A Dual-Component Nurse Practitioner Intervention to Improve Symptom Management for Caregivers of Persons Living With Dementia

Abstract

The number of patients living with dementia (PLWD) has steadily increased, making it the fifth leading cause of death among adults. While hospice care is standard for end-of-life symptom management, predicting 6-month survival is challenging, leaving many who could benefit ineligible. The study team conducted a single-armed pilot study implementing a nurse-practitioner-led telehealth program for caregivers at an outpatient clinic, focusing on symptom management for PLWD. The study team recruited 15 caregivers with a mean age of 68 years. Most were women (60%), non-Hispanic (80%), White (67%), and children of the patient (67%). A total of 86 tele-visits were conducted. Overall, 14 caregivers found it easy to learn how to access the tele-visits. In 85 of 86 visits, caregivers felt it addressed their concerns, and all (N = 15) were satisfied with the program. Caregiver burden (12-item Zarit Burden Interview) decreased significantly (β = −0.79 (95% CI −1.22 to −0.36), P = .001), with no significant change in anxiety (General Anxiety Disorder-7), depression (Patient Health Questionnaire-9), or pain scores (Doloplus-2). The data suggest that a nurse-practitioner-led telehealth program is a feasible and acceptable intervention for caregivers caring for PLWD, with improvement in caregiver burden scores. Future studies are needed to examine its efficacy and broader implementation.