Supporting Caregivers of Veterans with TBI and Mixed Dementia: The REACH Hope Behavioral Intervention
Abstract
Family members who care for Veterans with both traumatic brain injury (TBI) and dementia often have heavy burden. Previous studies have developed interventions to help family caregivers who provide care to Veterans with single health conditions, such as Alzheimer’s dementia. These interventions often provide face-to-face, one-on-one training. Their goal is to help the caregiver engage in good problem-solving or to take better care of themselves. These interventions can be tailored to meet the needs of the caregiver or Veteran, but they are often brief and scheduled ahead of time just as a medical appointment would be. As a result, there is little or no support between scheduled sessions. Caregivers can use computer- or smartphone-based caregiving strategies on their own. However, the information they provide is often not specific to the Veteran’s health condition or personalized in any way. Currently, there is no caregiving intervention that combines the strengths of one-on-one training with digital flexibility. In addition, there are no interventions for caregivers of Veterans with both TBI and dementia. The need is great. More Veterans are experiencing TBI and dementia now, and the rate will grow in the future. The Department of Veterans Affairs (VA) National Caregiver Center and Virginia Commonwealth University are partners in this project. They will develop and evaluate a one-on-one plus smartphone-based intervention, REACH Hope. The intervention will reduce burden among family members providing care to Veterans with both TBI and dementia. The study will combine two award-winning interventions. The first is the VA’s REACH VA (Resources for Enhancing All Caregivers Health). It will be coupled with the Department of Defense’s Virtual Hope Box mobile app. REACH VA and Virtual Hope Box have been shown to improve burden, depression, health, stress, or coping skills. REACH Hope has good potential to reduce caregiving burden. The REACH VA component involves training in problem-solving and stress management skills one-on-one from a trainer. It will be personalized to address Veteran-specific situations that create burden. The customizable Virtual Hope Box app will provide anytime access to personalized audio, video, mindfulness exercises, activity planning, and inspirational quotes. These tools can meet caregiver needs during and beyond the REACH Hope intervention. Caregivers of Veterans with TBI and dementia and caregiving researchers will work together to modify REACH Hope for this specific Veteran caregiving population. This study will test the ability of REACH Hope to improve caregivers’ burden, depression and anxiety, and confidence in themselves as caregivers, as well as Veteran safety. We expect that REACH Hope caregivers will improve, with a primary focus on reducing caregiver burden. We will compare caregivers of Veterans with both TBI and dementia who receive REACH Hope to a group of caregivers who do not receive REACH Hope until the end of the study. We will nationally recruit 110 caregivers of Veterans with TBI and either Alzheimer’s or Mixed Dementia. Half will receive REACH Hope at the beginning of the study and half at the end of the study. Outcomes will be measured at the start of the study, 3 months later (end of treatment), and 6 months later (3 months after treatment). The proposed REACH Hope caregiver intervention will establish a new intervention model. This model will include one-on-one personalized training by telephone and mobile smartphone support. REACH Hope has the potential to improve the burden of care for caregivers of Veterans with TBI and dementia. It could also help caregivers of Veterans with other chronic conditions.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Mar 10, 2021
- Source ID
- W81XWH2010756
Entities
People
- Linda Nichols
Organizations
- Memphis VA Medical Center
- United States Army