102-104 One systematic review concluded that individually tailored behavior management therapy over at least six sessions successfully reduced caregiver distress and burden in both the short and

longer term, but support for the effectiveness of group therapy teaching general principles of behavior management was lacking.104 Mittelman and colleagues105 demonstrated that individually tailored individual, family, and ad-hoc counseling sessions covering topics specific to individual caregivers successfully reduced caregiver depression scores Inhibitors,research,lifescience,medical over 2 years. Pinquart and Sorenson103 determined that longer interventions were more successful at reducing depression and the risk of institutionalization than shorter or “one-off” support or information sessions. Inhibitors,research,lifescience,medical A meta-analysis by Brodaty et al102

reported that the strongest predictor of success for an intervention was involving the patient in addition to the caregiver in a structured program, such as teaching the caregiver how to manage problem behaviors. The metaanalysis by Brodaty et al102 found a small significant overall effect of intervention on caregiver burden Inhibitors,research,lifescience,medical in addition to effects on knowledge/abilities, psychological health of caregivers, subjective wellbeing, and care receiver symptoms due to the inclusion of more recent studies which Inhibitors,research,lifescience,medical were found to have stronger effects on burden. The Seattle Protocols Stem Cell Compound Library provide a systematic, structured yet individualized approach to training

family caregivers to reduce behavioral and psychiatric disturbances in people with Alzheimer’s disease by teaching caregivers to monitor problems, identify possible events that trigger disturbances, and develop more effective responses.106 It has been successfully used to improve caregivers’ quality of life, reduce subjective burden and reactive responses to dementia care recipients’ problem Inhibitors,research,lifescience,medical behaviors,106 and to reduce dementia-related problems including depression,107 agitation108 and sleep disturbance.109 The Resources for Enhancing Alzheimer’s Caregiver Health (REACH) multi-site, multicomponent intervention included information provision, didactic instruction, role-playing, problem-solving, skills training, stress management techniques, Cell press and telephone support.110 The randomized, controlled trial involving 642 caregivers in ethnically diverse populations in the US resulted in significantly lower depression, burden, and care recipient problem behaviors, and higher self-care and social support in Caucasian and Hispanic caregivers as compared with controls but not for African- American caregivers, apart from better spousal caregiver quality of life.110 Caregiver interventions can delay nursing-home placement.