Memphis VA Medical Center
Memphis Researchers Help Brain Injury Caregivers
By By Jason Bolton Data Editor, Memphis Business Journal
Thursday, January 16, 2020
Linda Nichols and Jennifer Martindale-Adams have been collaborating on research so long, they can finish each other's sentences.
Coworkers since 1989, they were instrumental in developing the REACH VA (Resources for Enhancing All Caregivers Health in the VA) program, which began in 1995.
Now, Nichols and Martindale-Adams are codirectors of the Caregiving Center at the Memphis Veterans Affairs (VA) Medical Center and are both preventative medicine professors at the University of Tennessee Health Science Center (UTHSC).
“I feel like we get to come to work every day and make a big difference in people’s lives,” Nichols said. “We are a great team.”
Both the familiarity with each other and with the REACH program will help them carry out a new, $1.3 million U.S. Department of Defense (DoD) research partnership award, called “Supporting Caregivers of Veterans with Traumatic Brain Injuries (TBI) and Alzheimer’s Dementia/Mixed Dementia: The REACH Hope Behavioral Intervention.”
The study combines two VA behavioral health programs to help caregivers who are taking care of veterans with traumatic brain injuries. Those with TBI are at a greater risk of developing dementia.
Based on more than 20 years of research and clinical experience — REACH is a four-session VA national intervention program that uses education, skills-building, and coaching to help caregivers cope with stress and maintain their own emotional and physical well-being.
The program utilizes the Virtual Hope Box, a DoD behavioral health app that supports “coping and emotional regulation” for military personnel through positive messaging, games, mindfulness exercises, and personalized tools.
The REACH Hope combination will involve a caregiver and a program coach working together on REACH coping strategies and the Hope Box. The study will be national in scope, recruiting subjects all across VA entities.
“For the veteran, we've seen a decrease in safety risks and a decrease in diagnosis-related behaviors that the caregiver is having to manage. For the caregiver, we see a decrease in depression and anxiety and in caregiving frustrations and burden, including time on [care] duty,” Nichols said.
The three-year research award will be implemented by Nichols and Martindale-Adams — who have expertise in dementia and caregiving — and two investigators and TBI experts from Virginia Commonwealth University (VCU), Paul Perrin and Ronald Seel.
Nichols and Perrin are leading the REACH Hope study.
Beyond the new REACH Hope study — which is currently recruiting participants — the original REACH program has and continues to help many caregivers in other states and locally.
The Caregiver Center in Memphis is run by Nichols and Martindale-Adams and works with VA staff across the country. The center helps thousands of veteran caregivers annually, Nichols said.
It receives about 70 to 100 referrals a month for REACH. And, that volume could grow in 2020.
“In 2020 as part of the VA Mission Act, we will be training coaches at each [VA] facility,” Nichols said. “So, there will be a lot more REACH across the country.”
Nichols and Martindale-Adams said REACH has already been extensively used in states such as Arkansas, Minnesota, and Maine.
“Caregivers have always been looked at as part of the medical team; they're there to help care for the person,” Martindale-Adams said. “Now, people are starting to realize that we have to take care of our caregivers.”
In the Memphis metro, REACH Community is made available for training through UTHSC’s Caregiving Center in its Department of Preventative Medicine.
“We train agencies that want to do the REACH model so we do have it outside the VA,” Martindale-Adams said. “They allowed us to move it over and be able to provide the training for community agencies.”