A Qualitative Evaluation of Caregiver Support Resources at the Cognitive Disorders Specialty Care Education Center of Excellence at the Atlanta Veterans Affairs Medical Center Open Access

Biello, Shannon Elizabeth (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/b5644r83v?locale=en
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Abstract

The Department of Veterans Affairs (VA) administers care to approximately 300,000 individuals with dementia. Projected increases in incidence pose unique challenges to this healthcare system, including how to assist the many informal caregivers who provide long-term, comprehensive support to Veterans. Recognizing the critical role caregivers play in Veteran's health, the Cognitive Disorders Specialty Care Education Center of Excellence (COE) at the Atlanta VA Medical Center implemented a suite of caregiver support services, including both formal programs and resource linkages. This quality improvement project sought to evaluate the effectiveness of COE caregiver support resources, identify any caregiver perceived gaps in these resources, and to explore current caregiver coping strategies that may be leveraged in future COE initiatives. Eleven in-depth, semi-structured interviews were conducted with caregivers of Veterans seen in the COE who have engaged with a caregiver support resource(s). For thematic analysis, codes were generated from the initial interviews, refined into a codebook of eight major codes, applied to the remaining transcripts, and synthesized across all interviews. COE caregiver resources that offered detailed information on dementia, social support, an emphasis on caregiver well-being and caregiver self-efficacy, and methods for behavioral change were positively received by caregivers. Identified gaps include the need for individually tailored resources and for practical support in matters like advanced directives and eligibility for VA benefits. Prominent caregiver coping strategies included individual free time (when the caregiver was not responsible for Veteran well-being), external support groups, and respite care. Findings will inform future improvements to COE caregiver support resources, such as an expansion of the caregiver educational programs' content, as well as efforts to increase the capacity of these resources. These results also highlight opportunities for the COE to interface with internal and external agencies and organizations to enhance existing caregiver services.

Table of Contents

Table of Contents

Introduction………………………………………………………………………………………..1 Literature Review………………………………………………………………………………….5 Methods…………………………………………………………………………………………..20 Participants……………………………………………………………………………….21 Procedures………………………………………………………………………………..23 Measures…………………………………………………………………………………25 Analysis…………………………………………………………………………………..27 Results……………………………………………………………………………………………28 Discussion………………………………………………………………………………………..52 Implications………………………………………………………………………………60

Strengths and Limitations………………………………………………………………..62

Conclusions………………………………………………………………………………63 Appendices……………………………………………………………………………………….76

Appendix A: Consent Form……………………………………………………………...76

Appendix B: Interview Guide…………………………………………………………....78

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