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Sunday, August 29, 2004
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A number of studies in the last few years have reviewed the stresses that caregivers and families endure while caring for chronically ill patients. Most notably this has received special attention in the areas of dementia, bipolar disorder and schizophrenia. Family therapy and other psychological interventions have been studied to understand and help minimize the frustrations felt by those who devote themselves to caring for the disabled. A new study in JAMA looked at a different angle of this age-old problem. Researchers from the University of Pittsburgh evaluated the factors that affect caregiver health after institutionalizing a relative. Placing a family member in a long-term care facility is a difficult and stressful process but often a decision that needs to be made. This study of relatives of dementia patients pointed out that the level of committment of the caregiver remained similar to those carried out when the relative was living at home (such as feeding, grooming, managing money, shopping, and providing transportation) In addition 'caregivers took on new tasks such as interacting with administration and staff of the facility and becoming an advocate for the residents.' The study evaluated caretakers for depression and anxiety using standardized tests. Nearly half of the caregivers following placement had results indicating that they were at risk for clinical depression. Spouses, compared with nonspouses, were significantly more depressed before placement and more depressed and anxious after placement. The changes did not differ significantly by caregiver relationship to care recipient. The percentage of caregivers taking anxiolytics also increased after placement. To assess long-term impact and changes in depression and anxiety, test scores after 1 year were compared with initial scores. (prior to placement) There were no significant changes in depression scored from preplacement levels but there was a statistically significant decrease in anxiety. The authors of the study point out that caregivers are at risk for adverse health outcomes not only while providing care at home, but also after the patient is institutionalized. Their findings indicate that spouses, caregivers who remain actively involved with the care recipient, caregivers who have high levels of depression, and those who lack adequate support from others should receive interventions, such as preparation for and guidance through the placement transition, medical treatment for anxiety and depression following their relative's placement, and the recruitment of family and friends to support the caregiver.
JAMA. 2004;292:961-967
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10:53:43 PM
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Last update: 9/7/04; 11:08:49 PM.
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