The Department of Veterans (VA) is expanding support nationally to caregivers of Veterans with Alzheimer’s disease. A pilot program of the REACH VA (Resources for Enhancing Alzheimer’s Caregiver Health in VA) program showed great success in reducing stress on caregivers while improving care outcomes for the Veterans....Alzheimer's Reading Room
REACH Program Improves Quality of Life for Caregivers and Veterans
“The REACH VA model exemplifies the many different kinds of support VA offers to the caregivers of Veterans,” said Secretary of Veterans Affairs Eric K. Shinseki. “This program has been proven to provide the right resources, training and a renewed focus on personal health that can make a world of difference to those caregivers and their Veterans.”
“Caregivers step up every day to serve Veterans they love who sacrificed to defend our Nation,” Shinseki added. “To them, caregiving is a labor of love and devotion, but that alone does not ease the burden and personal stress placed on those who provide daily care for the disabled.”
REACH VA involved 127 caregivers connected to 24 VA medical centers. The median age for the caregiver was 72 and the majority of the participants were spouses.
Typical issues caregivers face when caring for Veterans with Alzheimer’s disease and dementia include memory problems, behavior problems and the need to provide basic attendance such as grooming assistance. Caregivers typically reported feeling overwhelmed, frustrated, cut off from family and friends, lonely, prone to bouts of crying and having worse physical health than the year before.
For six months, the REACH VA caregivers were provided 12 individual in-home and telephone counseling sessions; five telephone support group sessions; a caregiver quick guide with 48 behavioral and stress topics; education on safety and patient behavior management; and training for their individual health and well being.
Caregivers saw their burden reduced; drops in depressive symptoms and their related daily impacts; fewer frustrations, including those that have clinical potential for abuse; and decreases in dementia-related behaviors from the Veterans they cared for. Caregivers also reported they were able to spend fewer hours per day devoted to caregiving duties.
“Dementia caregiving is such an all encompassing task,” said Dr. Linda Nichols from the VA medical center in Memphis, Tenn., and co-author of a recent study on the program. “The intervention provided time for themselves, which caregivers never have enough of. REACH VA improved our caregivers’ knowledge to manage care, made them feel more confident and competent as they formed bonds with the VA staff supporting them, and decreased the inevitable feelings of isolation and loneliness that come from a selfless, but very sacrificial duty of care.”
VA will roll out REACH VA on a national basis through home-based primary care programs across the country. In addition, the program will be modified to assist caregivers of Veterans with other diagnoses like spinal cord injury and traumatic brain injury.
“Providing support to caregivers who sacrifice so much to allow Veterans to remain at home surrounded by loved ones is the right thing for VA to do,” said Dr. Robert Petzel, VA’s under secretary for health.
An article on the REACH VA program is being published in the Feb. 28 issue of the Archives of Internal Medicine. Nichols and Dr. Jennifer Martindale-Adams, also from VA’s Memphis facility, are the lead authors and based the VA pilot on the National Institute on Aging and the National Institute for Nursing Research funded REACH II study. REACH VA is the first national clinical implementation of a proven behavioral intervention for stressed and burdened dementia caregivers.
Local caregiver support coordinators are available to assist Veterans of all eras and their caregivers in understanding and applying for VA’s many caregiver benefits. VA also features a website, www.caregiver.va.gov, with general information on REACH VA and other caregiver support programs available through VA and the community.
Caregivers at a Glance
- 54 Million adults in the US provide unpaid care to an adult family member or friend
- Over two-thirds are women
- 45% are age 18-49
- 40% are age 50-64
- More than half are married
- Approximately three-fourths have worked while caregiving
- Over 40% say they did not have a choice in taking on the caregiver role
- A majority assist their loved one with at least one activity of daily living (usually helping the person in and out or bed and chairs)
- Over 50% experience medium to high levels of stress as a result of the demands of their role as a caregiver
- One-quarter say they have a difficult time coordinating care with health care professionals or service providers
*National Alliance for Caregiving and American Association of Retired Persons Survey - 2009
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Original content Bob DeMarco, the Alzheimer's Reading Room