CE/CME

Caregivers of Dementia Patients: Mental Health Screening & Support

Clinician Reviews. 2016 June;26(6):42-49

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Although accreditation for this CE/CME activity has expired, and the posttest is no longer available, you can still read the full article.

Expires May 31, 2017

Caregivers, mostly family and friends, play an important role in the complex care of persons with Alzheimer disease and other dementias. Primary care providers are uniquely positioned to assess for the negative consequences of caregiving, including depression, anxiety, and caregivers' failure to care for their own health needs. This article provides you with reliable, valid screening tools and recommendations for evidence-based interventions to increase the caregiver’s and patient’s quality of life and care.

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References

1. 2015 Alzheimer’s Disease Facts and Figures. Chicago: Alzheimer’s Association; 2015. www.alz.org/facts/downloads/facts_figures_2015.pdf. Accessed May 20, 2016.
2. Wallis L. Reach VA helps family caregivers of dementia patients. Am J Nurs. 2011;111(6):18.
3. Office of Disease Prevention and Health Promotion. 2020 Topics and objectives—objectives A–Z. Healthy People 2020. www.healthypeople.gov/2020/topics-objectives. Accessed May 20, 2016.
4. Levine C, Halper D, Peist A, Gould D. Bridging troubled waters: family caregivers, transitions, and long-term care. Health Aff. 2010;29(1):116-124.
5. MetLife Mature Market Institute, National Alliance for Caregiving, and the University of Pittsburgh Institute on Aging. The MetLife Study of Working Caregivers and Employer Health Care Costs. February 2010. www.metlife.com/assets/cao/mmi/publications/studies/2010/mmi-working-caregivers-employers-health-care-costs.pdf. Accessed May 20, 2016.
6. Zarit SH. Assessment of family caregivers: A research perspective. In: Family Caregiver Alliance. Caregiver Assessment: Voices and Views From the Field. Report from a National Consensus Development Conference. Volume II. San Francisco: Family Caregiver Alliance; 2006:14. https://caregiver.org/sites/caregiver.org/files/pdfs/v2_consensus.pdf. Accessed May 20, 2016.
7. Family Caregiver Alliance National Center on Caregiving. (2012). Selected Caregiver Assessment Measures: A Resource Inventory for Practitioners. 2nd ed. https://www.caregiver.org/selected-caregiver-assessment-measures-resource-inventory-practitioners-2012. Accessed May 20, 2016.
8. Family Caregiver Alliance. Caregivers Count Too! A Toolkit to Help Practitioners Assess the Needs of Family Caregivers. San Francisco: Family Caregiver Alliance; 2006. www.caregiver.org/sites/caregiver.org/files/pdfs/Assessment_Toolkit_20060802.pdf. Accessed May 20, 2016.
9. Antonovsky A. The structure and properties of the Sense of Coherence Scale. Soc Sci Med. 1993;36(6):725-733.
10. Bédard M, Molloy DW, Squire L, et al. The Zarit Burden Interview: a new short version and screening version. Gerontologist. 2001;41(5):652-657.
11. Czaja SJ, Gitlin LN, Schulz R, et al. Development of the Risk Appraisal Measure (RAM): a brief screen to identify risk areas and guide interventions for dementia caregivers. J Am Geriatr Soc. 2009;57(6):1064-1072.
12. Gort AM, Mingot M, March J, et al. Short Zarit scale in dementias. Med Clin (Barc). 2010;35(10):447-449.
13. Kinney JM, Stephens MA. Caregiving Hassles Scale: assessing the daily hassles of caring for a family member with dementia. Gerontologist. 1989;29(3):328-332.
14. Locke DEC, Dassel KB, Hall G, et al. Assessment of patient and caregiver experiences of dementia-related symptoms: development of the Multidimensional Assessment of Neurodegenerative Symptoms Questionnaire. Dement Geriatr Cogn Disord. 2009;27:260-272.
15. Picot SJ, Youngblut J, Zeller R. Development and testing of a measure of perceived caregiver rewards in adults. J Nurs Meas. 1997;5(1):33-52.
16. Radloff LS, Teri L. Use of the Center for Epidemiological Studies-Depression Scale with older adults. Clin Gerontol. 1986;5:119-136.
17. Seng BK, Luo N, Ng WY, et al. Validity and reliability of the Zarit Burden Interview in assessing caregiving burden. Ann Acad Med Singapore. 2010;39(10):758-763.
18. Family Caregiver Alliance. Caregiver Assessment: Principles, Guidelines and Strategies for Change. Report from a National Consensus Development Conference (Vol. I). San Francisco: Family Caregiver Alliance; 2006:12. https://www.caregiver.org/sites/caregiver.org/files/pdfs/v1_consensus.pdf. Accessed May 20, 2016.
19. Michigan Dementia Coalition. Caregiver Assessment Tool Grid. The Rosalynn Carter Institute. www.rosalynncarter.org/UserFiles/Michigan%20Assessment%20Grid.pdf. Accessed May 20, 2016.
20. Zarit SH, Reever KE, Bach-Peterson J. Relatives of impaired elderly: correlates of feelings of burden. Gerontologist. 1980;20(6):649-655.
21. Miyamoto Y, Tachimo H, Ito H. Formal caregiver burden in dementia: impact of behavioral and psychological symptoms of dementia and activities of daily living. Geriatr Nurs. 2010;31(4):246-253.
22. Pearlin LI, Mullan JT, Semple SJ, Skaff MM. Caregiving and the stress process: an overview of concepts and their measures. Gerontologist. 1990;30(5):583-594.
