Date of Graduation

Fall 12-18-2017

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




Psychiatric Mental Health Nurse Practitioner

First Advisor

Melanie Keiffer


Dementia is becoming increasing more prevalent as individual’s age. More than half of caregivers for patients with dementia rate the emotional stress of caregiving as high or very high (Alzheimer’s Association, 2016). Chronic stress can leads to caregiver fatigue, burnout, irritability and depression (Alzheimer’s Association, 2016). Recognizing stress may help improve the caregiver-patient relationship. The Progressively Lowered Stress Threshold (PLST) model is recommended as a framework for devising non-pharmacological interventions for persons with dementia across living environments (Buckwalter, 1987 & Coon et al, 2012). The purpose of this scholarly project is to conduct a review of the literature to understand the use of the PLST as a method to lower stress in caregivers of patients with dementia 1) develop and implement a pilot PLST education program 2) assess caregiver knowledge of behavioral symptoms of dementia and 3) evaluate levels of stress among caregivers. PLST is used as a framework to educate caregivers about the dementia and to expand caregiver skills in effectively responding to cognitive impairment, behavioral symptoms and care related needs. The educational program was developed, delivered and evaluated by thirty-seven health care provider/caregivers of patients with significant cognitive impairment. Feedback were obtained using a survey method to determine whether this type of programming improves knowledge of behavioral symptoms of dementia and lowers caregiver stress. Caregiver feedback and results revealed that the educational program was beneficial in improving knowledge of strategies to cope with dementia patient’s behavioral symptoms. More studies are needed to determine the impact of education on caregiver sensitivity toward the patient with dementia and whether training results in less work stress and improved satisfaction in caregiving.

Keywords: dementia, PLST, cognitive impairment, caregiver stress