Abstract 4143204: Participation in a Resilience Intervention for Caregivers of Recently Hospitalized Patients with Heart Failure and Stroke

Introduction Family caregivers of persons with advanced heart failure (HF) and stroke bear increased responsibilities as care recipients recover from acute hospitalization. Few formalized supports are available. We conducted a feasibility pilot of a caregiver-targeted support program: Heart Failure and Stroke Resilience Intervention for Caregivers (HEROIC) using a randomized waitlist-control design. Here we sought to understand similarities and differences in participation between HF and stroke enrolled caregiver participants. Methods We recruited caregivers of HF and stroke patients via review of the electronic health record and/or provider referral after the first follow-up visit. Baseline surveys were collected electronically. Enrolled participants were randomized to the intervention or waitlist group. HEROIC consists of 5 nurse-led, remote sessions over a 10-week period. Components incorporate resilience resources including emphasis on caregiver life purpose and values, goal-setting for self-care, social support, community and palliative care resources. Characteristics of participants were analyzed using descriptive statistics and t-test or chi-square as appropriate. Results We identified 158 potential caregivers through electronic health records and provider referral. 65% (n=103) were reached by phone and 57/103 (55%) were eligible for participation. Fifty caregivers consented but only 31 completed baseline data collection and were randomized. Reasons for drop out included loss to follow-up, patient death and too many competing demands. Caregivers were on average 58.4 years old (SD: 11.4), 84% female and 45% Black. They supported patients with moderate to severe functional impairment and 5.5 ± 2.3 instrumental activities of daily living (IADL) on average. Over half of caregivers reported financial strain. Caregivers reported moderate caregiver strain using the Modified Caregiver Strain Index (Mean: 11.9, SD: 6.0). Most caregivers supported persons with HF (n=19). The only statistically significant difference noted between HF and stroke caregivers was gender; more caregivers of stroke patients were male. Conclusions Similarities in baseline characteristics of HF and stroke caregivers suggest similar caregiving experiences. HEROIC or other early post-hospital caregiver support interventions may appeal to caregivers to increase resilience to the stresses of transitions of care but recruitment strategies require additional consideration.