An Awareness Toolkit Intervention for Alzheimer Caregivers: Randomized Group Comparison Study

Background:

Over 7 million Americans aged 65 and older live with Alzheimer’s in the United States, and more than 11 million caregivers of people with Alzheimer’s disease or other dementias provided an estimated 18 billion hours of unpaid care valued at $340 billion (Alzheimer’s Association, 2023). Data revealed that individuals with dementia initially required 151 hours of caregiving per month, which subsequently escalated to 283 hours per month over an eight-year period (Jutkowitz et al., 2020). In this study, the researchers devised and implemented a new intervention called "Awareness Toolkit" for Alzheimer's caregivers. This toolkit comprises Alzheimer’s disease-related education, community resources, and caregiver support tailored to the community where care is administered, incorporating tips for caregiver self-care and coping. The aim of this study is to evaluate the impact of the Awareness Toolkit intervention and examine its influence on Alzheimer caregivers’ perceived preparedness, burden, and personal growth.

Methods:

A master list comprising 260 eligible patients diagnosed with Alzheimer’s dementia, along with their caregivers, was compiled from the database of primary care practices in Eastern Pennsylvania. Randomly assigned caregivers in the Intervention group were informed about the Awareness Toolkit intervention, supplemented with a case management service, in early September 2023. Conversely, randomly assigned caregivers in the Control group received this intervention upon the study's conclusion. A survey questionnaire was distributed to Alzheimer's caregivers in both groups in early October 2023 to evaluate the impact of the Awareness Toolkit intervention, focusing on whether it helped them feel more prepared, reduced their burden, and facilitated personal growth. A total of 52 completed surveys were returned, comprising 28 surveys from the Intervention group and 24 surveys from the Control group. The three measurements were used to measure levels of caregiver burden, preparedness, and growth: 1) the Zarit Caregiver Burden Assessment (Zarit et al., 2001); 2) the Preparedness for Caregiving Scale (Archbold et al., 1990); and 3) the Posttraumatic Growth Inventory Short Form (Cann et al., 2010).

Results:

There was a significant difference in the preparedness scores between the intervention group (M=2.2, SD=.67) and the control group (M=1.8, SD=.70); t(47)=1.9, p=.032. Female caregivers showed a higher level of posttraumatic growth than that of male caregivers (p=.003). The results of the regression analysis indicated the two predictors explained 20% of the variance; R² =.36, F(6,43)=3.52, p=.007. It was found that receiving the Awareness Toolkit intervention significantly predicted caregiver’s preparedness (β=.31, p=.02).

Implications:

The results of this study underscore the value of an Awareness Toolkit intervention for Alzheimer's caregivers, providing essential preparation and support across the progression of the disease. The gender differences in the findings aligned with previous research. Prior literature indicates that female caregivers tend to exhibit a higher level of posttraumatic growth, along with a greater inclination towards positive reappraisal and positive self-talk compared to their male counterparts (Li et al., 2021; Rausch et al., 2008; Tamres et al., 2002). Presenters will demonstrate the practical application of the Awareness Toolkit intervention and discuss its implications for practice settings.