Wednesday, August 25, 2004
Caregivers become more depressed, study shows.
KNIGHT RIDDER NEWSPAPERS
PHILADELPHIA -- Contrary to what researchers expected, placing a loved one with dementia in a nursing home does not make caregivers feel better.
In fact, most were just as depressed and anxious after their family member was in the nursing home, and some felt worse, said Richard Schulz, a University of Pittsburgh psychiatry professor who led a government-funded study published today.
Anxiety abated after a year, but depression remained just as high as when the dementia patients were at home.
Caring for someone in the later stages of Alzheimer's disease is both mentally and physically exhausting, so one might expect that caregivers would feel less stress once a relative with dementia is in a nursing home, Schulz said. Plus, earlier research by his team found that Alzheimer's caregivers quickly become less depressed after their loved one's death.
"We kind of were expecting similar effects in this group," he said.
Results
Instead it seemed that caregivers were trading one kind of stress for another. Spouses in particular still visited frequently and were involved in the physical care of their disabled partners. They were still witnessing their loved ones' decline and many felt guilty about the nursing home placement. There were financial worries and caregivers had to learn how to deal with the nursing home bureaucracy.
Nearly half the caregivers were at risk for clinical depression.
Schulz said caregivers need more counseling and treatment for depression and anxiety. "They could probably benefit from increased knowledge and understanding of how long-term care facilities operate and what their role might be," he added. He believes that helping caregivers plan for the deaths of their relative also helps.
The study of 1,222 caregiver-patient pairs was published in the Journal of the American Medical Association.
During the four-year study, 180 people with dementia were put in nursing homes. The researchers said the study was the first to examine what leads to nursing home placement, the nature of contact between caregivers and their relatives after placement and how these factors affect caregiver health.
Schulz said nursing home placement is "an act of last resort ... It's something you don't do lightly. You do it after you've run out of all your other options." He did not know if caregivers would have been even more depressed if they had tried to keep their loved ones at home.