Stanford Pilot Program For At-Home Caregivers Of Veterans Seeks Participants

Main Category: Caregivers / Homecare
Also Included In: Veterans / Ex-Servicemen
Article Date: 13 Mar 2009 - 6:00 PDT

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Researchers at the Stanford University School of Medicine are recruiting participants for a pilot program aimed at improving at-home caregiving for U.S. veterans. The study will assess the effectiveness of an online workshop that provides training to at-home caregivers of veterans who suffer from traumatic brain injury, post-traumatic stress disorder, Alzheimer's disease or other forms of dementia. Veterans who are caring for people with these disorders are also eligible.

The six-week-long workshop, called "Building Better Caregivers," will train informal caregivers, such as family members and friends, how to not only provide better care, but also to manage their own emotions, stress and physical health. The interactive online workshop will also provide a forum in which small groups of caregivers can share personal experiences and insights on solving problems, handling difficult emotions and celebrating milestones. Each week, participants will be asked to log on at least three times and spend two hours on lessons and homework.

A major impetus for this study has been the conflicts in Iraq and Afghanistan. The Brain Trauma Foundation, a national nonprofit organization whose mission is to improve outcomes for TBI patients, estimates that between 150,000 and 300,000 Iraq veterans have some level of traumatic brain injury. That's 10 to 20 percent of Iraq veterans. Shock-wave blasts from explosive devices, land mines and rocket-propelled grenades are the leading cause of TBI for active duty military personnel in combat zones, according to the Brain Injury Association of America. Such dramatic events can lead to relatively subtle symptoms, such as confusion, headache, dizziness, mood changes, sleep disturbances, agitation and problems with memory and attention.

"Caregiving has become a major, major problem," said Kate Lorig, RN, DrPH, emeritus professor of immunology and rheumatology, currently at the Stanford Patient Education Research Center. "Usually, older caregivers stay in caregiving relationships, despite the challenges. But increasingly, young wives and, in some cases, husbands are affected. It's a hellishly difficult task that may cause young relationships to end. As a result, siblings and parents, who never expected to be caregivers at that stage in life, must step in."

Currently, resources for these serendipitous caregivers are lacking. "There are some small group networks and call centers that caregivers can rely on, but there are very few resources for them on the Internet. In particular, there's not much structured interaction among caregivers outside of the hospital. The hardest problem is reaching folks who are really isolated," said Lorig.

In response to this growing need for caregiver training, the Department of Veterans Affairs announced in December 2007 a nationwide initiative that would provide nearly $4.7 million for eight caregiver assistance pilot programs. "Building Better Caregivers" is one of the projects. Its focus is to help caregivers cope with difficult behaviors - angry outbursts and violence - as well as the inability to make decisions, and fears about the future. "The course teaches strategies for coping with stress," said Lorig. "If they can reduce stress, caregivers will be healthier."

If the program proves successful, it may be used nationally, she said. Eventually, she would like to extend this program to rural areas, where caregivers are the hardest to reach. "This is a real opportunity for people in difficult situations to help others help themselves."

Potential participants must be either a veteran who is a caregiver or a caregiver of a veteran; provide caregiving services for at least 10 hours a week; be over age 18; and reside in Hawaii, California or southern Nevada. The injured person must have TBI, PTSD or physician-diagnosed memory loss. To learn more, visit http://caregivers.stanford.edu, call Diana Laurent at (650) 723-7935, or e-mail caregivers@med.stanford.edu.

The study is being conducted jointly by the Stanford Patient Education Research Center and the VA Greater Los Angeles Healthcare System. Collaborators include Dolores Gallagher-Thompson, PhD, professor of psychiatry and behavioral sciences; Laurent, MPH, social science research assistant at the Stanford Patient Education Research Center; Theodore Hahn, MD, VA Greater Los Angeles Healthcare System; and Laural Traylor, MSW, VA Desert Pacific Healthcare System. Support for this study has been provided by a grant from the Department of Veterans Affairs, Patient Care Services, Office of Care Management and Social Work.

Stanford University Medical Center integrates research, medical education and patient care at its three institutions - Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children's Hospital at Stanford. For more information, please visit the Web site of the medical center's Office of Communication & Public Affairs at http://mednews.stanford.edu.

Stanford University Medical Center

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