ShareThisBy LEE BOWMAN
Monday, November 13, 2006
Counseling people who are caring for a husband or wife with Alzheimer's disease can delay by an average of one-and-a-half years their need to put their spouse in a nursing home, a long-term study has found.
Researchers studied 406 spouse caregivers in New York City over a 19-year period. Half the spouses got enhanced counseling and support, including six sessions of individual and family counseling, and were able to reach counselors by phone whenever they wanted to.
The caregivers were also encouraged to take part in weekly support groups.
The remaining spouses received "usual care," which meant that they got resource information and help on request, but didn't participate in formal counseling sessions or have their families included in counseling.
Mary Mittelman, a research professor of psychiatry at the New York University Medical School, and colleagues at several other institutions used a sophisticated statistical analysis to evaluate outcomes for the two groups.
Writing in Tuesday's issue of the journal Neurology, they report that patients whose spouses were in the counseling and support group were placed in nursing homes an average of 557 days later than patients with spouses in the usual-care group.
The interventions in the study, which is still ongoing, appeared to help caregivers gain more support from family and friends.
"Spouse caregivers are often very isolated," Mittelman said. "Managing the care of a relative with dementia is very lonely, time-consuming and difficult.
"Caregivers in the treatment group were not only able to keep their spouses at home with them longer, but as a result of the intervention, they had greater tolerance for patient memory and behavior problems, improved satisfaction with the support provided by family and friends and fewer symptoms of depression."
The findings have financial as well as medical implications, the researchers noted. The average annual cost of nursing-home care in the United States is more than $65,000 this year. So delaying the placement of a patient in a nursing home for nearly a year-and-a-half represents a savings of at least $100,000 per patient.
According to the Alzheimer's Association, there are some 4.5 million Americans suffering from the disease, and that number is expected to triple by mid-century as the population ages. Other researchers have estimated that delaying the institutionalization of Alzheimer's patients by just one month could save more than $1 billion a year in long-term-care costs for the nation.
The study was supported by the National Institute of Mental Health, the National Institute on Aging, the NYU Alzheimer's Disease Center and the Florida Alzheimer's Disease Research Center.
Mittelman noted: "The value of social support for family caregivers isn't restricted to Alzheimer's disease." For instance, family support has been shown to have positive effects on the quality of life of caregivers for those recovering from strokes.
"Comprehensive medical treatment, particularly for the elderly, has got to include more than just using a prescription pad," Mittelman said.
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