U.S. flag

An official website of the United States government

Talk to the Veterans Crisis Line now
Skip to main content

Last updated

Caregivers Finding Important Resources, Support, and Training (Caregivers FIRST)

Share Print

Caregivers FIRST (Formerly Helping Invested Families Improve Veterans' Experiences or IHI-FIVES) is offered to caregivers of Veterans of all eras and diagnoses, and is a highly adaptable “grab and go” curriculum package that includes four in-person classes (60-75 minutes each) and optional training topics. The program is designed to help caregivers build coping, support-seeking, and hands-on skills and strategies while connecting with VA supports available and each other.

This innovation is scaling widely with the support of national stakeholders. See more scaling innovations.

Origin:

March 2013, Durham VA Medical Center

Adoptions:

106 successful

Awards and Recognition:

QUERI Partnered Evaluation Initiative

Partners:

Caregiver Support Program, Quality Enhancement Research Initiative

Contact Team

Overview

Problem

Over 5 million former or current military personnel receive informal care in the home from family members or friends. Unintended impacts on caregivers can include strain, burden, burnout, and depression. Additionally, half of caregivers of Veterans with functional/cognitive limitations report unmet needs for training.

Solution

Caregivers FIRST is an evidence-based, caregiver skills group training program with the goal of connecting caregivers with each other and to resources to help them feel more confident, capable, and supported in their caregiving role. Caregivers FIRST is a “grab and go” off the shelf curriculum that includes four classes and optional training topics helping c ... See more

Results

The results of the trial showed promising outcomes including increased caregiver’s satisfaction of VA care at 6 months and at 12 months and Veteran’s satisfaction at 12 months, reduced caregiver feelings of isolation, and increased Veteran days at home in the community at 12 months (9% more)*.
Caregivers FIRST is expected to:
Improve caregiver satisfaction
... See more

Links

Metrics

  • 97% of caregiver participants agree or strongly agree that the training was worth the time invested (2018-2020 caregiver participant evaluations, n=124).

Diffusion tracker

Does not include Clinical Resource Hubs (CRH)

