Multi-Component Support Program Helps Lessen Burden for Caregivers of Aging Veterans with Disabilities
The need for healthcare services in the home continues to increase as greater numbers of Veterans age with long-term disabilities. Moreover, the conditions for which Veterans need care (e.g., traumatic brain injury, spinal cord injury) may differ from those affecting other populations receiving home care, and they are often complicated by comorbid mental illness (e.g., depression, anxiety disorders). To ensure the availability of adequate assistance services for Veterans and their caregivers, the Veterans Benefits, Health Care, and Information Technology Act of 2006 required VA to evaluate the "feasibility and advisability" of approaches to improve and expand caregiver assistance services to Veterans and their caregivers. In response, a support services program was initiated for caregiver/Veteran dyads, with services that were previously unavailable to caregivers of Veterans. A multi-component support services program that allowed Veterans aging with a disability to remain in the home, while also addressing the unmet needs of caregivers, was implemented and evaluated in one VA facility in 2009. Caregiver support/respite services included assistance with ADLs/IADLs, meal preparation, light housekeeping, personal care, and medication administration, offered 24 hours/day for a consecutive two-week period. Forty-two Veteran/caregiver dyads participated. Caregivers also were offered the opportunity to participate in support groups. Caregiver participants included the primary informal (non-paid) caregiver (mostly female spouses) of a Veteran. Caregivers were interviewed at baseline and after program use (follow-up). Investigators assessed demographics, as well as physical, mental, and general health, in addition to caregiver burden and satisfaction with support services.
- Caregivers experienced meaningful improvements in burden after support services were rendered.
- Although there were no changes in caregivers' physical health status, the support services program had a positive impact on mental health that was reflected in significant improvements in caregiver scores on the mental health components of the SF-12 health status scale.
- Satisfaction with services increased from baseline to follow-up (at follow-up the satisfaction score was 29 out of a possible high score of 32).
- Due to these favorable findings, since the end of this study, revisions to the VA Respite Policy have been made to ensure that an in-home option is available to interested Veterans and caregivers.
- Follow-up assessements were completed within two weeks of completion of services, which may reflect only an immediate impact of care provision.
- Sample sizes were small, and a control group was not included.
This study was funded by VA's Office of Patient Care Services. Drs. LaVela and Weaver, and Mr. Miskevics are part of HSR&D's Center for Management of Complex Chronic Care, Hines, IL.
LaVela SL, Johnson B, Miskevics S, and Weaver FM. Impact of a Multi-Component Support Services Program on Informal Caregivers of Adults Aging with Disabilities. Journal of Gerontological Social Work February 2012;55(2):160-174.