September 17, 2007
Counseling and support is not just good for easing stress in those who care for a loved one with Alzheimer's disease. It may also boost physical health as well, a new study from Dr. Mary Mittelman and colleagues at New York University School of Medicine shows.
"Preserving the health of spouse caregivers through counseling and support also benefits the person with Alzheimer's disease, as caregivers who are in poor health are more likely to have difficulty providing good care," says Dr. Mittelman, research professor in the Department of Psychiatry at NYU. Dr. Mittelman also serves on the editorial board of the Fisher Center for Alzheimer's Research Foundation.
Caring for a loved one with Alzheimer's is among the most difficult of tasks and can take a serious toll on mental and physical wellbeing. The stress of caregiving can be especially devastating for older men and women who care for a spouse with the disease. This current study, published in the September issue of the American Journal of Geriatric Psychiatry, adds to the growing list of benefits that counseling and support can provide to those who care for someone with Alzheimer's disease.
The research is 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) Six sessions of individual and family counseling that provided 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) Ongoing support for the care partner and family members, including encouragement for caregivers to join support groups, and telephone counseling for the caregiver and other family members when needed.
The researchers gauged caregivers' self-reported health, an important predictor of physical illness, with questions that have been used widely in national surveys by the Centers for Disease Control and Prevention, and internationally by the World Health Organization. They found that caregivers who received the targeted counseling and support scored higher on the self-rated health than those who received standard care, consisting of information and help on request but no formal counseling sessions. The benefits began within four months of enrollment and lasted more than a year, according to the study.
The intervention achieved its effects largely through 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.
"Individualized counseling programs that improve social support for caregivers can have many indirect benefits, including sustaining their physical health," says Dr. Mittelman.
According to the Family Caregiver Alliance, in 2004 there were approximately 44 million family caregivers in the United States. "The public health implications of providing this intervention on a wide scale are potentially enormous," said Kathleen Kelly, Executive Director of the Alliance.
Previous results from the study, now 20 years running, have shown that spouses who cared for a loved one with Alzheimer's disease were much less likely to place their partner in a nursing home if they received targeted counseling and support. This delay in institutional care can be beneficial for both family members and those with Alzheimer's and save millions of dollars in health-care costs.
A targeted program of counseling and support services can also ease depression and help to ease feelings of sadness and isolation while caring for a loved one with Alzheimer's disease, previous findings have shown. 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.
The current study adds physical well being to the list of the many benefits that counseling and support can provide to those who care for a loved one with Alzheimer's disease. The study was supported by the National Institute of Mental Health, the National Institute of Aging, the New York University School of Medicine Alzheimer's Disease Center, and the Florida Alzheimer's Research Center.
For more information about new programs for caregivers at NYU, or to enroll in future studies, call the Psychosocial Research and Support Program of the New York University School of Medicine Silberstein Institute at (212) 263-5728 or (212) 263-5710.
To learn more about care-giving and Alzheimer's disease, visit www.ALZinfo.org.
By www.ALZinfo.org. The Alzheimer's Information Site.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.
Dr. Mary Mittelman, et al: American Journal of Geriatric Psychiatry, September, 2007. Press release: American Association for Geriatric Psychiatry.