Statuses

AK: Colonel Mary Louise Rasmuson Campus of the Alaska VA Healthcare System (Anchorage) AL: Birmingham VA Medical Center (Birmingham, Alabama) AL: Central Alabama VA Medical Center-Montgomery (Montgomery) AL: Tuscaloosa VA Medical Center (Tuscaloosa) AR: John L. McClellan Memorial Veterans' Hospital (Little Rock, Arkansas) AZ: Carl T. Hayden Veterans' Administration Medical Center (Phoenix, Arizona)
  • Started adoption on 09/2019.
AZ: Tucson VA Medical Center (Tucson) CA: Fresno VA Medical Center (Fresno) CA: Jennifer Moreno Department of Veterans Affairs Medical Center (San Diego, California) CA: Los Angeles VA Clinic (Los Angeles) CA: Palo Alto VA Medical Center (Palo Alto, California) CA: Sacramento VA Medical Center (Sacramento) CA: Tibor Rubin VA Medical Center (Long Beach) CO: Aurora VA Clinic (Aurora, Colorado) CO: Grand Junction VA Medical Center (Grand Junction, Colorado) DC: Washington VA Medical Center (Washington, District of Columbia) DE: Wilmington VA Medical Center (Wilmington, Delaware) FL: Bruce W. Carter Department of Veterans Affairs Medical Center (Miami) FL: C.W. Bill Young Department of Veterans Affairs Medical Center (Bay Pines) FL: James A. Haley Veterans' Hospital (Tampa, Florida) FL: Orlando VA Medical Center (Orlando) FL: West Palm Beach VA Medical Center (West Palm Beach) GA: Carl Vinson Veterans' Administration Medical Center (Dublin) GA: Charlie Norwood Department of Veterans Affairs Medical Center (Augusta Downtown) GA: Joseph Maxwell Cleland Atlanta VA Medical Center (Atlanta, Georgia) HI: Spark M. Matsunaga Department of Veterans Affairs Medical Center (Honolulu) IA: Des Moines VA Medical Center (Des Moines, Iowa) IA: Iowa City VA Medical Center (Iowa City, Iowa) ID: Boise VA Medical Center (Boise) IL: Edward Hines Junior Hospital (Hines)
  • Started adoption on 05/2019.
IL: Jesse Brown Department of Veterans Affairs Medical Center (Chicago, Illinois) IL: Marion VA Medical Center (Marion, Illinois) IN: Richard L. Roudebush Veterans' Administration Medical Center (Indianapolis, Indiana) KS: Colmery-O'Neil Veterans' Administration Medical Center (Topeka) KS: Robert J. Dole Department of Veterans Affairs Medical and Regional Office Center (Wichita) KY: Franklin R. Sousley Campus (Lexington Leestown) KY: Robley Rex Department of Veterans Affairs Medical Center (Louisville) LA: Alexandria VA Medical Center (Alexandria, Louisiana) MA: Edith Nourse Rogers Memorial Veterans' Hospital (Bedford) MD: Baltimore VA Medical Center (Baltimore) ME: Togus VA Medical Center (Togus) MI: Aleda E. Lutz Department of Veterans Affairs Medical Center (Saginaw, Michigan) MI: Battle Creek VA Medical Center (Battle Creek) MI: John D. Dingell Department of Veterans Affairs Medical Center (Detroit) MN: Minneapolis VA Medical Center (Minneapolis, Minnesota) MO: John J. Pershing Veterans' Administration Medical Center (Poplar Bluff)
  • Started adoption on 10/2018.
MO: Kansas City VA Medical Center (Kansas City, Missouri) MO: St. Louis VA Medical Center-Jefferson Barracks (St. Louis Jefferson Barracks) MT: Fort Harrison VA Medical Center (Fort Harrison) NC: Charles George Department of Veterans Affairs Medical Center (Asheville) NC: Durham VA Medical Center (Durham)
  • Started adoption on 05/2019.
ND: Fargo VA Medical Center (Fargo) NE: Omaha VA Medical Center (Omaha, Nebraska) NJ: East Orange VA Medical Center (East Orange) NV: Ioannis A. Lougaris Veterans' Administration Medical Center (Reno) NV: North Las Vegas VA Medical Center (North Las Vegas) NY: Bath VA Medical Center (Bath) NY: Brooklyn VA Medical Center (Brooklyn) NY: Buffalo VA Medical Center (Buffalo, New York) NY: Canandaigua VA Medical Center (Canandaigua) NY: Northport VA Medical Center (Northport) NY: Samuel S. Stratton Department of Veterans Affairs Medical Center (Albany, New York) NY: Syracuse VA Medical Center (Syracuse) OH: Chalmers P. Wylie Veterans Outpatient Clinic (Columbus, Ohio) OH: Chillicothe VA Medical Center (Chillicothe) OH: Cincinnati VA Medical Center (Cincinnati, Ohio) OH: Dayton VA Medical Center (Dayton) OH: Louis Stokes Cleveland Department of Veterans Affairs Medical Center (Cleveland, Ohio) OR: Portland VA Medical Center (Portland, Oregon) OR: Roseburg VA Medical Center (Roseburg) PA: Butler VA Medical Center (Butler New Castle Road) PA: Corporal Michael J. Crescenz Department of Veterans Affairs Medical Center (Philadelphia, Pennsylvania) PA: Erie VA Medical Center (Erie) PA: James E. Van Zandt Veterans' Administration Medical Center (Altoona) PA: Lebanon VA Medical Center (Lebanon) PA: Pittsburgh VA Medical Center-University Drive (Pittsburgh) PA: Wilkes-Barre VA Medical Center (Wilkes-Barre) RI: Providence VA Medical Center (Providence) SC: Ralph H. Johnson Department of Veterans Affairs Medical Center (Charleston, South Carolina) SD: Fort Meade VA Medical Center (Fort Meade, South Dakota) SD: Royal C. Johnson Veterans' Memorial Hospital (Sioux Falls) TN: Lt. Col. Luke Weathers, Jr. VA Medical Center (Memphis) TN: Nashville VA Medical Center (Nashville)
  • Started adoption on 10/2019.
TX: Audie L. Murphy Memorial Veterans' Hospital (San Antonio, Texas)
  • Started adoption on 10/2019.
TX: Dallas VA Medical Center (Dallas) TX: El Paso South Central VA Clinic (El Paso South Central) TX: George H. O'Brien, Jr., Department of Veterans Affairs Medical Center (Big Spring) TX: Harlingen VA Clinic (Harlingen) TX: Olin E. Teague Veterans' Center (Temple) TX: San Antonio VA Clinic (San Antonio Fredericksburg Road) TX: Thomas E. Creek Department of Veterans Affairs Medical Center (Amarillo) UT: George E. Wahlen Department of Veterans Affairs Medical Center (Salt Lake City) VA: Hampton VA Medical Center (Hampton) VA: Richmond VA Medical Center (Richmond, Virginia) WA: American Lake VA Medical Center (American Lake)
  • Started adoption on 10/2018.
WA: Jonathan M. Wainwright Memorial VA Medical Center (Walla Walla) WA: Mann-Grandstaff Department of Veterans Affairs Medical Center (Spokane, Washington) WA: Seattle VA Medical Center (Seattle)
  • Started adoption on 10/2018.
WA: Vancouver VA Medical Center (Vancouver)
  • Started adoption on 05/2020.
WI: Clement J. Zablocki Veterans' Administration Medical Center (Milwaukee, Wisconsin) WI: Tomah VA Medical Center (Tomah) WI: William S. Middleton Memorial Veterans' Hospital (Madison)
  • Started adoption on 05/2020.
WV: Beckley VA Medical Center (Beckley) WV: Louis A. Johnson Veterans' Administration Medical Center (Clarksburg) WV: Martinsburg VA Medical Center (Martinsburg) WY: Cheyenne VA Medical Center (Cheyenne)

