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International Journal of Alzheimer’s Disease
Volume 2013, Article ID 913606, 11 pages
Clinical Study

Clinical Trial of a Home Safety Toolkit for Alzheimer’s Disease

1VA New England Geriatric Research Education & Clinical Center, Bedford, MA 01730, USA
2Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA 01730, USA
3Alzheimer’s Disease Center, Boston University School of Medicine, Boston, MA 02118, USA
4VA Center for Health Quality Outcomes and Economics Research, Bedford, MA 01730, USA
5Department of Occupational Therapy, Tufts University, Medford, MA 02155, USA
6VA Boston Healthcare System, Boston, MA 02130, USA
7Massachusetts General Hospital Yvonne L. Munn Center for Nursing Research, Boston, MA 02114, USA

Received 29 March 2013; Revised 8 August 2013; Accepted 16 August 2013

Academic Editor: Matti Viitanen

Copyright © 2013 Kathy J. Horvath et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


This randomized clinical trial tested a new self-directed educational intervention to improve caregiver competence to create a safer home environment for persons with dementia living in the community. The sample included 108 patient/caregiver dyads: the intervention group ( ) received the Home Safety Toolkit (HST), including a new booklet based on health literacy principles, and sample safety items to enhance self-efficacy to make home safety modifications. The control group ( ) received customary care. Participants completed measures at baseline and at twelve-week follow-up. Multivariate Analysis of Covariance (MANCOVA) was used to test for significant group differences. All caregiver outcome variables improved in the intervention group more than in the control. Home safety was significant at , caregiver strain at , and caregiver self-efficacy at . Similarly, the care receiver outcome of risky behaviors and accidents was lower in the intervention group ( ). The self-directed use of this Home Safety Toolkit activated the primary family caregiver to make the home safer for the person with dementia of Alzheimer's type (DAT) or related disorder. Improving the competence of informal caregivers is especially important for patients with DAT in light of all stakeholders reliance on their unpaid care.