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

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 72; no. 1; pp. 246 - 257
• Main Authors: Gassoumis, Zachary D, Martinez, Julia M, Yonashiro-Cho, Jeanine, Mosqueda, Laura, Hou, Anthony, Han, S Duke, Olsen, Bonnie, Louis, Anat, Connolly, Marie-Therese, Meyer, Kylie, Marnfeldt, Kelly, Salinas Navarro, Sheila A, Yan, Mengzhao, Wilber, Kathleen H
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.01.2024
• Subjects: Aged; Caregivers; Chronic Disease; Chronic illnesses; Dementia; Dementia disorders; Elder Abuse - prevention & control; Humans; Intervention; Older people; Patient-centered care; Pilot Projects; Quality of Life; elder mistreatment intervention; caregiver support; caregiver training; elder abuse prevention; elder abuse
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/jgs.18597

Elder 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. We 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. The 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). In 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.