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Effects of the home environmental skill-building program on the caregiver-care recipient dyad: 6-month outcomes from the Philadelphia REACH Initiative
Abstract
PURPOSE: We examine 6-month effects of the Environmental Skill-Building Program on caregiver well-being and care recipient functioning and whether effects vary by caregiver gender, race (White or non-White), and relationship (spouse or nonspouse). DESIGN AND METHODS: We enrolled 255 family caregivers of community-residing persons with Alzheimer's disease or related disorders, of whom 190 participated in a follow-up interview. Caregivers were randomized to a usual care control group or intervention group that received five home contacts and one telephone contact by occupational therapists, who provided education, problem-solving training, and adaptive equipment. Baseline and 6-month follow-up included self-report measures of caregiver objective and subjective burden, caregiver well-being, and care recipient problem behaviors and physical function. RESULTS: Compared with controls (n = 101), intervention caregivers (n = 89) reported less upset with memory-related behaviors, less need for assistance from others, and better affect. Intervention spouses reported less upset with disruptive behaviors; men reported spending less time in daily oversight; and women reported less need for help from others, better affect, and enhanced management ability, overall well-being, and mastery relative to control group counterparts. Statistically significant treatment differences were not found for hours helping with instrumental activities of daily living, upset with providing assistance with instrumental activities of daily living and activities of daily living, perceived change in somatic symptoms, White versus non-White caregivers, or care recipient outcomes. IMPLICATIONS: The Environmental Skill-Building Program reduces burden and enhances caregiver well-being in select domains and has added benefit for women and spouses.
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“A review including seven RCTs showed that OT interventions may maintain physical function and ADL in community-dwelling persons with dementia (105, 122).”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [122]
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Metadata
- Authors
- Gitlin, L. N., Winter, L., Corcoran, M., Dennis, M. P., Schinfeld, S., & Hauck, W. W.
- Affiliations
- Thomas Jefferson University (US)
- Corresponding author
- Gitlin, Laura N.
- Venue
- The Gerontologist
- Publisher
- Oxford University Press (OUP)
- Published
- 2003-08
- Volume
- 43
- Issue
- 4
- Pages
- 532-546
- ISSN
- 0016-9013 (ISSN-L)
- 1758-5341
- OpenAlex
- W2136216460
- Cited by
- 271
- References
- 47
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 7 · 2023: 7 · 2022: 9 · 2021: 10 · 2020: 10 · 2019: 7 · 2018: 11 · 2017: 9 · 2016: 17 · 2015: 22 · 2014: 16 · 2013: 14 · 2012: 14
- FWCI
- 29.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Gerontologist (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (U01AG013265)
- Topics
- Health Sciences › Nursing › Research and Theory › Nursing care and research
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Geriatrics and Gerontology › Geriatric Care and Nursing Homes
- Keywords
- family caregivers, Alzheimer's disease, caregiver burden, caregiver well-being, home modification, occupational therapy intervention, gender differences in caregiving, spousal caregivers, behavioral problems, instrumental activities of daily living
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Alzheimer Disease, Female, Health Education, Home Nursing, Humans, Male, Middle Aged, Social Support, Stress, Psychological, Philadelphia, Caregivers
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