Practice of Acceptance, Awareness, and Compassion in Caregiving (PAACC)
Abstract
Rationale: Alzheimer’s disease and related dementias (AD/ADRD) and traumatic brain injury-related dementia (TBI-AD) are major public health problems, with more individuals being diagnosed with these conditions each year. Both conditions share a range of common behavioral/mood symptoms including depression, agitation, sleep disturbance, and cognitive changes such as difficulties with memory, attention, and language. Nearly 60% of caregivers of individuals with AD/ADRD and TBI-AD experience high levels of burden, and more than a third report clinically significant symptoms of depression. Caregiver stress impacts the quality of life of both the caregiver and the care recipient. Current research supports the effectiveness of multi-component interventions over single component treatments to reduce caregiver burden. At this point in time, there are very few empirically supported clinical interventions that can effectively decrease the burden experienced by these caregivers. One of these is Resources for Enhancing Alzheimer’s Caregiver Health (REACH). REACH has been translated into REACH-VA, to be used with Department of Veterans Affairs (VA) patients and their caregivers. REACH-VA provides education about the illness, teaches skills to manage behaviors and to reframe negative thoughts, and encourages healthy self-care behaviors. Caregivers often find it difficult to reframe and change their negative thoughts while experiencing increasing stress with progression of the care recipient’s illness. This study aims to build upon the success of existing evidence and examine a multi-component mindfulness-based caregiver intervention called Practice of Acceptance, Awareness, and Compassion in Caregiving (PAACC). Mindfulness enables caregivers to re-perceive their thoughts and feelings in a less judgmental, more compassionate, and accepting manner. Objective: The primary objectives of this project are (1) to evaluate the effectiveness of PAACC in the reduction of burden in caregivers of individuals with AD/ADRD and TBI-AD, and (2) to compare mindfulness-based PAACC with the cognitive behavior-based REACH-VA intervention. PAACC incorporates caregiver education regarding the symptoms of AD/ADRD and TBI-related AD, positive health behavior promotion, mindfulness practice for stress reduction, mindful compassion, and problem-solving skills for managing the care recipient’s challenging dementia-related behaviors. PAACC will also have a positive impact on caregiver health, the care recipient’s problem behaviors, family dynamics, and the quality of life of both caregivers and care recipients. This study will examine the effectiveness of PAACC, as compared with REACH-VA, in burdened caregivers of individuals with AD/ADRD or TBI-related AD. Caregivers in REACH-VA will receive four in-person sessions providing education about the illness, identifying problem behaviors of the care recipient, encouraging healthy self-care, developing problem-solving skills, and promoting cognitive restructuring of negative thoughts. REACH-VA does not offer tools to reduce the caregiver’s feelings of personal enmeshment with the care recipient. Caregivers enrolled in the PAACC intervention will receive four in-person sessions providing education about the illness, identifying problem behaviors of the care recipient, encouraging healthy self-care, developing problem-solving skills, and facilitating mindfulness-based stress reduction exercises. This study will compare the impact of PAACC versus REACH-VA on caregiver depression, burden, self-care, social support, and problem behaviors of the individual with AD/ADRD or TBI-AD by measuring these outcomes before and after the treatment. There are enormous benefits to increasing treatment options for caregivers. PAACC is a particularly appealing option based on the existing evidence related to the needs of caregivers. By including several effective components of education, skills building, and mindful
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1710326
Entities
People
- Mamta Sapra
Organizations
- United States Army