Author contributions: Chiu M was responsible for study design, data collection and analysis, and wrote the introduction, methods and results sections of the manuscript; Wesson V wrote the introduction, discussion and comments sections, is a co-developer of the CARERS program and has delivered the intervention to carers; Sadavoy J is the founding Reitman Centre program director, designed the intervention and evaluation framework, supervised the study design and edited the manuscript. Supported by Abstract AIM:To study the effectiveness of Reitman Centre "Coaching, Advocacy, Respite, Education, Relationship, and Simulation" (CARERS) program, which uses problem-solving techniques and simulation to train informal dementia carers. METHODS:Seventy-three carers for family members with dementia were included in the pilot study. Preand post-intervention data were collected from carers using validated measures of depression, mastery, role captivity and overload, caregiving competence and burden, and coping styles. To assess program effectiveness, mean differences for these measures were calculated. One-way ANOVA was used to determine if change in scores is dependent on the respective baseline scores. Clinical effects for measures were expressed as Cohen's D values. RESULTS:Data from 73 carers were analyzed. The majority of these participants were female (79.5%). A total of 69.9% were spouses and 30.1% were children of the care recipient. Participants had an overall mean age of 68.34 ± 12.01 years. About 31.5% of participating carers had a past history of psychiatric illness (e.g. , depression), and 34.2% sustained strained relationships with their respective care recipients. Results from carers demonstrated improvement in carers' selfperception of competence (1.26 ± 1.92, P < 0.0001), and significant reduction in emotion-focused coping (measured by the Coping Inventory of Stressful Situations, -2.37 ± 6.73, P < 0.01), Geriatric Depression scale (-0.67 ± 2.63, P < 0.05) and Pearlin's overload scale (-0.55 ± 2.07, P < 0.05), upon completion of the Program. Secondly, it was found that carers with more compromised baseline scores benefited most from the intervention, as they experienced statistically significant improvement in the following constructs: competence, stress-coping style (less emotion-oriented), sense of mastery, burden, overload. CONCLUSION:Study results supported the effectiveness of the CARERS Program in improving caregiving competence, stress coping ability and mental well-being in carers caring for family members with dementia. Chiu M et al . Piloting the Reitman Centre CARERS Program comprehensive package of evidence-based interventions for informal carers comprised of 3 integrated components: group psychotherapy, Problem-Solving Techniques and skill acquisition for specific current challenging interactions in caregiving. The demonstrated outcomes are reduction of emotion-based coping, enhanced mastery, and reduced burden. The Program is structured, and requires active participation of carers as they acqu...
Spousal caregivers of persons with dementia often have difficulty engaging persons with dementia in leisure activities. This qualitative descriptive study identifies how caregivers perceive their spouses' participation in leisure activities since dementia onset and the professional guidance caregivers require to increase persons with dementia participation in shared leisure activities. Nine spousal caregivers from a hospital-based caregiver intervention attended one of three focus groups. Using symbolic interactionism and selective optimization with compensation theory as guiding frameworks, thematic content analysis was performed. Three major themes were identified: Recognizing and acknowledging changes, Making sense of changes and conflicts, and Embracing changes and forging ahead. Findings can be used by healthcare providers to better understand caregivers' needs for engaging persons with dementia in shared leisure activities, and inform development of feedback protocols to enhance caregiver interventions.
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.
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