Home Assessments of Needs of Caregivers and Loved Ones With Dementia Help Caregivers Feel "Mastery" And Cope Better
Wednesday, May 14, 2008
Taking care of a loved one with dementia can be extremely stressful. Caregivers struggling to care for relatives with dementia run higher risks of depression, anxiety and other health problems. Caregivers who are struggling are also more likely to move loved ones with dementia to nursing homes or other institutions than are family caregivers who are having less difficulty.
While caring for a relative with dementia can be stressful, it can also be a source of satisfaction. It can, for example, give the caregiver a sense of competence or "mastery," if he or she can successfully care for the loved one with dementia. This sense of mastery can help caregivers cope with the demands of caring for relatives with dementia.
Dementia care management programs can help family caregivers take care of patients with dementia. These programs offer a number of home—and community-based services— they assess patients' and caregivers' needs, and provide caregiver support and education, for example.
New Research in the Journal of the American Geriatrics Society
Dementia care management programs can be helpful, but it is not clear which of the services they provide that are the most helpful. To investigate, researchers recently studied 238 pairs of caregivers and the older patients with dementia for whom they cared. Each of these pairs enrolled in a free care management program run by a team that included a nurse and social work care manager.
At the beginning of the study, the nurse or social worker care manager assessed each caregiver's and each patient's needs, and worked with each caregiver to come up with an individualized care plan that met these needs. Among other things, the care manager checked to see whether the caregivers had a sense of mastery when caring for their loved ones.
Over the next 18 months, the care manager periodically assessed each pair's needs again, and updated the care plan. In keeping with the care plan, the nurse or social worker care manager provided caregiver support, education, and helped caregivers find appropriate medical care and other supportive services in the community.
After the 18 months, the researchers surveyed and evaluated the caregivers again, to see how they and their loved ones were doing, and how the caregivers' sense of mastery had changed since the start of the study.
The more frequently the care manager assessed a caregiver-patient pair's needs to find out if new or different kinds of help were needed, the more the caregivers' sense of mastery increased over the 18 months, the researchers found.
"Home assessments for specific needs of caregivers and person with dementia are associated with improvement in caregiver's sense of mastery," the researchers conclude. It is also important to note that care manager interventions that did not provide specific education and guidance did not increase the caregiver's sense of mastery. "Future work is needed to determine whether this increase is sustained over time and decreases the need for" placing older adults with dementia in nursing homes and other institutions.
What Should I Do?
For more information about caring for an older loved one at home, visit the Dementia and Home Care topics on the left-hand side.
The summary above is from the full report titled, "Determining Care Management Activities Associated with Mastery and Relationship Strain for Dementia Caregivers." It is in the May 2008 issue of the Journal of the American Geriatrics Society (Volume 56, Issue 5). The report is authored by Karen I. Connor, RN, MBA, PhD, Donna K. McNeese-Smith, RN, EdD, Barbara G. Vickrey, MD, MPH, Gwen M. van Servellen, RN, PhD, Betty L. Chang, RN, PhD, Martin L. Lee, PhD, Stefanie D. Vassar, MS, and Joshua Chodosh, MD, MSHS.