Can Senior Volunteers Deliver Reminiscence and Creative Activity Interventions? Results of the Legacy Intervention Family Enactment Randomized Controlled Trial

• Published in: Journal of pain and symptom management Vol. 48; no. 4; pp. 590 - 601
• Main Authors: Allen, Rebecca S., PhD, Harris, Grant M., MA, Burgio, Louis D., PhD, Azuero, Casey B., MPH, MA, Miller, Leslie A., BA, Shin, Hae Jung, PhD, Eichorst, Morgan K., MA, Csikai, Ellen L., PhD, DeCoster, Jamie, PhD, Dunn, Linda L., DSN, RN, CNL, Kvale, Elizabeth, MD, Parmelee, Patricia, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-10-2014; Elsevier
• Subjects: Aged; Aged, 80 and over; Anesthesia & Perioperative Care; Biological and medical sciences; Caregivers - psychology; Community-based RCT; Female; Humans; Male; Medical sciences; Middle Aged; mixed methods; Occupational Diseases - prevention & control; Occupational Diseases - psychology; Pain Medicine; Palliative Care - psychology; palliative care dyads; Pharmacology. Drug treatments; Psychotherapy, Group - methods; Social Support; Stress, Psychological - prevention & control; Stress, Psychological - psychology; Treatment Outcome; Volunteers; United States > US; palliative care dyads; mixed methods; volunteers; Community-based RCT; Human; Volunteer; Method; Randomized controlled trial; Biological activity; Result; Mixed; Palliative care; Elderly
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2013.11.012

Abstract Context Palliative care patients and their family caregivers may have a foreshortened perspective of the time left to live, or the expectation of the patient's death in the near future. Patients and caregivers may report distress in physical, psychological, or existential/spiritual realms. Objectives To conduct a randomized controlled trial examining the effectiveness of retired senior volunteers (RSVs) in delivering a reminiscence and creative activity intervention aimed at alleviating palliative care patient and caregiver distress. Methods Of the 45 dyads that completed baseline assessments, 28 completed postintervention and 24 completed follow-up assessments. The intervention group received three home visits by RSVs; control group families received three supportive telephone calls by the research staff. Measures included symptom assessment and associated burden, depression, religiousness/spirituality, and meaning in life. Results Patients in the intervention group reported a significantly greater reduction in frequency of emotional symptoms ( P = 0.02) and emotional symptom bother ( P = 0.04) than the control group, as well as improved spiritual functioning. Family caregivers in the intervention group were more likely than control caregivers to endorse items on the Meaning of Life Scale ( P = 0.02). Only improvement in intervention patients' emotional symptom bother maintained at follow-up after discontinuing RSV contact ( P = 0.024). Conclusion Delivery of the intervention by RSVs had a positive impact on palliative care patients' emotional symptoms and burden and caregivers' meaning in life. Meaningful prolonged engagement with palliative care patients and caregivers, possibly through alternative modes of treatment delivery such as continued RSV contact, may be necessary for maintenance of therapeutic effects.