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Translation of a dementia caregiver support program in a health care system–REACH VA


Nichols, Linda Olivia, Martindale-Adams, Jennifer, Burns, Robert, Graney, Marshall J., Zuber, Jeffrey


Archives Of Internal Medicine, Volume: 171, No.: 4, Pages.: 353-359

Year of Publication



Background: Based on the National Institute on Aging/National Institute of Nursing Research Resources for Enhancing Alzheimer’s Caregiver Health (REACH) randomized controlled trial (REACH II), REACH VA (Department of Veterans Affairs) was the first national clinical translation of a proven behavioral intervention for dementia caregivers, running from September 2007 through August 2009. This article describes the population and outcomes of the REACH VA translation of REACH II into the VA.; Methods: Clinical staff members from 24 VA Medical Center Home-Based Primary Care programs in 15 states delivered the intervention to stressed caregivers of patients with dementia. Like REACH II, the 6-month REACH VA intervention, structured through a protocol and individualized through a risk assessment, targeted education, support, and skills training to address caregiving risk areas of safety, social support, problem behaviors, depression, and health through 12 individual in-home and telephone sessions and 5 telephone support group sessions. Staff members of the Memphis VA Medical Center, Memphis, Tennessee, collected data on burden, depression, health and healthy behaviors, caregiving frustrations, social support, dementia-related behaviors, and time spent providing care and on duty.; Results: From baseline to 6 months, caregivers reported significantly decreased burden, depression, impact of depression on daily life, caregiving frustrations, and number of troubling dementia-related behaviors. A 2-hour decrease in hours per day on duty approached significance. Caregivers (96%) believed that the program should be provided by the VA to caregivers.; Conclusions: This clinical translation achieved outcomes similar to the REACH II randomized controlled trial, providing clinically significant benefits for caregivers of a veteran with a progressive dementing disease. This model of caregiver support can inform public policy in providing assistance to caregivers.;

Bibtex Citation

@article{Nichols_2011, doi = {10.1001/archinternmed.2010.548}, url = {}, year = 2011, month = {feb}, publisher = {American Medical Association ({AMA})}, volume = {171}, number = {4}, author = {Linda Olivia Nichols and Jennifer Martindale-Adams and Robert Burns and Marshall J. Graney and Jeffrey Zuber}, title = {Translation of a Dementia Caregiver Support Program in a Health Care System{textemdash}{REACH} {VA}}, journal = {Arch Intern Med} }


aged, aged, 80 and over, care, caregivers, delivery of health care, dementia, female, humans, male, providing, psychology, reach, risk assessment, social support, spent, tennessee, therapy, time

Countries of Study


Types of Dementia

Dementia (general / unspecified)

Types of Study

Randomised Controlled Trial

Type of Outcomes

Behaviour, Carer Burden (instruments measuring burden), Carers’ Mental Health, Other, Other carer outcomes (e.g. financial burden and more)



Type of Interventions

Intervention for Carers

Carer Focussed Interventions

Training programmes / workshops including behavioural training