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An intensive 10-day residential training program for dementia carers has previously been shown to be associated with increased patient survival at home and decreased psychological morbidity in carers (Brodaty & Gresham, 1989). Results from a further follow-up, about 39 months after entry into the trial, were even more impressive. Patients whose carers had trained in the program had much higher adjusted rates of survival at home (53% versus 13%) and, unexpectedly, fewer deaths (20% versus 41%) than those whose carers did not have training. Patients whose carers had delayed training achieved intermediate results (31% surviving at home and 21% dying). These results were achieved with an average saving of $A7,967 ($U.S.5975) per patient over the first 39 months.

SUMMARYDementia caregivers are known to be distressed and may be helped by psychoeducational interventions. We investigated the effectiveness of one model of intervention comprising a structured package of six sessions of training, focusing on education, stress management and problem behaviour management in a group setting. Three groups of caregivers were compared--those who had completed ( N = 33) or partially completed (N = 22) training and a control group ( N = 26)-on measures of psychological stress, burden, satisfaction with life, well-being and knowledge. There were no significant differences in outcome between the three groups. We conclude that, with methodological qualifications, this quasi-experimental study of one model of training was not empirically effective. Interventions for caregivers should be tailored to individual needs from a range of techniques encompassing psychological and practical strategies.

How long a dementia patient is cared for in the home before admission to a nursing home depends on the state of the patient and the state of the caregiver. Using 5-year follow-up data, the times until entry to nursing home and until death are modeled using a Cox survival model in which patient and caregiver variables at entry to study as well as changes in these variables over the following 12 months are the regression variables. Treatment variables quantify the effects of a caregiver training program. Statistical methods used in fitting the Cox survival model and consequent predictions of survival rates are discussed.

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