Impact of a multicomponent support services program on informal caregivers of adults aging with disabilities

Study Aim/Purpose: The aim of this study was to evaluate the impact of a multi-component support program for caregivers of adults with aging Veterans with disabilities, implemented through a Veterans Administration site in Tampa Florida. The program included 24-hr in-home respite care, caregiver group support, and education/skills training. Caregivers had the option to receive services for 14 consecutive days. 

Summary of Methods: Researchers used a pre-/post design involving interviews with a sample of 42 veteran/caregiver dyads prior to the receipt of services and two weeks after program use. Data were collected on caregiver and veteran care recipients’ demographic and health characteristics, caregiver satisfaction with support services (using the Client Satisfaction Questionnaire), caregiver perceived physical and mental health status (using the SF-12 to measure physical and social functioning, role limitations, pain, vitality, distress and well-being), positive aspects of caregiving (using the Positive Aspects of Caregiving Instrument),and caregiver burden (using the Zarit Caregiver Burden scale). 

Summary of Key Results: Participants in the study used an average of 10 days of in-home respite services, with use ranging from 1-13 days. Caregivers reported high satisfaction with services and “the use of services over consecutive days was a consistent positive comment that caregivers made (open-ended responses) with regard to the helpfulness of the program.” Caregiver mental health improved significantly from pre to post-test. While mean caregiver burden did not show statistically significant improvement, bivariate analyses comparing “clinically meaningful improvement in burden (4 points on the Zarit scale) versus no clinically meaningful improvement showed that a statistically greater proportion of women experienced a clinically meaningful improvement in caregiver burden than women who did not.” Multivariate analyses found that worse physical health of the care recipient at program onset was significantly associated with the caregiver experiencing a clinically meaningful improvement in burden. There was also a trend toward a clinically meaningful improvement in burden for caregivers who had provided care for a long duration of time. Other measures did not differ significantly from pre to post-test. 

Study Limitations: The authors cited the short follow-up period, small sample size, and lack of a control group as limitations of the study design. 

Authors’ Discussion/Conclusions: The study findings “can be used to identify and target veteran/caregiver dyads within which a short-term, yet consecutive break with support services (including 24-hr respite) offered in the home would meaningfully improve caregiver burden. Additional research is needed to understand the long-term health status outcomes for caregivers who benefitted from a short-term break over consecutive days.” The authors suggest “a larger prospective randomized trial is needed to examine outcomes for caregivers and care recipients participating in this kind of program and to identify which components have the largest impact.”