The Potential for the Internet and Telehealth in Caregiver Support. Comment on “Using Technology to Facilitate Fidelity Assessments: The Tele-STAR Caregiver Intervention”

We read with interest the recent paper entitled “Using Technology to Facilitate Fidelity Assessments: The Tele-STAR Caregiver Intervention” by Lindauer et al [1]. The authors concluded that Tele-STAR contributed to low caregiver burden and showed good fidelity as an intervention method.

Internet-based videoconferencing technology is an important source of support for caregivers of persons with dementia. Researchers have previously demonstrated the positive potential of computer-mediated interventions and technology-based cognitive behavioral therapy interventions for caregivers of people with dementia [2,3]. Others have raised the difficulties in measuring intervention fidelity in a consistent manner [4,5], which raises the importance of consistency when considering fidelity evaluations. Moreover, as the study reported results that may be attributed to both in-home and telehealth intervention experiences of participants, it may be useful to consider the interplay of these aspects.

Lindauer and colleagues [1] reported a slight reduction in caregiver burden, attributed to an improvement in caregivers’ responses to patients with dementia, facilitated by the Tele-STAR intervention. Caregiver burden is an important consideration in the field of dementia care. A recent study found an internet-based intervention to be effective in increasing the positive aspect of subjective appraisal for caregivers of persons with dementia [6]. In addition, we have studied the subjective appraisal of both negative and positive aspects in this population [7]. Assessments that take into account both sides of subjective appraisal are capable of providing a broad understanding of a caregiver’s context, and we would argue that an outcome that takes both into account would be more useful than current practices allow for.

The support that can be offered to caregivers using internet-driven technologies should continue to be explored, and the study conducted by Lindauer and colleagues [1] provides useful data in this regard. We agree that internet-based interventions will be beneficial to caregivers of persons with dementia in the future.