Advanced Caregiver Training (ACT)


Categories associated with best practice:

  • Individual
  • PP-icon1
  • Adult (ages 25-64) icon
  • Seniors (ages 65+) icon
  • Home
  • Injury Prevention

Determinants of Health: Personal health practices and coping skills


ACT was designed to target problem behaviors identified by caregivers as most troublesome and provide strategies to manage them effectively. ACT conceptualized problem behaviors as a consequence of interacting factors reflecting three domains: patient based (unmet needs, discomfort or pain, incipient medical condition), caregiver based (stress, communication style), and environment based (clutter, hazards). ACT sought to identify and then modify potential triggers in each of these domains to help caregivers eliminate, reduce, or prevent the targeted problem behavior. ACT involved a 16-week active phase of up to nine occupational therapy (OT) sessions and two nursing sessions (one home and one telephone) and a maintenance phase (16–24 weeks) of three brief OT telephone contacts to reinforce strategy use.

Primary Source Document

Gitlin L, Winter L, Dennis M, Hodgson N, Hauck W., Targeting and Managing Behavioral Symptoms in Individuals with Dementia: A Randomized Trial of a Nonpharmacological Intervention. J Am Geriatr Soc. 2010 Aug;58(8):1465-74. doi: 10.1111/j.1532-5415.2010.02971.x. Epub 2010 Jul 19.

Contact information of developer(s) and/or implementer(s)

Laura N. Gitlin, Director, Jefferson Center for Applied Research on Aging and Health, Thomas Jefferson University, 130 S. 9th Street, Suite 513, Philadelphia, PA 19130.

Intervention Focus

Intervention Goal / ObjectiveLevel(s) TargetedEquity Focus
Reduction in care recipient problem behaviour.
  • Interpersonal level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.
Improvement in caregiver well-being and management skills.
  • Interpersonal level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.

Health Issue(s) that is/are addressed by the Intervention

Health Promotion

    Risk Reduction

    • Prevent injury

    Specific Activities of the Intervention

    • Other training session

    Priority/Target Population for Intervention Delivery

    Life Stage

    • Adults (age 25-64 years)
    • Seniors (age 65+ years)


    Educational Settings

      Community Setting

      • Home


      Outcomes and Impact Chart
      Level of ImpactDescription of OutcomeEquity Focus
      Individual LevelACT sought to reduce caregiver upset by providing skills to manage problem behaviours effectively.Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.


      Implementation History

      • Implemented once (could be a pilot) - The intervention has been implemented once and is theoretically replicable elsewhere.

      Expertise Required for Implementation within the Context of the Intervention

      • Requires specialized skills that are easily available within the context - The intervention requires the participation of personnel with advanced skills (e.g. medical doctors, epidemiologists, social workers) but that are easily available within the intervention context.

      Are there supports available for implementation


      Are there resources and/or products associated with the interventions