug treatments.
“With regard to management, current evidence suggests that non-pharmacologic strategies, such as family care giver interventions, show greater effect than most drug treatments.”
From Assessment and management of behavioral and psychological symptoms of dementia (2015) · cites this paper as [93]
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Self-citation
- Authors
- Nichols, L. O., Martindale-Adams, J., Burns, R., Graney, M. J., & Zuber, J.
- Affiliations
- Memphis VA Medical Center (US)
- University of Tennessee Health Science Center (US)
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2011-02-28
- Volume
- 171
- Issue
- 4
- Pages
- 353-9
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2015278479
- Cited by
- 172
- References
- 24
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 9 · 2023: 13 · 2022: 11 · 2021: 9 · 2020: 10 · 2019: 13 · 2018: 13 · 2017: 16 · 2016: 12 · 2015: 16 · 2014: 17 · 2013: 11 · 2012: 7
- FWCI
- 8.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- clinical translation, behavioral interventions, caregiver burden, caregiver depression, social support, veterans, home-based primary care
- MeSH terms
- Aged, Aged, 80 and over, Delivery of Health Care, Dementia, Female, Humans, Male, Social Support, Tennessee, Caregivers, Risk Assessment
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