PURPOSE: This study determined whether the NYU Caregiver Intervention, adapted in Minnesota for adult child caregivers (NYUCI-AC), prevented or delayed residential care placement for persons with dementia. Design and METHODS: A single-blinded randomized controlled trial design was used. One hundred and seven adult child caregivers of persons with dementia were randomly assigned to the NYUCI-AC treatment group who received individual and family counseling, support group referral, and ad hoc consultation or a contact control group. Participants were asked to complete structured assessments quarterly during Year 1 and every 6 months thereafter for a minimum of 2 years. RESULTS: Two thirds (66%) of adult child caregivers in the control condition admitted their parent to a residential care setting compared with 37% in the treatment condition. Logistic regression and Cox proportional hazards models found that NYUCI-AC participants were significantly less likely (p < .05) to admit their parents to a residential care setting and delayed their parents’ time to admission significantly longer (228.36 days longer on average) than those in the control group. Implications: The multicomponent NYUCI-AC offered adult children the psychosocial support required to continue providing care to cognitively impaired parents at home.
<b>OBJECTIVES: </b>This study determined whether the NYU Caregiver Intervention for Adult Children (the NYUCI-AC) significantly reduced depressive symptoms and improved quality of life for adult child caregivers of persons with dementia.<b>METHODS: </b>The NYUCI-AC was evaluated within a single-blinded randomized controlled trial. The sample included 107 adult child caregivers of persons with dementia (N = 54 assigned to the multi-component treatment group; N = 53 assigned to a contact control group). Participants completed comprehensive assessments every 4 months during the first year and every 6 months thereafter for at least 2 years and up to 3.79 years.<b>RESULTS: </b>Individual growth curve models found that caregivers in the NYUCI-AC treatment condition indicated statistically significant (p <0.05) curvilinear decreases in symptoms of depression indicating withdrawal, apathy, and lack of vigor and increases in perceptions of overall quality of life over a 3-year period in comparison to control caregivers.<b>CONCLUSIONS: </b>The NYUCI-AC offered adult child caregivers the capacity, via individual and family counseling as well as ongoing support, to enhance their quality of life and overcome their social withdrawal and apathy over time. These findings lend additional support to the NYUCI as an evidence-based approach to support family caregivers of persons with dementia.
Purpose of the STUDY: This study determined whether the NYU Caregiver Intervention for Adult Children (the NYUCI-AC) significantly reduced primary subjective stress for adult child caregivers of persons with dementia. Design and METHODS: The NYUCI-AC was evaluated within a single-blinded randomized controlled trial. The sample included 107 adult child caregivers of persons with dementia (n = 54 assigned to the multicomponent treatment group; n = 53 assigned to a contact control group). Participants completed comprehensive assessments at baseline and at 4-month intervals during the first year and every 6 months thereafter. The focus of the current analysis was on the effects of the NYUCI-AC on change in primary subjective stress over 8, 12, and 18 months. RESULTS: Individual growth curve models found that caregivers in the NYUCI-AC treatment condition indicated statistically significant (p < .05) linear declines in overall negative reactions to behavior problems over a 1-year period when compared with controls. Adult child caregivers in the NYUCI-AC also indicated greater decreases in negative reactions to disruptive behavior problems when compared with controls over 8, 12, and 18 months. Implications: The NYUCI-AC offered adult child caregivers counseling and support that improved their ability to manage their reactions to disruptive behaviors. This occurred despite the fact that other primary subjective stressors, such as role captivity and role overload, were not reduced.
BACKGROUND AND OBJECTIVES: Many evaluations of nonpharmacologic interventions for family members of persons with Alzheimer's disease or related dementias (ADRDs) exist, but few consider effects on outcomes that are pertinent to caregivers' roles and relationships. The current study evaluated the efficacy of the New York University Caregiver Intervention-Adult Child (NYUCI-AC) on perceptions of family conflict, role conflict (effects of family caregiving and time, family, and social life), and perceived social support for adult child caregivers of relatives with ADRD over a 3-year period.
RESEARCH DESIGN AND METHODS: A single-blinded randomized controlled trial design was used. One-hundred and seven adult child caregivers were enrolled in the NYUCI-AC and randomly assigned to a treatment or contact control group. Assessments were scheduled to be completed every 4 months during the first year of participation and every 6 months thereafter for up to 3 years. Individual growth curve models were utilized to ascertain the effects of the NYUCI-AC on change in family conflict, role conflict, and perceptions of social support.
RESULTS: Among the entire sample, role conflict significantly (p < .05) declined and satisfaction with instrumental assistance increased over the course of the study, whereas family conflict slightly increased over the initial study period and then declined slightly. The findings indicated that the NYUCI-AC did not exert statistically significant effects on changes in family conflict, role conflict, or perceptions of social support over the 3-year study period.
DISCUSSION AND IMPLICATIONS: Although the clinical content of some dementia caregiver interventions is tailored to the specific needs of each caregiver and family, the outcomes selected to judge the efficacy of these interventions might not follow similar principles. Incorporating clinical content and evaluation outcomes that are family-centered will help to advance the state of the art of dementia caregiving interventions.
Purpose of the STUDY: A noted limitation of dementia caregiver intervention research is a lack of focus on the mechanisms of successful programs. The purpose of this study was to conduct a process evaluation of the New York University Caregiver Intervention-Adult Child (NYUCI-AC) to describe its delivery and determine which of its components were associated with key outcomes (caregiver stress and well-being; care recipient residential care admission). Design and METHODS: Adult child caregivers randomly assigned to receive the NYUCI-AC intervention (n = 54) were included. Detailed data on the frequency and duration of each intervention component received, 4-month review checklists, and regular caregiver assessments were collected. Quantitative (descriptive, logistic regression, Cox proportional hazards models, growth curve models) and qualitative thematic analyses were performed. RESULTS: Adult children receiving the NYUCI-AC completed a mean of 5.19 individual and family counseling sessions; it took on average a little over 11 months to do so. All NYUCI-AC counseling components were generally well-received and improved caregivers' management of care-related stress. The individual counseling sessions' clinical benefits in reducing primary subjective stress were most apparent in the first year of the intervention. Caregivers who experienced negative outcomes over time used more family sessions. Implications: A key mechanism of benefit for adult child caregivers in the NYUCI-AC was the frequent use of individual counseling sessions. The qualitative and quantitative results emphasize the value of the NYUCI-AC's flexibility in allowing adult child caregivers to choose the timing and use of specific intervention components.
This study determined whether the NYU Caregiver Intervention, adapted in Minnesota for adult child caregivers (NYUCI-AC), prevented or delayed residential care placement for persons with dementia. Design and
METHODS:
A single-blinded randomized controlled trial design was used. One hundred and seven adult child caregivers of persons with dementia were randomly assigned to the NYUCI-AC treatment group who received individual and family counseling, support group referral, and ad hoc consultation or a contact control group. Participants were asked to complete structured assessments quarterly during Year 1 and every 6 months thereafter for a minimum of 2 years.
RESULTS:
Two thirds (66%) of adult child caregivers in the control condition admitted their parent to a residential care setting compared with 37% in the treatment condition. Logistic regression and Cox proportional hazards models found that NYUCI-AC participants were significantly less likely (p < .05) to admit their parents to a residential care setting and delayed their parents’ time to admission significantly longer (228.36 days longer on average) than those in the control group. Implications: The multicomponent NYUCI-AC offered adult children the psychosocial support required to continue providing care to cognitively impaired parents at home.
