Caregiver self-efficacy improves following complex care training: Results from the Learning Skills Together pilot study.

No control group: caregivers were all compared with themselves, so the improvement could reflect time, experience, or other changes rather than the program. Small pilot with 35 participants, so the study was too small to confirm the result. Attrition and selection bias: 29 of 35 completed the 4-week survey and 25 of 35 completed the 8-week survey, and those who dropped out had higher baseline depression scores. The complex care confidence measure was author-generated and not previously validated. Participants were English-speaking caregivers with reliable internet who cared for someone in mid-stage dementia and were not planning nursing home placement in the next 3 months, so results may not apply to other caregiver groups. Online delivery removed direct hands-on practice and expert feedback on skills such as toothbrushing. Care recipient diagnosis and dementia stage were based on caregiver report rather than clinical verification.

The study was supported by NIH/NIA grants R21AG068027, P30AG066539 and R01MD009815. The authors declared no conflicts of interest. Before the research study, the program had been paid by a local Area Agency on Aging to deliver LST under the National Family Caregiver Support Program.

Do not read the confidence gains as proof that Learning Skills Together works. This was a single-group pilot with 35 participants and no control group, and the authors state that changes cannot be attributed to the intervention alone because caregivers may have gained experience and some participants with higher depression dropped out.