There are no in-progress adoptions for this innovation.

There are no unsuccessful adoptions for this innovation.

Multimedia

Images

The randomized control trial was shown to: 1 ) Increase the experience of VA care for caregivers at 6 months and 12 months and for patients at 12 months; 2) Reduce caregiver feelings of isolation; 3) Increase Veteran days in the community (not in an institution) at 12 months (9% more)

Implementation

Timeline

  • Months 1-3
    • Review the potential benefits and program components for Caregivers FIRST.
    • Gather leadership support.
    • Determine any program adaptations.
    • Develop a plan for program documentation.
    • Develop and operationalize plan for caregiver recruitment.
    • Deliver train-the-trainer with program facilitators.
  • Month 4-6: Launch Caregivers FIRST
    • With team, conduct debrief to review first found of Caregivers FIRST and discuss barriers and facilitators.

Departments

  • Mental health care
  • Social work
  • Chaplaincy
  • Geriatrics
  • Caregiver support

Core Resources

Resource type Resource description
PEOPLE
  • 2 Clinical Staff to serve as facilitators, can consider students and volunteers as well
  • Staff effort for one round of training (Classes 1-4) is estimated below: • Orientation and reviewing training material: 4-8 hours total • Training time: 8 training hours per round of classes (4 hours direct training time, 3-4 hours set up) • Recruitment (varies): Estimate of 12-16 hours per round of classes Documentation and administrative (including meeting with team: Estimate 5-8 hours per round of classes
PROCESSES
  • Caregivers FIRST is designed to be a “grab and go” off the shelf training to be delivered by clinical staff. No certifications or training of staff is required.
TOOLS
  • Caregivers FIRST provides PDFs of the facilitator’s guide and caregiver workbooks. Sites are responsible for printing training and any marketing materials. For Caregivers FIRST delivery, technology will be needed for virtual delivery (e.g., VANTS line or video conference), or projectors and laptops for in-person delivery

Files

Links

Support Resources

Files

Links

  • CaregiversFIRST Sharepoint Site with all Training Materials and Toolkits Sharepoint

Contact

Comment

Comments and replies are disabled for retired innovations and non-VA users.

Email

Email with questions about this innovation.

About

Origin story

Caregivers FIRST is a rebranding of the evidence-based program, HI-FIVES, which was first delivered by Dr. Van Houtven and her team in Durham in 2013. In 2016, this program was expanded to 8 VAMC sites under Function QUERI. In 2021, the National Program Office of Caregiver Support named Caregivers FIRST a minimum standard, supporting national expansion of t ... Caregivers FIRST is a rebranding of the evidence-based program, HI-FIVES, which was first delivered by Dr. Van Houtven and her team in Durham in 2013. In 2016, this program was expanded to 8 VAMC sites under Function QUERI. In 2021, the National Program Office of Caregiver Support named Caregivers FIRST a minimum standard, supporting national expansion of this program.

Original team

Courtney Van Houtven

Project Lead

Kasey Decosimo

Project Coordinator

Josh D'adolf

Caregiver Support Coordinator

Matthew Tucker

Research Assistant