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To capture the scope of literature exploring interventions for caregivers of aging persons with TBI.A scoping review of peer reviewed literature was conducted in two phases. Phase I: Searching seven databases, two independent raters screened articles using a set of predetermined criteria. Included articles were reviewed, and categorized according to common themes. Phase II: Five stakeholders were engaged in a consultation. A content analysis was performed by extracting statements from each interview using an inductive strategy, and organizing each into themes.A total of 11 articles were included in the final analysis. Inter-rater reliability was assessed at both the title and abstract search [98.8% agreement; k = 0.3425 (95% CI, .246 to .439), p .05]; and the full-text review [83% agreement; k = 0.542 (95% CI, 0.340 to 0.745), p .05] phases. Seven articles identified potential interventions, and four identified and evaluated an intervention. Interventions targeted subjective burden (n = 4) and objective burden (n = 4), with caregiver knowledge and skill development (n = 3) classified as a sub-category of objective burden. Stakeholders overwhelmingly emphasized the need for interventions to reduce objective burden.Included articles were primarily composed of levels six and seven evidence, suggesting that this literature is in an early stage of development. Future research should emphasize the development and evaluation of interventions to reduce objective burden.

To establish whether the budgeting task of the Instrumental Activities of Daily Living (IADL) Profile discriminates individuals with a traumatic brain injury (TBI) from healthy controls and to identify the nature of the observed difficulties.This study tested 27 adults with moderate or severe TBI and 27 controls matched for age, sex and education on the budgeting task of the IADL Profile. The budgeting task is a complex real-world problem involving the preparation of a yearly budget for an individual living on a fixed income with the goal of saving money to purchase a car.The results showed that TBI subjects, the majority of whom had documented frontal lesions and/or diffuse axonal injury based on CT scan reports, were more likely than control subjects to experience difficulties on all task-related operations (planning, carrying out and verifying attainment of goal), with planning being particularly affected. These deficits were shown to impact on financial abilities, an issue of particular concern for TBI individuals reporting full responsibility of their finances.The budgeting task of the IADL Profile discriminates TBI subjects from controls. Planning was shown to be the most significant difficulty underlying reduced independence in the task.

To examine relationships between classical measures of executive functions (EF) and indices of traumatic brain injury (TBI) severity with the IADL Profile, a new performance-based measure of independence in instrumental activities of daily living (IADL) based on EF. This study hypothesized the presence of correlations between classical tests of EF and the IADL Profile, as the latter aims to establish whether the subject's main difficulties pertain to goal formulation, planning, carrying out the task and/or attaining the initial task goal; all important components of EF.One hundred subjects with a moderate/severe TBI aged 16-65 years (convenience sample) were recruited. Subjects were tested with the IADL Profile and three measures of EF within their home environment. Data was analysed using Pearson correlations, t-tests and multiple stepwise regressions.Post-traumatic amnesia and working memory emerged as the major determinants of IADL Profile scores. Together, indices of injury severity, measures of EF, education, age and environmental factors accounted for 12-28% of the variance in IADL Profile scores.This study has shown that the IADL Profile's non-structured approach permits the observation of a broad range of behaviours related to EF deficits and thus provides a closer approximation of the person's independence in IADL. Further study is required to demonstrate the IADL Profile's ability to inform more targeted treatment interventions.