Counseling benefits Alzheimer's disease caregivers
By Joene Hendry
NEW YORK (Reuters Health) - Individualized, long-term counseling appears to reduce the burden and depressive symptoms felt by caregivers of people with Alzheimer's disease, researchers report.
"Alzheimer's disease is an illness with a number of important transition points such as diagnosis, increasing dependence, residential care need, and even bereavement," Dr. Joseph E. Gaugler told Reuters Health.
Counseling can allow families to balance the need for 'aging in place' with the potential need to utilize 24-hour residential care, he said.
Gaugler of the School of Nursing at the University of Minnesota in Minneapolis and colleagues assessed the differences in the burden and depressive symptoms felt by 191 spouses of Alzheimer's disease patients who participated in the New York University Caregiver Intervention and 194 spouses who only had access to support groups and privately obtained services.
The intervention included regular counseling sessions for spouse caregivers and family members, support group counseling, and telephone access to intervention counselors as needed, the investigators report in the Journal of the American Geriatrics Society.
Participants were enrolled in the study for approximately 9.5 years and were an average of 71 years old at study entry.
The caregivers reported a considerable decrease in burden and depressive symptoms after moving their loved one into a nursing home, regardless of which group they were in, the investigators report.
However, the caregivers in the intervention group had fewer depressive symptoms before and at the time of nursing home placement, even though they tended to care for their loved one at home for a longer period than did the usual care group.
Moreover, after loved ones had been placed in nursing home care, the perceived burden among the intervention caregivers continued to be significantly lower compared with that in the usual care group.
In conjunction with group-based support, individual counseling can address the unique needs of each family as they provide ongoing, long-term care to a loved one suffering from Alzheimer's disease, Gaugler commented to Reuters Health.
The investigators suggest that primary care providers or hospital-based clinics accept such models as a standard for dementia care.
SOURCE: Journal of the American Geriatrics Society, March 2008.