Creating harmony at home via environmental cueing: A feasibility trial of a non-pharmacological intervention for rural caregivers of persons with dementia

INTRODUCTION: Behavioral and psychiatric symptoms of dementia (BPSDs) and functional impairment have a major impact on quality of life for people living with dementia (PLWD). Development of caregiver-initiated interventions, including environmental assessment and modification, are priorities in the field. METHODS: An open-label study of 40 caregivers of PLWD with BPSDs that underwent a 6-week telehealth person-environment intervention, Harmony at HOME, was conducted. Feasibility was assessed by improved caregiver mastery. RESULTS: Twenty-eight caregivers completed the intervention, which increased caregiver mastery and decreased stress and burden. There were statistically significant improvements in functional performance of the person living with dementia (p < 0.005) and caregivers’ satisfaction with the person living with dementia's functional performance (p < 0.001). DISCUSSION: The intervention increased caregivers’ skills and knowledge in assessing and modifying the environment to address BPSDs. Although overall caregiver mastery was not changed significantly, additional clinical research assessing caregiver mastery in relation to specific caregiving tasks within the home environment is needed. CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov NCT05202223. Highlights: Aging in place is difficult to achieve for individuals with dementia. A novel dyadic care intervention, Harmony at HOME, improved caregiver outcomes. Future care research should explore performance-based patient outcomes.