Part 3: Measuring the Effects of the Powerful Tools for Caregivers Program
The Powerful Tools for Caregivers (PTC) program is effective in helping family caregivers’ develop tools to better manage their role as a caregiver. A survey of program participants in Georgia shows that following the program, family caregivers report being better able to manage their own needs and emotions, more confident in their ability to provide care, and better able to access needed community resources.
“As the state sought to expand the availability of programs that support caregivers, it was important to them to know that the program was achieving the expected results, which is why we implemented an evaluation of the Powerful Tools program in Georgia,” says Kristi Fuller, a senior research associate at the Georgia Health Policy Center (GHPC).
PTC is an evidence-based six week educational training program for family caregivers. Previous research shows that caregivers are vulnerable to high rates of depression, anxiety and other health problems. PTC is designed to provide caregivers with the tools to: reduce personal stress; recognize the messages in their emotions; communicate their needs to family members and health care or service providers; and make tough caregiving decisions.
PTC is based on the Chronic Disease Self-Management program developed by Kate Lorig, Dr.P.H., and colleagues at Stanford University and has been used by more than 70,000 caregivers across the country.
The Georgia Division of Aging Services contracted with all 12 Georgia Area Agencies on Aging (AAAs) to implement PTC. GHPC conducted pre- and post-program surveys to evaluate the effectiveness of the program for caregivers throughout the state. Eleven of 12 Georgia AAAs were represented in the survey.
The 229 caregivers who participated in the PTC program and took both surveys were mostly female (85 percent) and just over half (57 percent) lived in cities, while a quarter lived in rural areas. Twenty-three percent of respondents were caring for their mother; 27 percent for their father; and 18 percent for their spouse. More than half of those receiving care had memory loss (57 percent). On average, respondents had been providing care for 7.5 years.
Post-program surveys showed that PTC participants showed significant improvements in all four core program areas: self-care behaviors; management of emotions; efficacy in coping with caregiving demands; and use of community resources.
By improving use of self-care behaviors, caregivers are better able to take care of themselves, which in turn, makes them more effective as a caregiver. Pre- and post-program responses show significant improvements in:
- Finding ways to take care of my own health
Those reporting “strongly agree” grew significantly from 56 respondents before the program to 134 after program completion.
- Taking time for myself without feeling guilty
The number disagreeing or strongly disagreeing dropped from 79 to 10, while those strongly agreeing increased from 47 to 128.
- Doing something to make myself feel better when I am feeling discouraged
Respondents disagreeing or strongly disagreeing dropped from 42 to 5, while the number strongly agreeing more than doubled from 56 to 126.
PTC enabled participants to have more positive thoughts about their caregiving experience and to realize they are not alone if experiencing negative feelings. After PTC participants report:
- Understanding that my emotions are a normal response to caregiving
Those strongly agreeing rose from 67 to 145.
- Be more positive about my role as a caregiver
The number of respondents disagreeing or strongly disagreeing dropped from 52 to 4, while the number strongly agreeing more than tripled from 41 to 136.
- Having an identity outside of being a caregiver
Those disagreeing or strongly disagreeing dropped from 33 to 9, while the number strongly agreeing doubled from 63 to 126.
Program participants also report feeling more empowered following PTC program completion.
- Asserting myself with others to get my needs met
The number of respondents disagreeing dropped from 62 to 16, while those strongly agreeing grew from 36 to 93.
- Having confidence in my ability as a caregiver
Those disagreeing or strongly disagreeing dropped from 51 to 7, while those strongly agreeing more than doubled from 52 to 114.
- Finding caregiving resources available in my area
Disagreeing or strongly disagreeing respondents dropped from 63 to 9, while the number strongly agreeing nearly tripled from 41 to 116.
In addition to the significant improvements in the survey, participants’ qualitative feedback indicated the program was a positive experience and provided valuable skill development in a supportive environment.
“The survey data, both quantitate and qualitative, support the expansion of the Powerful Tools for Caregivers program as a valuable resource to improve the lives of caregivers,” states Fuller. “From the program content to the lay leaders to the peer exchange, this program made a significant impact in the short-term for those who participated.”
Fuller previously presented these findings as part of the panel “Empowering Caregivers Through Evidenced-Based Programing” at the Aging and Disability Resource Connection’s Healthy Communities Summit (Atlanta; June 17-19, 2015).
This is the final story in a three-part series on Long-Term Services & Supports. As the Baby Boomer generation ages and individuals with disabilities live longer, the need for long-term services and supports grows. The Georgia Health Policy Center (GHPC) strives to be at the forefront of efforts that target improving the lives of those who are aging and disabled, as well as those supporting them. On an ongoing basis the center conducts policy analysis surrounding long-term care program financing; strategic planning; and evaluation of program implementation and effectiveness.
The series documenting recent GHPC work in the area of long-term services and supports included:
- Assessing services needed for older adults to maintain community living
- Evaluating the appropriate annual caseload for options counselors
- Measuring the effects of the Powerful Tools for Caregivers Program