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Cited by 23Dementia and Cognitive Impairment ResearchNursing care and researchGeriatric Care and Nursing Homes

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Embedding Caregiver Support within Adult Day Services: Outcomes of a Multi-site Trial

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Gitlin, Laura N, Roth, David L, Marx, Katherine, Parker, Lauren J, Koeuth, Sokha, Dabelko-Schoeny, Holly, Anderson, Keith, Gaugler, Joseph E·2023·The Gerontologist
DOI 10.1093/geront/gnad107PMC PMC10943495
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Abstract

BACKGROUND AND OBJECTIVES: Adult day services (ADS) provide quality-of-life benefits to people with dementia, but few provide systematic caregiver support. We report outcomes of a multisite, national trial testing a staff-delivered caregiver program, ADS Plus. RESEARCH DESIGN AND METHODS: Cluster-randomized trial involving 34 ADS: 18 sites provided ADS (controls) and 16 provided ADS and ADS Plus (intervention). Trained staff met with caregivers to provide dementia education, support/validation, referrals/linkages, and strategies for care challenges and self-care over 12 months. Main outcomes included depressive symptoms (Center for Epidemiological Studies Depression Scale [CES-D]) and well-being at 6 and 12 months, and client attendance over 12 months. RESULTS: Of 203 caregivers (Intervention = 102; Control = 101), 5.9% at 3 months, 12.8% at 6 months, and 22.7% at 12 months were lost to follow-up. Caregivers were predominantly female (80.3%), with 76.4% identifying as White/Caucasian, 14.8% Black/African American, and 12.3% Hispanic/Latino. Most (88.2%) had ≥college education and were 65.0 years old (SD = 13.46). For those with 6-month data, 40.4% control and 40.2% ADS Plus caregivers had depressed symptoms (≥16 CES-D) at baseline. By 6 months, 43.6% control versus 34.2% ADS Plus caregivers had ≥16 scores (odds ratio = 0.38, p = .072). By 12 months, after covariate adjustments, ADS Plus caregivers reported reduced total depression scores versus controls (p = .013) and lower depressed affect scores (p = .015). Of 18 sites providing 12-month client attendance data, 9 intervention sites reported 126.05 days attended versus 78.49 days for 9 control sites (p = .079). DISCUSSION AND IMPLICATIONS: Compared with ADS alone, by 12 months, ADS Plus improved caregiver mood and increased ADS utilization by 60.6%. Results support ADS staff delivering evidence-based caregiver support to enhance ADS benefits. CLINICAL TRIAL REGISTRATION: NCT02927821.

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Metadata

Authors
Gitlin, L. N., Roth, D. L., Marx, K., Parker, L. J., Koeuth, S., Dabelko-Schoeny, H., Anderson, K., & Gaugler, J. E.
Affiliations
  • Drexel University (US)
  • Johns Hopkins University (US)
  • Age-Friendly Innovation Center, College of Social Work, The Ohio State University , Columbus, Ohio, USA
  • University of Mississippi (US)
  • University of Minnesota (US)
Corresponding author
Gitlin, Laura N
ORCID
Venue
The Gerontologist
Publisher
Oxford University Press (OUP)
Published
2023-08-07
Volume
64
Issue
4
ISSN
  • 0016-9013 (ISSN-L)
  • 1758-5341
DOI
10.1093/geront/gnad107
PMC
PMC10943495
OpenAlex
W4385621703
Cited by
23
References
0
Citations by year
2026: 5 · 2025: 8 · 2024: 9 · 2023: 1
FWCI
4.68
Type
journal article
Language
en
Open access
Licence
academic.oup.com/pages/standard-publication-reuse-rights (am)
Locations
  • The Gerontologist (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute on Aging (R01AG049692, K01AG066812)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Nursing › Research and Theory › Nursing care and research
  • Health Sciences › Medicine › Geriatrics and Gerontology › Geriatric Care and Nursing Homes
Keywords
adult day care, caregiver support, dementia, caregiver depression, caregiver well-being, dementia education, self-care strategies, quality of life, service utilization, multisite trials, caregiver education
MeSH terms
Aged, Dementia, Female, Humans, Male, Middle Aged, Quality of Life, Self Care, Caregivers

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