Hospital GamePlan4Care for Caregivers

Overseen By Molly Horstman, MD MS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Unable to complete informed consent

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 34

50 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Hospital GamePlan4Care for Caregivers?

The research highlights the importance of patient and family engagement in hospital planning, which can lead to better outcomes. Although not directly about Hospital GamePlan4Care, involving caregivers in planning and improvement processes has shown benefits in healthcare settings. ^{1 2 3 4 5}

How is the Hospital GamePlan4Care treatment different from other treatments for caregivers?

Hospital GamePlan4Care is unique because it focuses on supporting caregivers themselves, rather than just the patients they care for. This treatment involves collaboration between caregivers and healthcare providers to improve care coordination and caregiver preparedness, which is not typically addressed in standard patient-focused care models. ^{6 7 8 9 10}

What is the purpose of this trial?

Hospital stays are stressful for the family and friends who care for adults with dementia. Following hospital discharge, adults with dementia often have increased care needs, which places new caregiving demands on their family and friends. Family and friends are critical to ensuring that Veterans with dementia can live safely in the community following discharge. Healthcare systems have an opportunity to support family and friends of adults with dementia by addressing dementia-specific caregiving challenges that arise during the transition from hospital to home. The investigators are comparing two different support programs for family and friends of hospitalized adults with dementia. The two programs are Hospital GamePlan4Care and Caregiver Education. Hospital GamePlan4Care was developed with feedback from people who care for Veterans with dementia. Hospital GamePlan4Care helps caregivers build skills to care for someone with dementia recently discharged from the hospital. It includes a written handbook, online training on the Hospital GamePlan4Care website, and phone calls with a dementia care specialist. The online training is tailored to the caregiver. The Caregiver Education program provides information that helps caregivers care for someone recently hospitalized. It includes a written handbook, recommendations for high-quality online resources, and phone calls with a dementia care specialist. Both programs will start when the adult with dementia is hospitalized. Each program lasts at least three months. To be eligible, the caregiver must care for a Veteran with dementia admitted to the Michael E. DeBakey VA Medical Center in Houston, Texas. Caregivers interested in participating and passing eligibility screening will be enrolled in the study for at least three months. Each enrolled caregiver will have a 50% chance of being enrolled in the Hospital GamePlan4Care group or the Caregiver Education group (like flipping a coin). Both groups will be asked to complete several questionnaires about their needs as a caregiver and their well-being. Questionnaires will be completed at the beginning of the study and one and three months after the Veteran is discharged from the hospital. Each questionnaire should take 30-60 minutes to complete.

Research Team

Molly Horstman, MD MS

Principal Investigator

Michael E. DeBakey VA Medical Center, Houston, TX

Eligibility Criteria

This trial is for caregivers of Veterans with dementia admitted to the Michael E. DeBakey VA Medical Center in Houston, Texas. Caregivers must be willing to participate in a study for at least three months and complete several questionnaires.

Inclusion Criteria

Provide care primarily due to a personal relationship, rather than a financial relationship

Veteran must be experiencing signs of dementia as verified by a score of 2 or greater on the AD-8

Have access to a telephone

Exclusion Criteria

I am unable to understand or sign the consent form.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Intervention

Caregivers receive either Hospital GamePlan4Care or Caregiver Education program starting from the hospitalization of the person with dementia.

3 months

4 scheduled contacts with a Dementia Care Specialist

Follow-up

Participants are monitored for caregiver-reported outcomes such as burden, depression, and self-efficacy.

3 months

Questionnaires at baseline, 30 days, and 90 days

Treatment Details

Interventions

• Hospital GamePlan4Care

Trial Overview The study compares two support programs: Hospital GamePlan4Care, which includes tailored online training and specialist phone calls, and Caregiver Education, offering general resources and specialist support. Each lasts at least three months starting from hospitalization.

Participant Groups

Group I: Hospital GamePlan4care Experimental Treatment 1 Intervention

Tailored caregiver skills training and support for caregiving for a person with dementia

Group II: Health Education Active Control 1 Intervention

Education on general caregiving topics.

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Findings from Research

A study involving 40 participants from nine hospitals identified four key themes essential for enhancing patient and family engagement (PE) in healthcare: resources, training, organizational commitment, and staff support.

Despite the recognition of PE's benefits, hospitals often lack dedicated funding and compensation for patient/family advisors, highlighting a critical barrier to effective engagement that needs further research and improvement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Organizational capacity for patient and family engagement in hospital planning and improvement: interviews with patient/family advisors, managers and clinicians. Anderson, NN., Baker, GR., Moody, L., et al.[2022]

Collaboration between patients, relatives, and healthcare professionals is essential for identifying and improving patient care processes, as their experiences often differ significantly.

The study highlights the importance of experience-based co-design (EBCD) in healthcare, suggesting that involving patients in quality improvement initiatives can lead to better healthcare outcomes, despite the study's limitations due to a small participant group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improvements in neonatal care; using experience-based co-design. Gustavsson, SM.[2022]

Patient engagement (PE) in hospital planning has been shown to have 14 beneficial impacts, including improvements in hospital structures, clinician functions, patient experiences, and overall patient outcomes, based on interviews with 38 participants from 9 hospitals.

