Support for Dementia Care Partners using Telehealth: Tele-STELLA Phase 1

Background: Effective interventions that reduce dementia Care Partner stress and burden are available, but access to them is impeded by barriers such as distance, cost, behavioral symptoms of dementia, stigma and social anxiety. Tele-STELLA is a multi-component, videoconference-based intervention designed to provide easily-accessible education and support for Care Partners. The goal of this intervention is to diminish the frequency of behavioral symptoms that persons with dementia experience, and Care Partner reactivity to these symptoms. Here we report on the findings of Phase 1 of Tele-STELLA. Method: In Tele-STELLA interventionists meet with Care Partners, via videoconferencing, to identify specific behavioral symptoms of dementia that are distressing for them. The interventionists and Care Partners meet, first individually and then in groups, to address these symptoms using an analytic approach. Care Partners are encouraged to contact each other for support. Prior to, during, and after the 8-week intervention we collect data on behavioral symptoms (frequency and Care Partner reactivity to the symptoms), depression, and burden using electronically-administered surveys. Result: Of the 26 Care Partners who completed 8 weeks of the intervention 19 (70%) were female, average age of 67; 25 (96%) identified as white; 14% lived in a rural area. Burden, as assessed on the Revised Memory and Behavior Problem Checklist, did not change significantly over the 8-week intervention, nor did scores on depression, grief or quality of life measures. There was no change in behavior frequency, but we did appreciate a significant improvement in Care Partner reactivity to the two personalized target problems they identified (Figures 1 and 2; p<0.01 and p = 0.025, respectively). Conclusion: Significant improvement was seen in Care Partner reactivity to the specific behavioral problems chosen by the Care Partners. This suggests the intervention is effective when Care Partners work on the personalized problems they identified. The lack of significant improvement on the (depersonalized) surveys may be due to unbiased reporting by Care Partners using electronically-administered surveys, small sample size, or stabilization of affective symptoms. Phase 1 will inform revisions for the remainder of the study (total n goal = 150).