BUFFALO, N.Y. – A telephone-based group education and
support intervention provided to spouses of veterans with mild to
severe dementia saved an average of $2,768 per patient over six
months compared to "usual care," a study conducted by a University
at Buffalo researcher has show.
However, those savings dissipated during the following six
months and by the one-year assessment the savings were lost.
The study appears in a recent issue of The Gerontologist.
is thought to be the first to examine the effects of caregiver
telephone education and support groups on total VA health care
costs for veterans with dementia.
Laura O. Wray, PhD, UB clinical assistant professor of medicine
and director of education at the VA Center for Integrated
Healthcare, is first author on the study.
"The goal of this study was to examine the effects of the
Telehealth Education Program (TEP) on the use of health care by the
dementia patients and the overall costs following caregiver
training," says Wray.
"We hypoth¬esized that veterans whose caregivers
participated in TEP would use less health care services while
receiving excellent care, which would reduce health care costs
compared to the costs of those receiving usual care (UC)," she
says. Usual care was defined as receiving all the usual VA
The study involved 158 couples from across upstate New York who
were assigned randomly to receive either TEP or UC. Eighty-three
couples participated in the intervention and 75 couples received
The TEP content addressed four major areas that can be
problematic for caregivers who want to take care of their spouses
or partners with dementia at home: verbal and nonverbal
communication; effective structuring of caregiver-patient
interactions; managing challenging behavior problems; and assessing
resources and planning for the future.
Four trained group leaders with geriatrics experience led the
TEP groups through 10 weekly interactive one-hour telephone
meetings. Participants received information about dementia and its
symptoms, resources to address these symptoms, care-giving skills,
and relaxation and self-care skills. Participants also helped each
other solve difficult problems and provided group support.
Assessment of the program found that in the first six months,
TEP resulted in a significant decrease in the overall cost of care
for the veterans compared to those in usual care, but at the
one-year assessment those savings had been eliminated.
Wray says the findings may have been different if support
programs had continued, based on results of similar support
"It's possible that the TEP cost savings could be maintained if
there had been follow-up meetings or periodic care management calls
to the caregivers," notes Wray. "We need to do further work to
determine if this is the case."
Additional authors on the paper are Mollie D. Shulan, MD, and
Kurt E. Freeman from Stratton VA Medical Center in Albany, NY;
Ronald W. Toseland, PhD, from SUNY Albany; Bob Edward Vasquez, PhD,
from Texas State University-San Marcos; and Jian Gao, PhD, from the
Department of Veterans Affairs in Albany, NY.
The research was supported by the VA Health Services Research
and Development Service.
The University at Buffalo is a premier research-intensive
public university, a flagship institution in the State University
of New York system and its largest and most comprehensive campus.
UB's more than 28,000 students pursue their academic interests
through more than 300 undergraduate, graduate and professional
degree programs. Founded in 1846, the University at Buffalo is a
member of the Association of American Universities.