A randomized, controlled trial of a home environmental intervention: Effect on efficacy and upset in caregivers and on daily function of persons withdementia

Purpose of Study: The authors determined short-term effects of a home envir onmental intervention on self-efficacy and upset in caregivers and daily fu nction of dementia patients. They also determined if treatment effect varie d by caregiver gender, race, and relationship to patient. Design and Method s: Families (N = 171) of dementia patients were randomized to intervention or usual care control group. The intervention involved 5 90-min home visits by occupational therapists who provided education and physical and social environmental modifications. Results: Compared with controls, intervention caregivers reported fewer declines in patients' instrumental activities of daily living (p = .030) and less decline in self-care and fewer behavior pr oblems in patients at 3 months post-test. Also, intervention spouses report ed reduced upset (p = .049), women reported enhanced self-efficacy in manag ing behaviors (p = .038), and women (p = .049) and minorities (p = .037) re ported enhanced self-efficacy in managing functional dependency. Implicatio ns: The environmental program appears to have a modest effect on dementia p atients' IADL dependence. Also, among certain subgroups of caregivers the p rogram improves self-efficacy and reduces upset in specific areas of caregi ving.