Just three training sessions can boost dementia care partners’ mood and confidence

Caring for someone with Alzheimer’s disease or another dementia can be overwhelming for informal care partners. Most training programs for family and caregivers focuses on practical knowledge related to medical needs and dementia-related behaviors. But a new approach is gaining traction: teaching care partners problem-solving skills to balance their caregiving role with their own needs.

Now, researchers have new insight into just how much training is needed to yield big results.

“We want the nearly 6 million care partners in the United States to better cope with and overcome the feelings of stress, depression and isolation that are so common,” said Matthew Lee Smith, PhD, a professor in the Texas A&M University School of Public Health and faculty affiliate with its Center for Community Health and Aging.

To that end, Smith and others on the research team developed an English- and Spanish-language training program that uses a simple A-B-C-D-E-F mnemonic to teach care partners how to break large problems into smaller, more manageable issues and to identify, attain and evaluate goals. The training is delivered via telephone or video conferencing.

Early studies found that both English- and Spanish-speaking care partners who took the training felt less depressed and burdened and were better able to adjust strategies when needed to handle everyday problems.

“The question then became: How much training is enough?” Smith said, adding that while just two to three sessions generated positive results, the researchers did not know how many sessions were best or whether post-intervention booster sessions added value.

To find out, Smith, along with center colleagues Gang Han, PhD, and Chung Lin (Novelle) Kew, PhD, and researchers from TIRR Memorial Hermann, the University of Texas Southwestern Medical Center, Washington University in St. Louis and University of Texas Rio Grande Valley assessed the training using four scenarios: three sessions with or without boosters and six sessions with or without boosters.

Their trial, conducted between June 2021 and July 2023, was funded by the Texas Alzheimer’s Research and Care Consortium and published in The Lancet Regional Health—Americas.

The researchers worked with 97 English- and Spanish-speaking dementia care partners in Texas, 80 of whom were women. The participants were randomly assigned based on language to three problem-solving training sessions with boosters (19 participants total) or without boosters (21) or to six with boosters (28) or without boosters (29).

All sessions were delivered by telephone or video conference by professional coaches with backgrounds in social work or counseling. In the regular sessions, held every week or so, participants learned how to gather information about their problems, generate and evaluate potential solutions, create an action plan and evaluate and revise plans as needed.

They also practiced applying the strategy to the goals or problems they identified, taking on more responsibility for this as the sessions progressed. All participants received the same training, but those in the six-session version had more time for practicing.

Booster sessions were shorter than the full sessions and were held monthly for six months after completion of the regular program. In these sessions, participants could develop and practice strategies and further discuss the training and possible applications with the coach.

The researchers measured participants’ depressive symptoms and level of caregiver burden before the training sessions began and after each session and booster.

“We found that both mood and problem-solving ability improved very quickly—in as few as three sessions without boosters,” Smith said.  “In addition, this improvement continued with additional time and support.”

He said the team intends to further refine the training so care partners could apply it to any of the complex and often overlapping physical, psychological, social and financial stressors associated with caregiving.

“Our goal is to develop a comprehensive program that gives care partners simple strategies for dealing with any of those stressors at any time, and for changing strategies as the situation changes, even from moment to moment,” Smith said.