PURPOSE OF STUDY: The authors determined short-term effects of a home environmental intervention on self-efficacy and upset in caregivers and daily function of dementia patients. They also determined if treatment effect varied by caregiver gender, race, and relationship to patient. DESIGN AND METHODS: Families (N = 171) of dementia patients were randomized to intervention or usual care control group. The intervention involved 5 90-min home visits by occupational therapists who provided education and physical and social environmental modifications. RESULTS: Compared with controls, intervention caregivers reported fewer declines in patients' instrumental activities of daily living (p = 0.030) and less decline in self-care and fewer behavior problems in patients at 3 months post-test. Also, intervention spouses reported reduced upset (p = 0.049), women reported enhanced self-efficacy in managing behaviors (p = 0.038), and women (p = 0.049) and minorities (p = 0.037) reported enhanced self-efficacy in managing functional dependency. IMPLICATIONS: The environmental program appears to have a modest effect on dementia patients' IADL dependence. Also, among certain subgroups of caregivers the program improves self-efficacy and reduces upset in specific areas of caregiving.
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