Optimization of Powerful Tools for Dementia Caregivers

Sponsorship Type: State-Funded, Florida Department of Health, Health Resources and Services Administration
Research Type: Human Subjects 
Impact: National

Photo courtesy of the Lincoln Herald.

As Alzheimer’s disease and other dementias progress, behavioral expressions such as agitation, wandering, aggression, and changes in mood become more severe. These behavioral and psychological symptoms of dementia decrease quality of life, are linked to a faster progression of the disease, and increased costs of care. Caregivers often become overwhelmed and burdened by these behavioral manifestations, which precipitate the placement of adults with dementia in nursing homes. These behaviors are often managed with antipsychotics, but the off-label use of these medications is linked to severe adverse effects, including death. There is thus an urgent need to identify alternative treatments that are safe and effective.

Family caregiver trainings and similar non-pharmacological interventions have shown some promise in addressing behavioral expressions. This study aimed to conduct a clinical trial to evaluate and enhance the clinical translation of a caregiver psychoeducational training. The intervention, Powerful Tools for Caregivers, is a 6-week, scripted educational program for family caregivers implemented in a group setting led by two trained group leaders. Powerful Tools for Caregivers is recognized as an evidence-based program by the Administration for Community Living, Administration on Aging.

As part of a funded cooperative agreement with the Health Resources and Services Administration (HRSA), we trained new group leaders and implementing the Powerful Tools for Caregivers program in communities across Florida. This study then tested whether the intervention reduces caregivers’ stress and improves self-care, coping skills, and quality of life as well as whether the intervention reduces care recipients’ behavioral expressions. Beyond the 6-week program, the study looked at the efficacy of follow-up reinforcement strategies. The project also examined the translational impact of training different types of group leaders, including lay caregivers, master-level social work students, and healthcare professionals.

The results of this study were published in an article in The Journal of the American Medical Directors Association in August 2020.

Dr. Antonio Terracciano