While PE activities generally have positive effects, some challenges were noted, such as the potential for overextending patient/family advisors and causing frustration among clinicians if the engagement process slowed down improvements.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impacts of patient and family engagement in hospital planning and improvement: qualitative interviews with patient/family advisors and hospital staff. Anderson, NN., Dong, K., Baker, GR., et al.[2022]

A multidisciplinary team intervention significantly improved caregiver retention of critical discharge instructions for pediatric cancer patients, with median retention scores increasing from 63 to 89 after the intervention (p = .001).

The intervention led to notable improvements in specific areas of knowledge, such as the correct choice of on-call number (from 57% to 100%, p = .004), indicating that collaborative teaching methods can enhance understanding and potentially improve patient outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Retention of discharge instructions using an interdisciplinary model for at-risk children with cancer: A quality improvement initiative. Offenbacher, R., Briggs, J., Ronca, K., et al.[2022]

The study involved qualitative interviews with 40 individuals from 9 hospitals, revealing that collaboration (like standing committees) is the most effective method for engaging patients in healthcare planning, followed by blended approaches and consultation methods.

Key strategies for optimizing patient engagement include involving diverse patients, ensuring patient representation in decision-making, and linking patient engagement efforts to hospital leadership, which can enhance the integration of patient perspectives in healthcare improvements.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Approaches to optimize patient and family engagement in hospital planning and improvement: Qualitative interviews. Anderson, NN., Baker, GR., Moody, L., et al.[2021]

A study involving 293 family caregivers of hospitalized older adults revealed that caregivers play a crucial role not only in direct patient care but also in coordinating and communicating with healthcare teams.

By actively participating in care planning and oversight, family caregivers can enhance the quality of care and improve patient outcomes during hospital stays.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family Caregiving During the Hospitalization of an Older Relative. Glose, S.[2021]

As cancer care shifts from hospitals to home settings, family members often take on the primary caregiving role for patients, highlighting the need for support systems.

Research has identified the specific family members who typically provide care, their needs, and the gaps in community resources and healthcare services available to assist them.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Needs of family caregivers of persons with cancer: a review. Laizner, AM., Yost, LM., Barg, FK., et al.[2019]

Family caregivers play a crucial role in supporting cancer patients but often face significant challenges and distress, highlighting the need for dedicated support services.

The article introduces a new program at the Princess Margaret Cancer Center aimed at systematically addressing the needs of family caregivers, proposing a model for psychosocial interventions that could be adopted in other healthcare settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Caring for the Family Caregiver: Development of a Caregiver Clinic at a Cancer Hospital as Standard of Care. Nissim, RS., Hales, S.[2023]

A study involving 506 family caregivers of hospitalized patients aged 70 and older found that collaboration with hospital nurses significantly improves caregivers' preparedness for their caregiving tasks after discharge.

The research highlights the importance of involving family caregivers as partners in care, suggesting that better communication and collaboration with nurses can enhance the quality of care for older patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The association of collaboration between family caregivers and nurses in the hospital and their preparedness for caregiving at home. Hagedoorn, EI., Keers, JC., Jaarsma, T., et al.[2021]

The Care for the Caregiver program was established to support clinicians facing emotionally distressing events, building on earlier communication and resolution programs endorsed by the Joint Commission since 2001.

Launched in 2014 across the MedStar Health System, the program has adapted to meet the evolving needs of healthcare providers, especially during the challenges posed by the COVID-19 pandemic.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

CE: Providing Care for Caregivers During COVID-19. Morales, C., Brown, MM.[2023]

References

1. England pubmed.ncbi.nlm.nih.gov

Organizational capacity for patient and family engagement in hospital planning and improvement: interviews with patient/family advisors, managers and clinicians. [2022]

2. England pubmed.ncbi.nlm.nih.gov

Improvements in neonatal care; using experience-based co-design. [2022]

3. England pubmed.ncbi.nlm.nih.gov

Impacts of patient and family engagement in hospital planning and improvement: qualitative interviews with patient/family advisors and hospital staff. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Retention of discharge instructions using an interdisciplinary model for at-risk children with cancer: A quality improvement initiative. [2022]

5. England pubmed.ncbi.nlm.nih.gov

Approaches to optimize patient and family engagement in hospital planning and improvement: Qualitative interviews. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Family Caregiving During the Hospitalization of an Older Relative. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Needs of family caregivers of persons with cancer: a review. [2019]

8. United States pubmed.ncbi.nlm.nih.gov

Caring for the Family Caregiver: Development of a Caregiver Clinic at a Cancer Hospital as Standard of Care. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

The association of collaboration between family caregivers and nurses in the hospital and their preparedness for caregiving at home. [2021]

10. United States pubmed.ncbi.nlm.nih.gov

CE: Providing Care for Caregivers During COVID-19. [2023]