December 4, 2006

Studies Show Benefits of Caregiver Support Programs

Picture of a caring couple

Programs designed to support caregivers of people with Alzheimer’s disease (AD) can help improve the quality of life for the caregivers and delay nursing home placement of the patients, two new studies have found.

The Resources for Enhancing Alzheimer's Caregiver Health II (REACH II) study was funded by NIH's National Institute on Aging (NIA) and National Institute of Nursing Research (NINR). It was developed based on the findings of the earlier REACH I study, which identified promising approaches to decrease burden and depression in caregivers of people with AD. REACH II was conducted at five sites nationwide, with the University of Pittsburgh as the coordinating center. It included 642 people — more than 200 each of Hispanic, white and African American caregivers of people with dementia. The caregivers within each ethnic/racial group were randomly assigned to either an intervention or a control group.

Trained project staff visited the caregivers in the intervention group at home nine times, talked with them during three half-hour telephone calls, and offered five structured telephone support sessions during the six-month study period. The strategies included information sharing, instruction, role playing, problem solving, skills training and stress-management techniques. Those in the control group received a packet of dementia education materials and two brief “check-in” telephone calls.

The researchers assessed the caregivers’ quality of life overall and in five specific areas: depressive symptoms, the burden of caregiving (such as the level of stress), engagement in self-care activities (such as getting rest or seeing a doctor when needed), level of social support and problem behaviors exhibited by the person with dementia. The investigators also looked at whether the people being cared for had been placed in institutions.

The results were published in the November 21, 2006, issue of Annals of Internal Medicine. After six months, significant quality of life improvements were found for 45% of Hispanic caregivers, 40% of white caregivers and 28% of African American caregivers in the intervention group, compared with 7%, 13% and 11%, respectively, in the control group. The rate of clinical depression was also significantly lower among caregivers in the intervention group than those in the control group (12.6% versus 22.7%).The rate of institutionalization for care recipients was lower in the intervention group as well (4.3% versus 7.2%), but the difference wasn't large enough to prove it wasn't due to chance

Another study, funded by NIA and NIH's National Institute of Mental Health and appearing in the November 14th issue of Neurology, recently showed that caregiver support is important for delaying nursing home placement. That study, by researchers at New York University, involved over 400 people caring for spouses with AD. It found that a counseling and support program for caregivers delayed the nursing home placement of patients with AD by an average of one and a half years.

“Family members and friends provide most of the care for millions of people with dementia who live at home. The challenges in doing so are serious, so it is important to examine interventions that can support the home situation for Alzheimer's patients and their caregivers,” notes NIA Director Dr. Richard J. Hodes. “These studies demonstrate that specific programs can make a meaningful difference.”

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