Comprehensive Older Adult and Caregiver Help (COACH): A person‐centered caregiver intervention prevents elder mistreatment

Abstract

AbstractBackgroundElder mistreatment (EM) harms individuals, families, communities, and society as a whole. Yet research on interventions is lagging, and no rigorous studies demonstrating effective prevention have been published. This pilot study examines whether a first‐of‐its‐kind coaching intervention reduced the experience of EM among older adults with chronic health conditions, including dementia.MethodsWe used a double‐blind, randomized controlled trial to test a strengths‐based person‐centered caregiver support intervention, developed from evidence‐based approaches used in other types of family violence. Participants (n = 80), family caregivers of older adults who were members of Kaiser Permanente, completed surveys at baseline, post‐test, and 3‐month follow‐up. The primary outcome was caregiver‐reported EM; additional proximal outcomes were caregiver burden, quality‐of‐life, anxiety, and depression. Nonparametric tests (Mann–Whitney U, Fisher's Exact, Wilcoxon Signed Rank, and McNemar's) were used to make comparisons between treatment and control groups and across time points.ResultsThe treatment group had no EM after intervention completion (assessed at 3‐month follow‐up), a significantly lower rate than the control group (treatment = 0%, control = 23.1%, p = 0.010).ConclusionsIn this pilot study, we found that the COACH caregiver support intervention successfully reduced EM of persons living with chronic illness, including dementia. Next steps will include: (1) testing the intervention's mechanism in a fully powered RCT and (2) scaling the intervention for testing in a variety of care delivery systems.