A mindfulness-based multicomponent caregiver intervention (PAACC): objectives, study design, and cohort description

INTRODUCTION

Effective interventions are needed to reduce caregiver burden and stress, particularly among family caregivers of veterans with dementia. Unique risk factors such as traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) further complicate caregiving. This study compares a four-session mindfulness-based multicomponent intervention (PAACC) with a cognitive behavioral intervention (REACH), both designed to alleviate caregiver burden, and provides a baseline evaluation of caregivers in the intervention. A two-arm, blinded, randomized controlled trial assigned 133 dementia caregivers to PAACC (n = 67) or REACH (n = 66). Baseline assessments included caregiver stress, burden, mindfulness receptivity, rumination, compassion, depressive symptoms, anxiety, and care recipient behavior. Participants averaged 67.17 years, 85% were women, and 70% were spousal caregivers. Caregivers in PAACC reported higher depressive symptoms and anxiety and lower mindfulness receptivity. This study introduces the first mindfulness-based intervention for veteran caregivers, designed to enhance cognitive flexibility, cultivate compassion, and provide practical skills to improve quality of life.

METHODS

The study utilized a two-arm, blinded, prospective randomized controlled trial to compare the PAACC and REACH interventions. A total of 133 dementia caregivers experiencing moderate to severe caregiver burden were assigned to receive either the PAACC intervention (n = 67) or the REACH intervention (n = 66). Baseline evaluations included caregiver stress, burden, mindfulness receptivity, rumination, compassion, depressive symptoms, anxiety, and the memory and behavior problems of the veteran living with dementia, using widely accepted measures from caregiving literature.

RESULTS

Baseline assessments were conducted on 133 family caregivers of veterans living with dementia. The average caregiver age was 67.17 years (SD = 9.8), 85% were women, and 70% were spousal caregivers. No significant demographic differences were found between the two intervention groups. However, baseline comparisons showed that caregivers in the PAACC intervention reported higher depressive symptoms and anxiety, and lower mindfulness receptivity. A detailed protocol for the mindfulness-based multicomponent caregiver intervention PAACC is described.

DISCUSSION

There is a growing need for multicomponent, skill-building interventions tailored for dementia caregivers who are at high risk of stress. This study introduces the first mindfulness-based intervention specifically for caregivers of veterans, designed to enhance cognitive flexibility, cultivate compassion, and equip caregivers with practical skills to improve their quality of life.

Highlights

• PAACC is a mindfulness-based multicomponent intervention for dementia caregivers of veterans.
• No demographic differences suggest psychological differences are not due to demographics.
• Baseline mental health and mindfulness readiness may impact intervention effectiveness.