Caregivers of Dementia Patients: Mental Health Screening & Support
Although accreditation for this CE/CME activity has expired, and the posttest is no longer available, you can still read the full article.
Expires May 31, 2017
Caregivers, mostly family and friends, play an important role in the complex care of persons with Alzheimer disease and other dementias. Primary care providers are uniquely positioned to assess for the negative consequences of caregiving, including depression, anxiety, and caregivers' failure to care for their own health needs. This article provides you with reliable, valid screening tools and recommendations for evidence-based interventions to increase the caregiver’s and patient’s quality of life and care.
Caregiver stress and SELF-CARE
Primary care providers can be instrumental in not only offering referral to services to reduce caregiver stress but also encouraging self-care behaviors for caregivers. They have the opportunity, early on, to anticipate the stresses that caregivers may experience as their loved one’s disease progresses and to provide helpful referral for services (including psychotherapy and support groups), information, and support to preventively address functional ability and self-care behaviors.
The relationship between caregiver stress and self-care behavior has been widely studied. Using the Caregiving Hassles Scale, Kinney and Stephens examined the mediating function of the relationship between caregiving stress and self-care behavior. They found caregiver stress to correlate to self-rated health at a statistically significant level (r = .30, P = .003).13 On a positive note, the investigators also found that the more symptoms family members reported (depression, poor health), the more self-care behaviors they used.
Lu and Wykle also used the Caregiving Hassles Scale in their correlational crossfunctional study. Caregivers (n = 99) were assessed for the mediating function of the relationship between caregiving stress and self-care behavior in response to symptoms.49 Those who reported higher levels of caregiving stress also reported poorer self-rated health, poorer physical function, high levels of depressed mood, and more self-care behaviors at a statistically significant level (r =.30, P = .003, Cronbach’s alpha = .95). The researchers determined that depressed mood was a strong mediator between caregiver stress and response to the symptoms with self-care behaviors.
,Unsteady on his feet, Henry became a fall risk. His growing confusion and cognitive decline led to increased depression and agitation, which reduced his socialization and physical activity. Over time, this resulted in a disturbing chain of events, including urinary tract infections, hospitalization, and behavior changes that were upsetting to his wife and children as well as to Henry. Joann was not sleeping well and contracted a cold that turned into pneumonia, leading to a hospitalization. Through all of this, Joann knew that she could call Henry’s NP for advice and support. She found solace in knowing that the caregiver support group she attended regularly would always be there to encourage and inform her and that Henry’s support group would not only give her respite as a caregiver but also provide Henry with cognitive stimulation shown to enhance the well-being of those experiencing memory loss. These groups soon became her lifeline. Without vital early screenings, this family would not have adequately managed the difficulties brought on by Henry’s unexpected diagnosis.
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