Taking Care of the Dyad: Frequency of Caregiver Assessment Among Veterans with Dementia

OBJECTIVES This study assessed frequency of caregiver identification and needs of a sample of persons with dementia (PWDs) and their caregivers to determine whether needs were addressed and whether documentation increased with growing levels of self-reported relationship problems and burden. DESIGN Cross-sectional design using data from electronic medical record (EMR) review and baseline research assessments (Burden Interview and Mutuality Scale). Items from a caregiver assessment tool were used to identify documentation of important factors in clinical guidelines. SETTING Michael E. Debakey VA Medical Center, Houston, TX. PARTICIPANTS A total of 211 PWDs from a randomized controlled trial testing a psychosocial intervention for preventing aggression in PWDs. MEASUREMENTS EMRs for 12 months before participation in the original study were abstracted, using a tool created by the authors to assess documentation of information deemed important to caregiver assessment in clinical guidelines (eg, caregiver needs, caregiver well-being, and caregiving context). The first two authors reviewed the EMRs, adjusting the tool, based on questions that arose. RESULTS Of 211 EMRs of PWDs reviewed, 177 (89%) identified caregivers. Of these, 88% identified the caregiver by name or relation to the PWD, 28% assessed caregiver well-being, and 41% assessed caregiver needs. All EMRs assessing caregiver needs showed provision of caregiver support (including psychoeducation, skills training, or referrals for additional aid). Levels of self-reported caregiver burden were not associated with documentation of assessment; however, higher levels of self-reported relationship problems were positively associated with increased caregiver contact documentation and negatively associated with caregiver need documentation and Alzheimer Association referrals. CONCLUSION Healthcare providers identified caregivers in most of the sample, but less than 50% assessed their well-being and needs. J Am Geriatr Soc 67:1604-1609, 2019