January 23, 2006
A targeted program of counseling and support services can help to ease feelings of sadness and isolation while caring for a loved one with Alzheimer's disease, a new report shows. Caregivers who tended to a spouse with the illness felt more connected with friends and family, less stressed, and generally more satisfied when they and family members were educated about the disease and provided with ongoing counseling and support.
"We found that the intervention increased the number of people to whom the caregiver felt close, his or her satisfaction with the support network, and the satisfaction with the assistance with caregiving provided by the support network," says Dr. Mittelman, Dr.P.H., Director of the Psychosocial Research and Support Program at the NYU School of Medicine's Silberstein Institute. "The intervention has a long-lasting effect on caregiver depression, largely achieved through improving social support. These findings are important because they make it clear that social support is key to the well-being of caregivers." Dr. Mittelman also serves on the Editorial Advisory Board for the Fisher Center for Alzheimer's Research Foundation.
The new report makes it clear that providing enhanced counseling and support may have significant, long-lasting benefits for the estimated five million Americans who care for someone with Alzheimer's disease. The majority of Americans who have Alzheimer's or another form of dementia currently live at home under the care of family members. It's no surprise that caring for a loved one with Alzheimer's can at times feel overwhelming, a burden that can lead to deep feelings of stress and depression.
Dr. Mittelman encourages doctors and caregivers to inquire about counseling programs that may be available in their areas. "Such counseling programs have proven value," she says.
The research was part of the large and ongoing NYU Spouse-Caregiving Intervention Study, the longest running research project of its kind. The NYU approach employs several key strategies designed to help friends and family cope with the stress of caring for someone with Alzheimer's disease. Components of the program include:
1) Education of caregivers and family members about Alzheimer's disease, its effects on the patient, how best to manage care and respond to symptoms, and how to improve social support for caregivers.
2) Counseling and ongoing support for the care partner and family members, including both individual and family counseling, encouragement for caregivers to join support groups, and telephone counseling for the caregiver and other family members when needed.
3) Improving social support and reducing family conflict to help the caregiver withstand the hardships of caregiving and to help family members understand the primary caregiver's needs, and how best to be helpful.
The current study was conducted by researchers at NYU and appeared in the journal Psychology and Aging, published by the American Psychological Association.
The NYU enhanced counseling and support intervention may have been particularly potent because it is focused predominantly on mobilizing existing natural social support resources through individual and family counseling sessions, while also strongly encouraging caregivers to attend weekly support groups. It also provided ongoing encouragement and support through ad hoc telephone counseling services.
"Our findings suggest that interventions for spouse caregivers should explicitly target existing social support resources and the caregivers' satisfaction with those resources," says Dr. Mittelman. "Not only can these interventions be effective in alleviating caregiver emotional distress, but previously published findings from this study also demonstrate that supporting caregivers can significantly affect the time they can keep their husbands and wives with Alzheimer's disease at home with them, rather than feeling compelled to place them in a nursing home. [See the article, "Counseling Offers Lasting Benefits for Alzheimer's Caregivers".] Thus, supporting the caregiver benefits not just the caregiver but has a major impact on the well-being of the patient as well."
The current study looked at husbands and wives who cared for a spouse with Alzheimer's disease. New York University School of Medicine is currently recruiting caregivers for three new studies aimed at showing whether short-term counseling can ease the psychological stress and depression of those with Alzheimer's and their family members. One will examine the effects of counseling and support for people who care for a parent with Alzheimer's. A second will focus on caregivers caring for a parent in the middle stages of Alzheimer's disease, when behavioral problems become common. The third study will provide couples counseling for those with Alzheimer's and their spouses.
By www.ALZinfo.org. Reviewed by Mary Mittelman, Dr.P.H., Director of the Psychosocial Research and Support Program at NYU School of Medicine's William and Silvia Silberstein Institute on Aging and Dementia. Dr. Mittelman serves on the editorial advisory board of the Fisher Center for Alzheimer's Research Foundation.
David L. Roth, Mary S. Mittelman, Olivio J. Clasy, Alok Madan, and William E. Haley: "Changes in Social Support as Mediators of the Impact of a Psychosocial Intervention for Spouse Caregivers of Persons with Alzheimer's Disease." Psychology and Aging, Volume 20, No. 4, 2005, pages 634-644.