Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-18T17:56:32.807Z Has data issue: false hasContentIssue false
  • English
  • Français

Effective psychosocial intervention for family caregivers lengthens time elapsed before nursing home placement of individuals with dementia: a five-year follow-up study

Published online by Cambridge University Press:  08 July 2008

Signe Andrén  and
Sölve Elmståhl
Signe Andrén*
Affiliation:
Department of Health Sciences, Division of Geriatric Medicine, Lund University and Malmö University Hospital, Malmö, Sweden.
Sölve Elmståhl
Affiliation:
Department of Health Sciences, Division of Geriatric Medicine, Lund University and Malmö University Hospital, Malmö, Sweden.
*
Correspondence should be addressed to: Dr. Signe Andrén, Department of Health Sciences, Division of Geriatric Medicine, Lund University, Malmö University Hospital, SE-205 02 Malmö, Sweden. Phone: +46 40 39 1315; fax: +46 40 39 1313. Email: [email protected].
Get access

Abstract

Background: This study was designed to determine the effectiveness of a psychosocial intervention for family caregivers in delaying nursing home placement of individuals with dementia.

Methods: The participants comprised 153 family caregivers of persons with dementia who underwent intervention and 155 family caregivers who did not. The intervention consisted of five weekly counselling sessions and a three-month conversation group. All patients with dementia underwent a standardized assessment of cognitive and functional ability. The degree of burden and the subjective health of family caregivers were assessed. Participation continued until the patient moved to a nursing home or died, or until five years of living at home had passed.

Results: There were significant delays (6 months) in nursing home placement, and a longer time at home for persons with dementia with adult children as caregivers in the intervention group compared to the control group at follow-up (p = 0.004). A greater delay of institutionalization was found where intervention-group caregivers were daughters (p = 0.028). The proportional hazards regression showed factors associated with nursing home placement to be the family caregiver's influence on intervention (OR = 1.55, p = 0.019), caregiver gender (OR = 0.66, p = 0.033) and the patient's severity of dementia (OR = 1.45, p = 0.002).

Conclusion: Family caregiver intervention for adult children was significantly associated with prolonged time to nursing home placement.

Keywords

social supportcaregiver burdenelderly communitylongitudinalcontrolled
Type
Research Article
Information
International Psychogeriatrics , Volume 20 , Issue 6 , December 2008 , pp. 1177 - 1192
Copyright
Copyright © International Psychogeriatric Association 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Altman, D. (1991). Practical Statistics for Medical Research. London: Chapman & Hall/CRC.Google Scholar
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American: American Psychiatric Association.Google Scholar
Andrén, S. (2006). Family caregivers of persons with dementia. Experiences of burden, satisfaction and psychosocial intervention. Unpublished doctoral dissertation, Department of Health Sciences, Division of Geriatric Medicine, Malmö. Lund University, Sweden.Google Scholar
Andrén, S. and Elmståhl, S. (2008). Psychosocial intervention for family caregivers of people with dementia reduces caregiver burden. Development and effect after 6 and 12 months. Scandinavian Journal of Caring Science, 22, 98–109.Google Scholar
Aneshensel, C. S., Pearlin, L. I., Mullan, J. T., Zarit, S. H. and Whitlatch, C. J. (1995). Profiles in Caregiving. The Unexpected Career. London: Academic Press Limited.Google Scholar
Berger, E. (1980). A system of rating the sevirity of senility. Journal of the American Geriatrics Society, 28, 234–236.CrossRefGoogle Scholar
Brodaty, H., Green, A. and Koschera, A. (2003). Meta-analysis of psychosocial interventions for caregivers of people with dementia. Journal of the American Geriatrics Society, 51, 657–664.CrossRefGoogle ScholarPubMed
Cooke, D. D., McNally, L., Mulligan, K. T., Harrison, M. J. and Newman, S. P. (2001). Psychosocial interventions for caregivers of people with dementia: a systematic review. Aging and Mental Health, 5, 120–135.CrossRefGoogle ScholarPubMed
Eaker, E. D., Vierkant, R. A. and Mickel, S. F. (2002). Predictors of nursing home admission and/or death in incident Alzheimer's disease and other dementia cases compared to controls: a population-based study. Journal of Clinical Epidemiology, 55, 462–468.CrossRefGoogle ScholarPubMed
Elmståhl, S., Malmberg, B. and Annerstedt, L. (1996). Caregiver's burden of patients 3 years after stroke assessed by a novel caregiver burden scale. Archives of Physical and Medical Rehabilitation, 77, 177–182.CrossRefGoogle ScholarPubMed
Elmståhl, S., Ingvad, B. and Annerstedt, L. (1998). Family caregiving in dementia: prediction of caregiver burden 12 months after relocation to group-living care. International Psychogeriatrics, 10, 127–146.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. M. and McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinical. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle Scholar
Hunt, S. and McEven, J. (1980). The development of a subjective health indicator. Sociology of Health and Illness, 2, 231–245.CrossRefGoogle ScholarPubMed
Jacoby, R. and Oppenheimer, C. (2002). Psychiatry in the Elderly. Oxford: Oxford University Press.Google Scholar
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A. and Jaffe, M. W. (1963). Studies of illness in the aged. The index of ADL: a standardized measure of biological and psycho-social function. JAMA, 185, 914–919.CrossRefGoogle Scholar
Ministry of Health and Social Affairs (2004). OECD Case Study on Dementia. Dnr S2002/7722. Stockholm: Ministry of Health and Social Affairs.Google Scholar
Mittelman, M. S., Haley, W. E., Clay, O. J. and Roth, D. L. (2006). Improving caregiver well-being delays nursing home placement of patients with Alzheimer's disease. Neurology, 67, 1592–1599.CrossRefGoogle Scholar
National Bureau of Statistics (2004). Population Statistics. Available at www.scb.se.Google Scholar
Peacock, S. C. and Forbes, D. A. (2003). Interventions for caregivers of persons with dementia: a systematic review. Cancer Journal Nursing Research, 35, 88–107.Google ScholarPubMed
Pinquart, M. and Sörensen, S. (2006). Helping caregivers of persons with dementia: which interventions work and how large are their effects? International Psychogeriatrics, 18, 577–595.CrossRefGoogle ScholarPubMed
Polit, D. and Beck, C. K. (2004). Nursing Research. Principles and Methods. Philadelphia: Lippincott Williams & Wilkins.Google Scholar
Pusey, H. and Richards, D. (2001). A systematic review of the effectiveness of psychosocial interventions for carers of people with dementia. Aging and Mental Health, 5, 107–119.CrossRefGoogle ScholarPubMed
Robinson, K. M., Buckwalter, K. C. and Reed, D. (2005). Predictors of use of services among dementia caregivers. Western Journal of Nursing Research, 27, 126–140.CrossRefGoogle ScholarPubMed
Schulz, R. et al. (2002). Dementia caregiver intervention research: in search of clinical significance. The Gerontologist, 42, 589–602.CrossRefGoogle ScholarPubMed
Sörensen, S., Pinquart, M. and Duberstein, P. (2002). How effective are interventions with caregivers? An updated meta-analysis. The Gerontologist, 42, 356–372.CrossRefGoogle ScholarPubMed
Wettstein, A., Schmid, R. and König, M. (2004). Who participates in psychosocial interventions for caregivers of patients with dementia? Dementia and Geriatric Cognitive Disorders, 18, 80–86.CrossRefGoogle ScholarPubMed
Wright, F. (1998). Continuing to Care. The Effect on Spouses and Children of an Older Person's Admission to a Care Home. York: Publishing Services Ltd.Google Scholar