Resources for Enhancing Alzheimer's Caregiver Health (REACH)

Alzheimer's caregiverPurpose

The REACH study was a multisite caregiver intervention study that compared a variety of interventions for dementia caregivers to control conditions. The study was a landmark in its large sample size, use of multiple sites, and inclusion of large numbers of White, Hispanic, and African American caregivers.

Strategy

Each site used a specific multi-component strategy:

  • Boston, MA: automated telecare intervention

  • Birmingham, AL: behavioral skills training

  • Memphis, TN: Long-term education in primary care

  • Miami, FL: Family therapy and teleconferencing among family members

  • Palo Alto, CA:  Psychoeducational group intervention

  • Philadelphia, PA: environmental skill-building intervention

Target Population

Family caregivers for persons with dementia.

Research Outcomes

The multi-site project coordinated assessment instruments across sites, allowing for cross-site comparisons as well as site-specific analyses of outcomes.

Overall pooled results across the six cites demonstrated that intervention was superior to control conditions. The description of the overall REACH project and the analyses conducted from the pooled results across sites were reported in a Special Section of the journal Psychology and Aging. A Special Section in The Gerontologist reported on the results from each of the six individual sites, and showed the value of a variety of structured caregiver intervention programs. See references below.

Outcomes Research References

Site-Specific Outcomes

Burgio, L., Stevens, A., Guy, D., Roth, D. L., & Haley, W.E. (2003). Impact of two psychosocial interventions on White and African American family caregivers of individuals with dementia. The Gerontologist, 43, 568–579.

Burns, R., Nichols, L. O., Martindale-Adams, J., Graney, M. J., & Lummus, A. (2003). Primary care interventions for dementia caregivers: 2-year outcomes from the REACH study. The Gerontologist, 43, 547–555.

Eisdorfer, C., Czaja, S. J., Loewenstein, D. A., Rubert, M. P., Arguelles, S., Mitrani, V. B., et al. (2003). The effect of a family therapy and technology-based intervention on caregiver depression. The Gerontologist, 43, 514–531.

Gallagher-Thompson, D., Coon, D. W., Solano, N., Ambler, C., Rabinowitz, Y., & Thompson, L. W., (2003). Change in indices of distress among Latino and Anglo female caregivers of elderly relatives with dementia: Site-specific results from the REACH national collaborative study. The Gerontologist, 43, 580–591.

Gitlin, L. N., Winter, L., Corcoran, M., Dennis, M. P., Schinfeld, S., & Hauck, W. W. (2003). Effects of the home environmental skill-building program on the caregiver–care recipient dyad: 6-month outcomes from the Philadelphia REACH initiative. The Gerontologist, 43, 532–546.

Mahoney, D. F., Tarlow, B. J., & Jones, R. N. (2003). Effects of an automated telephone support system on caregiver burden and anxiety: findings from the REACH for TLC intervention study. The Gerontologist, 43, 556–567.

Cross-Site Outcomes

Gitlin, L. N., Burgio L., Czaja S., Mahoney D., Gallagher-Thompson D., Burns R., et al. (2003). Effect of multi-component interventions on caregiver burden and depression: The REACH multi-site initiative at 6 months follow-up. Psychology and Aging, 18, 361-374.

Schulz, R., Burgio, L., Burns, R., Eisdorfer, C., Gallagher-Thompson, D., Gitlin, L., et al. (2003). Resources for Enhancing Alzheimer's Caregiver Health (REACH): Overview, Site- Specific Outcomes, and Future Directions. The Gerontologist, 43(4), 514-520.

Clinical Approach References

Project descriptions for each site are maintained on the REACH Coordinating Center web site