Dementia Care

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"Caring for a loved one with dementia presents a number of challenges that can seriously compromise the caregiver's quality of life," said Dr. Louis Burgio, Distinguished Research Professor at the Center for Mental Health and Aging at The University of Alabama and principal investigator at one of the five study sites. "For the millions of Americans who care for a loved one at home, an intervention that can improve their quality of life and lessen the burden of caregiving can make meaningful differences in their ability to better care both for themselves and their loved ones," he said.

The findings are significant, according to the researchers, because not only is caring for a loved one with dementia stressful, but the experience can contribute to the development of psychiatric and physical illnesses and increased risk for death among the caregivers.
The researchers found that, overall, the intervention was effective across racial and ethnic groups, with the most significant improvements among Hispanic and white caregivers. In African-Americans, the intervention was effective among spouse-caregivers, but relatively ineffective among caregivers who were caring for a relative other than their husband or wife.

The study enrolled 642 people who were caring for a relative with Alzheimer's disease or a related disorder at sites in Birmingham and Tuscaloosa, Ala.; Memphis, Tenn.; Miami; Palo Alto, Calif.; and Philadelphia. Hispanics, whites and African-Americans were evenly represented. The more than 200 participants in each ethnic group were randomized to receive either the intervention or an approach used for controlled comparison.

Hispanic and white participants saw the greatest benefit. African-American spouse-caregivers also saw improvement in the problem areas as a result of the intervention, while African-Americans caring for a non-spousal relative did not see any benefit.
In the intervention group, Hispanics had the greatest improvement in reduction of caregiver depressive symptoms and problem behaviors of the recipient. Whites saw the most impact in the area of social support, and African-American spouse-caregivers had the most positive outcome in reducing the caregiver burden and improving self-care.
At the six-month follow-up, the rate of clinical depression was significantly lower among participants who received the intervention from those in the control group. Caregivers also reported that the intervention helped them feel more confident and able to deal with caring for their loved one, improved the care-recipient's quality of life and helped them keep the recipient at home.

"Medicine doesn't work in the same way across all races and ethnicities, or even from person-to-person," said Burgio, the researcher in The University of Alabama's College of Arts and Sciences. "Health professionals need to identify caregivers whose quality of life has been compromised and help them to get the help they need, for their sake and the sake of their loved ones."

The study intervention was developed based on findings from the first phase of this study, Resources for Enhancing Alzheimer's Caregiver Health (REACH) I, in which multiple caregiver interventions were studied to identify which were the most promising.