Chronic Disease: A Telehealth Transition Assistance Program (TAP) for Veteran Caregivers

Thursday, 15 July 2010: 4:05 PM

Jane A. Anderson, PhD
Neurology Care Line, Michael E. DeBakey VA Medical Center, Houston, TX
Pamela Willson, RN, PhD, FNP, BC
College of Nursing, Prairie View A & M University, Houston, TX

Purpose: About 80,000 veterans receiving health care in the Veterans Health Affairs (VHA) are stroke survivors and about 9,000-11,000 veterans are hospitalized annually with a new stroke. Almost 80% of stroke survivors are discharged home and live for at least five years, shifting a large amount of continuing care to informal caregivers. Informal caregivers play a key role in assisting stroke survivors to sustain independent living in their own homes and communities The purpose of this presentation is to report findings of the impact of the TAP on caregiver strain, depression, and satisfaction with the program and changes in veteran’s functional status.

Methods: The demonstration pilot program was conducted at the Stroke Specialty Rehabilitation Program, VA Caribbean Healthcare System, San Juan, PR and the Michael E. DeBakey VA Stroke Center,Houston, TX. These two centers have the highest volume of stroke treatment in the VHA. The program used our previous research findings on stroke caregiving and stroke recovery after discharge home. The Transition Assistance Program (TAP) includes three components to reduce caregiver strain and depression: (1) skill development; (2) education; and (3) supportive problem solving. 

Results: A total of 88 dyads participated including 52 from Puerto Rico and 36 fromHouston, Texas.  Of these participants, 61 dyads were able to complete the 3 month follow up. Participants were randomly assigned to Control and Treatment Group (videophone). Findings indicate that the TAP reduced depression and caregiver strain.  As caregiver satisfaction with TAP increased, strain, and depression decreased.

Conclusion: When coupled with the very high rate of program satisfaction, which was 9.5 out of a maximum of 10, this pattern suggests that TAP participation helped caregivers cope. Veteran motor function was significantly linked  to caregiver satisfaction with TAP suggesting that as satisfaction with TAP increased, so did veteran functional ability.