The effect on caregiver burden of a problem-based home visiting programme for frail older people. Supporting caregivers of frail older adults in an HMO setting. The effectiveness of a telephone support program for caregivers of frail older adults. Caregivers of frail rural older adults. Effects of an advanced practice nursing intervention. Health education groups for caregivers in an HMO. The PLUS intervention: a pilot test with caregivers of depressed older adults.
OBJECTIVE caregiver effects of geriatric care models focusing primarily at the patient have not been consistently studied . We studied caregiver effects of a nurse-led comprehensive geriatric evaluation and management ( GEM ) programme for community-dwelling frail older people that showed-in a r and omised comparison with usual care -- health-related quality of life benefits for the care receivers . METHODS this r and omised trial included 110 caregiver/patient dyads who were followed up for 6 months . Primary analyses were intention-to-treat analyses of caregiver burden assessed with Zarit Burden Interview  ( ZBI ; 0 - 88 ; higher means more burden ) . Preplanned subgroup analyses were conducted for cognition , living arrangement and patient/caregiver co-residence . RESULTS overall , perceived caregiver burden showed no significant differences between study groups in changes over time . However , perceived burden was at baseline more than eight points higher in caregivers sharing a household with patients ( n = 23 ) compared to caregivers living separately ( n = 87 ) . The intervention performed better in caregivers living together with the patient than in caregivers living separately ( P for interaction = 0.04 ) . Co-resident caregivers experienced six-Zarit point improvement compared with four-point deterioration in the non-co-resident caregivers . CONCLUSIONS GEM at home benefited patients , but maybe not caregivers . Caregiver effects are related to whether caregivers live with the patient or not The long-term effectiveness of a structured health education program ( HEP ) for spouses and frail older adults was evaluated in a staff model health maintenance organization ( HMO ) . HEP is a multicomponent group program that includes emotion-focused and problem-focused coping strategies , education , and support . For caregivers , HEP was more effective than usual care ( UC ) in reducing depression , increasing knowledge of community services and how to access them , and changing caregivers ' feelings of competence and the way they respond to the caregiving situation . For care recipients , HEP was more effective than UC in preventing increases in somatic symptoms and symptoms of anxiety/insomnia . ( ( c ) 2004 APA , all rights reserved PURPOSE The purpose of this study was to evaluate the effectiveness of a telephone support group program on spouses and adult child caregivers of frail older adults . DESIGN AND METHODS The Telephone Support Group ( TSG ) model is a multicomponent group program offered in 12 weekly , 90-minute group sessions . It includes emotion-focused and problem-focused coping strategies , education , and support . We recruited for this study 36 spouses and 61 adult children and r and omly assigned them to TSG or to usual services . We assessed the participants before and after the completion of TSG or usual services . RESULTS The results indicated that , for adult child caregivers , TSG was more effective than usual services in reducing burden , depression , social support , and pressing problems , and increasing knowledge and use of community services . We found no significant differences for spouse caregivers . IMPLICATION S This is the first study to compare the effectiveness of TSG for adult child and spouse caregivers of frail older adults .  TSG showed itself to be an effective means of delivering support to adult child caregivers of frail older adults but not to spouses . More research is needed about how to make TSG effective for spouse caregivers Informal caregivers are responsible for providing the majority of post-discharge care for many frail older adults in rural setting s. The purpose of this study was to investigate whether an advanced practice nurse ( APN ) intervention would promote more positive physical and emotional outcomes in caregivers of rural older adults who are frail and were recently discharged from urban-based hospitals . Thirty-two caregivers of frail rural elderly individuals were r and omly assigned to treatment ( APN intervention ) and control groups ( no APN intervention ) . Assessment s of caregiver outcomes were collected via telephone interviews at 48-hour , 2-week , and 4-week intervals after hospital discharge of the frail rural older adults . Outcomes were operationalized as caregiver physical health and well being , and stress and burden . The former was measured using the Health and Daily Living form ( HDL ) and the latter by the Thoughts and Feeling and Time and Energy subscales of the Caregiver Burden Inventory ( CBI ) . Additional information on caregiver problems and APN visit time was collected by the APN using the Omaha Classification System . Caregivers in the treatment group experienced significantly more positive physical and emotional health outcomes . The caregivers who received the APN intervention had higher self-rated emotional health scores , fewer emotional symptoms at Week 4 , fewer depressive symptoms at Week 2 and 4 , and lower Thoughts and Feelings stress scores at 48 hours than the control group . Findings support the importance of addressing the needs of caregivers post-discharge and the ability of APNs to improve post-discharge outcomes for home health care recipients and their caregivers The short-term effectiveness of a Health Education Group ( HEP ) intervention program for spouses of frail older adults was compared to the usual care ( UC ) offered to the spouses of frail older persons in a staff model health maintenance organization . HEP is a multicomponent group program offered in eight weekly , two-hour group sessions , and ten monthly , two-hour follow-up group sessions . It includes emotion-focused and problem-focused coping strategies , education , and support . One-hundred and five spouses were recruited and r and omly assigned to  HEP  ( n = 58 ) or  UC  ( n = 47 ) . Spouse caregivers and care recipients were assessed within two weeks of intervention and within two weeks after the completion of the eight weekly group meetings . The results indicate that , for caregivers , HEP was more effective than UC in reducing depression , maintaining social integration , increasing effectiveness in solving pressing problems , increasing knowledge of community services and how to access them , changing caregivers ' feelings of competence , and the way they respond to the care giving situation . No significant differences , however , were found between care recipients in the two arms of the study on any of the outcome measures The PLUS Nursing Intervention , which is aim ed at caregivers of elderly persons with depression and design ed to increase caregiver personal re sources , respond to caregiver learning/skill development needs , address caregiver unanticipated needs , and assist with caregiver stress/illness management , was pilot tested for efficacy . Thirteen families were assigned to the PLUS group and 12 families to the st and ard home care control group .  There were no significant outcome differences between the two groups . However , caregivers who received the PLUS intervention made significantly more improvements over St and ard Home Care caregivers when patients made functional improvements . Findings suggest that patient functioning might be a better predictor of long-term caregiver outcomes than psychiatric symptoms
Introduction Informal caregivers are important re sources for community-dwelling frail elderly .
But caring can be challenging .
To be able to provide long-term care to the elderly , informal caregivers need to be supported as well .
The aim of this study is to review the current best evidence on the effectiveness of different types of support services targeting informal caregivers of community-dwelling frail elderly .