Objective
The objective of this study was to determine the effects of counseling and support
on the physical health of caregivers of spouses of people with Alzheimer disease.
Methods
A randomized controlled trial, conducted between 1987 and 2006 at an outpatient research
clinic in the New York City metropolitan area compared outcomes of psychosocial intervention
to usual care. Structured questionnaires were administered at baseline and regular
follow-ups. A referred volunteer sample of 406 spouse caregivers of community dwelling
patients with Alzheimer disease enrolled over a 9.5-year period. Enhanced counseling
and support consisted of six sessions of individual and family counseling, support
group participation, and continuous availability of ad-hoc telephone counseling. Indicators
of physical health included self-rated health (SRH) of caregivers and the number of
reported illnesses.
Results
Controlling for baseline SRH (mean: 7.24), intervention group caregivers had significantly
better SRH than control group caregivers based upon model predicted mean scores four
months after baseline (6.87 versus 7.21), and this significant difference was maintained
for two years (6.70 versus 7.01). The effect of the intervention on SRH remained significant
after controlling for the effects of patient death, nursing home placement, caregiver
depressive symptoms and social support satisfaction. Similar benefits of intervention
were found for number of illnesses.
Conclusion
Counseling and support preserved SRH in vulnerable caregivers. Enhancing caregivers'
social support, fostering more benign appraisals of stressors, and reducing depressive
symptoms may yield indirect health benefits. Psychosocial intervention studies with
biological measures of physical health outcomes are warranted.
Key Words
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Article info
Publication history
Accepted:
March 5,
2007
Received in revised form:
February 25,
2007
Received:
September 21,
2006
Footnotes
This work was supported by grants from the National Institute of Mental Health (R01 MH 42216), the National Institute on Aging (R01 AG14634), the Alzheimer's Disease Core Center (P30-AG08051), and the Florida Alzheimer's Disease Research Center (P50-AG025711 to WEH).
The authors thank the NYU Caregiver Counseling staff, Steven Ferris, Ph.D., and the caregivers for their participation.
Identification
Copyright
© 2007 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
