REACH Hope Intervention for Dementia and TBI Caregivers

Supporting Caregivers of Veterans With TBI and Mixed Dementia: The REACH Hope Behavioral Intervention

This three-year randomized clinical trial will evaluate a behavioral intervention for caregivers of Veterans with traumatic brain injury (TBI) and Alzheimer's dementia or mixed Dementia (AD/MD) to reduce caregiver depression, anxiety and burden, and improve veterans' health management. The study will combine and deliver two award-winning behavioral interventions - REACH VA (Resources for Enhancing All Caregivers Health in Department of Veterans Affairs) and the DoD's Virtual Hope Box, which we call REACH Hope. Both REACH and Hope Box have evidence of effectiveness individually but have not been delivered together for caregivers supporting veterans with complex neurodegenerative diagnoses and health conditions. Our primary hypothesis is that REACH Hope will improve caregivers' quality of life as measured by reduced burden.

Inclusion Criteria:

• primary caregiver for person with diagnosis of TBI and subsequent dementia
• at least one activity of daily living limitation or 2 or more instrumental activity of daily living limitation
• provide 4 or more hours of care per day for at least 6 months
• endorse a score of at least high burden (>8) on the Zarit Burden Inventory-4

Exclusion Criteria:

• no mobile telephone or electronic device that can accept the Hope Box application
• current diagnosis of schizophrenia or other major mental illness
• auditory impairment that would make telephone use difficult