Effects of Respite care training on respite provider knowledge and confidence and outcomes for family caregivers receiving respite services

Author(s): Ackerman, L. and Sheaffer, L.

Published In: Home Health Care Services Quarterly, Feb 9: 1-20

Study Aim/Purpose: This article presents the results from a large nationwide evaluation of the Respite Education and Support Tools (REST) respite provider training program. 

Summary of Methods: The first component of the study was a pre/post design including 895 trainees who participated in 126 different REST training workshops between June 2014 and June 2017 in 18 different states. The pre-training survey collected demographic information and Likert scale questions about perceived respite knowledge and confidence. The post-training survey included objective measures of respite knowledge on ten core areas of respite care. Repeated measures mixed ANOA tests were performed to analyze changes in knowledge and confidence. The second study component surveyed 102 family caregivers six months after their respite care provider had received training, using a modified version of a respite efficacy questionnaire developed by ARCH. This survey asked caregivers to rate their actual and anticipated wellbeing at 3 time points: 1) before respite; 2) while respite was being received; and 3) if respite were to end. Caregivers were asked to rate their stress level, general health status, opportunities to engage in desired social/recreational activities, and likelihood of placing the care recipient in out-of-home care. The survey also listed 12 common stress-related health symptoms and asked caregivers how many of these they experienced before respite and while receiving respite. 

Summary of Results: The authors found significant improvements in respite provider knowledge and confidence after training, regardless of trainees’ prior respite experience and professional background. Additionally, 84 percent of respondent trainees achieved satisfactory respite knowledge after training completion. With regard to family caregiver outcomes, the study found significantly lower self-reported stress, general health problem status, and out-of-home placement risk, and more opportunities for caregivers to engage in social/recreational opportunities during the period of respite receipt compared to before respite was received and what caregivers assumed would occur if respite ended. 

Study Limitations (as cited by authors): The authors note that the study findings have limited generalizability due to the lack of comparison groups and their use of use of a one-time survey for caregivers to self-report changes in their well-being pre/post provider training. 

Authors’ Discussion/Conclusions: The authors recommend that researchers, practitioners and policy makers work together to develop programs and policies that reflect the positive findings on REST’s effects. They also recommend additional research to examine the effects of varied aspects of respite program delivery on caregiver outcomes, the use of clinical and biomarkers of caregiver stress and health status as well as a focus on how respite care quality impacts the care recipient and larger family system.