Evaluating the Efficacy of Time for Living & Caring (TLC): An Online Intervention to Support Dementia Caregivers’ Use of Respite

Abstract Background and Objectives Respite, defined as time away from caregiving, is the most requested type of caregiver support. Time for Living and Caring (TLC) is a virtual coaching "app" that helps caregivers schedule and plan their respite time-use. The objectives of this analysis are: 1) to assess the efficacy of the TLC intervention on respite time-use and on caregiver well-being, and 2) to identify the key features of the intervention that serve as the likely mechanism of action. Research Design and Methods A sample of dementia caregivers (n=163, 79% female, 84% White, 6% Hispanic, average age 62) were randomized into one of two intervention delivery methods. Intervention efficacy was evaluated using pre/post comparisons of respite time-use and an additive “dosing” model that estimated unique parameters associated with the exposure to each specific intervention component. Results Both immediate and delayed-attention groups reported increased respite time. They also improved in their ability to plan and perceive benefit from their respite time-use over the 16-week intervention period. At 8 weeks, the immediate group did not change in anxiety while the delayed group worsened (p < 0.001). At 16 weeks, the groups were similar in their anxiety levels. By the 20-week follow-up period, when neither group had access to TLC, both experienced an increase in anxiety. Discussion and Implications TLC is a promising intervention that may support caregivers’ well-being, by helping them schedule and plan their respite to maximize its benefit. The provision of weekly coaching seems to be the intervention component (mechanism) associated with caregiver outcomes.