Supporting caregivers of veterans with Alzheimer’s disease and traumatic brain injury: study protocol for a randomized controlled trial

Abstract

Background: Patients with Alzheimer's disease and related dementias (ADRD) and traumatic brain injury (TBI) and their caregivers require cognitive and behavioral symptom management, interdisciplinary care, support for caregivers, and seamless care coordination between providers. Caring for someone with ADRD or TBI is associated with higher rates of psychological morbidity and burden, social isolation, financial hardship, and deterioration of physical health. Tremendous need exists for primary care-based interventions that concurrently address the care needs of dyads and aim to improve care and outcomes for both individuals with ADRD and TBI and their family caregivers. Methods: The Aging Brain Care Acquiring New Skills While Enhancing Remaining Strengths (ABC ANSWERS) study is a randomized controlled trial that tests the effectiveness of an intervention based on two evidence-based programs that have been developed for and previously tested in populations with ADRD, TBI, stroke, and late-life depression and/or who have survived an intensive care unit stay. This study includes 200 dyads comprised of a veteran with a diagnosis of ADRD or TBI and the veteran's primary informal caregiver. Dyads are randomized to receive the ABC ANSWERS intervention or routine Veterans Health Administration (VHA) primary care with a standardized educational and resource information packet. Data collection occurs at baseline and three follow-up time points (3 months, 6 months, and 12 months). The primary outcome is caregiver quality of life (QoL). A secondary measure for the caregiver is caregiver burden. Secondary measures for both the veteran and caregiver include symptoms of depression and anxiety. Discussion: The ABC ANSWERS intervention integrates common features of an evidence-based collaborative care model for brain health while concurrently attending to the implementation barriers of delivering care and skills to dyads. We hypothesize that caregivers in dyads randomized to the ABC ANSWERS program will experience higher levels of QoL and lower levels of depression, anxiety, dyadic strain, and caregiver burden at 12 months than those receiving usual VHA primary care.

Caregiving Preparedness and Caregiver Burden in Omani Family Caregivers for Patients with Acquired Brain Injury

“…27 Other studies show that a high level of caregiving burden is associated with the patient's brain injury severity, low ability to perform activities of daily living, presence of a tracheostomy tube, and speech or swallowing disorders. 1,3,11,12,28 The present study, like previous ones, supports the observation that it takes time for the FCs to attain adequate preparedness or readiness to care for the patient with ABI at home. 10,29,30 Therefore, supportive interventions and deliberate training for FCs are needed to shorten the time and reduce the challenges faced in the process of achieving preparedness.…”

“…10 On the other hand, education programmes for FCs have been found to improve caregiver preparedness and well-being. 11 The caregiver role requires tolerance and commitment to meet the ABI patient's needs related to personal hygiene, dressing, nutrition, communication, emotional support, mobility, and safety, especially for patients with minimal physical capabilities. 12 Therefore, the FCs play a vital role in the recovery, rehabilitation, and community re-integration of a patient with ABI.…”

“… 10 On the other hand, education programmes for FCs have been found to improve caregiver preparedness and well-being. 11 …”

Contribution of neuropsychiatric symptoms in Parkinson’s disease to different domains of caregiver burden

“…Apathy may influence social relationships, including between the caregiver and care recipient [ 35 ]. Preemptive caregiver education and support could reduce caregiver social isolation and loneliness [ 36 , 37 ]. Several educational tools are available for PD patients and their caregivers, including materials developed via systematic approaches [ 38 ].…”

Advances and Perspectives in Dental Pulp Stem Cell Based Neuroregeneration Therapies

“…Neuroregenerative therapies have always been a priority for health research in developed countries due the overwhelming social, economic and dependency burdens suffered by both the affected patients and their close relatives [ 1 , 2 , 3 ]. The nervous system in humans possesses a very limited capacity of self-repair in the event of injury.…”