Preserving identity and planning for advance care (PIPAC): an intervention to increase coping in the early stages of dementia

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University of Alabama Libraries

The current study examined the feasibility and limited efficacy testing of the newly developed Preserving Identity and Planning for Advance Care (PIPAC) intervention. This intervention combined one self-adjusting component and one self-maintaining component to maximize coping and enhance quality of life in individuals in the early stages of dementia. Blocked randomization stratified by race and gender was used to assign participants and a family contact to either the: (a) multi-component intervention group, or the (b) minimal support phone contact control group. Of the 19 dyads randomly assigned to group 18 completed post-treatment assessment (i.e., 10 intervention and 8 control). Individuals with dementia were M = 82.8 (SD = 6.46) years old; six (31.6%) were men and 13 were women (68.4%). Participants were predominantly White/Caucasian (94.7%) with one Black/African American (5.3%) individual with dementia. Family contacts were M = 70.14 (SD = 12.16) years old and were predominantly spouses (47.4%) or adult children (42.1%). They were 84.2% White/Caucasian and 12.5% Black/African American. Feasibility data, including a focus group with research staff, demonstrated successful implementation, acceptability, and practicality of the intervention package. Furthermore, limited efficacy testing using between subjects ANCOVAs to control for baseline values revealed clinically meaningful differences (i.e., medium to large effect sizes) between groups at post-treatment for depression, quality of life, indicators of health-related quality of life, and decisional conflict. Higher levels of coping and awareness were also observed post-treatment in intervention group individuals. Overall, the PIPAC intervention shows promise as a brief, manualized, psychosocial treatment for individuals in the early stages of dementia.

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Clinical psychology, Gerontology, Aging