23. American Medical Association. Caregiver Self-Assessment Questionnaire. National Caregivers Library. www.caregiverslibrary.org/Portals/0/CaringforYourself_CaregiverSelfAssessmentQuestionaire.pdf. Accessed May 20, 2016.
24. Greenberg SA. The Geriatric Depression Scale (GDS). In: Try This: Best Practices in Nursing Care to Older Adults. Issue 4. New York, NY: Hartford Institute for Geriatric Nursing, NYU College of Nursing; 2012. https://consultgeri.org/try-this/general-assessment/issue-4. Accessed May 20, 2016.
25. Sheikh JI, Yesavage JA. Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. In: Brink TL, ed. Clinical Gerontology: A Guide to Assessment and Intervention. New York, NY: The Haworth Press; 1986:165-173.
26. Pinquart M, Sörensen S. Helping caregivers of persons with dementia: which interventions work and how large are their effects? Int Psychogeriatr. 2006;18(4):577-595.
27. Matschinger H, Schork A, Riedel-Heller S, Angemeyer M. On the application of the CES-D with the elderly: dimensional structure and artifacts resulting from oppositely worded items. Int J Methods Psychiatr Res. 2006;9(4):199-209.
28. Caregiver Burden Scale. Family Practice Notebook. www.fpnotebook.com/Geri/Exam/CrgvrBrdnScl.htm. Accessed May 20, 2016.
29. Caregiver Stress Self-Assessment. www.mass.gov/elders/docs/caregiver-stress-self-assessment.pdf. Accessed May 20, 2016.
30. US Department of Veterans Affairs. Caregiver Self-Assessment Worksheet. http://www.va.gov/GERIATRICS/guide/longtermcare/Caregiver_Self_Assessment.pdf. Accessed May 20, 2016.
31. Thompson CA, Spilsbury K, Hall J, et al. Systematic review of information and support interventions for caregivers of people with dementia. BMC Geriatr. 2007;7:18-29.
32. Chien LY, Chu H, Guo JL, et al. Caregiver support groups in patients with dementia: a meta-analysis. Int J Geriatr Psychiatry. 2011;26:1089-1098.
33. Burns R, Nichols LO, Martindale-Adams J, et al. Primary care interventions for dementia caregivers: 2-year outcomes for the REACH study. Gerontologist. 2003;43(4):547-555.
34. Schulz R, Burgio L, Burns R, et al. Resources for Enhancing Alzheimer’s Caregivers Health (REACH): overview, site-specific outcomes, and future directions. Gerontologist. 2003;43(4):514-520.
35. Gottlieb BH, Thompson LW, Bourgeois M. Monitoring and evaluating interventions. In: Coon DW, Gallagher-Thompson D, Thompson LW, eds. Innovative Interventions to Reduce Dementia Caregiver Distress: A Clinical Guide. New York, NY: Springer; 2003:28-49.
36. Marriott A, Donaldson C, Tarrier N, Burns A. Effectiveness of cognitive-behavioral family intervention in reducing the burden of care in carers of patients with Alzheimer’s disease. Br J Psychiatry. 2000;176:557-562.
37. Chu H, Yang CY, Liao YH, et al. The effects of a support group on dementia caregivers’ burden and depression. J Aging Health. 2011;23(2): 228-241.
38. Elliott AF, Burgio LD, DeCoster J. Enhancing caregiver health: findings from the Resources for Enhancing Alzheimer’s disease Health II intervention. J Am Geriatr Soc. 2010;58:30-37.
39. Sörensen S, Pinquart M, Duberstein P. How effective are interventions with caregivers? An updated meta-analysis. Gerontologist. 2002;42(3): 356-372.
40. Mittelman MS, Roth DL, Coon DW, Haley WE. Sustained benefit of supportive intervention for depressive symptoms of caregivers in patients with Alzheimer’s disease. Am J Psychiatry. 2004;161(5):850-856.
41. Mittelman M, Roth D, Clay O, Haley W. Preserving health of Alzheimer caregivers: impact of a spouse caregiver intervention. Am J Geriatr Psychiatry. 2007;15(9):780-789.
42. Lavretsky H, Siddarth P, Irwin MR. Improving depression and enhancing resilience in family dementia caregivers: a pilot randomized placebo-controlled trial of escitalopram. Am J Geriatr Psychiatry. 2010;18(2):154-164.
43. Wimo A, von Strauss E, Nordberg G, et al. Time spent on informal and formal caregiving for persons with dementia in Sweden. Health Policy. 2002;61(3):255-268.
44. Koerner SS, Shirai Y, Kenyon DB. Sociocontextual circumstances in daily stress reactivity among caregivers for elder relatives. J Gerontol B Psychol Sci Soc Sci. 2010;65(5):561-572.
45. Lai DW, Thomson C. The impact of perceived adequacy of social support on caregiving burden of family caregivers. Fam in Soc: J Contemp Social Serv. 2011;92(1):99-106.
46. Martin-Carrasco M, Martin M, Valero C, et al. Effectiveness of a psychoeducational intervention program in the reduction of caregiver burden in Alzheimer’s disease patients’ caregivers. Int J Geriatr Psychiatry. 2009;24:489-499.
47. Mittelman MS, Haley WE, Clay OJ, Roth RL. Improving caregiver well-being delays nursing home placement of patients with Alzheimer disease. Neurology. 2006;67(9):1592-1599.
48. Gaugler JE, Roth DL, Haley WE, Mittelman MS. Can counseling and support reduce burden and depressive symptoms in caregivers of people with Alzheimer’s disease during the transition to institutionalization? Results from the New York University caregiver intervention study. J Am Geriatr Soc. 2008;56(3):421-428.
49. Lu YFY, Wykle M. Relationships between caregiver stress and self-care behaviors in response to symptoms. Clin Nurs Res. 2007;16:29-43.

Caregivers of Dementia Patients: Mental Health Screening & Support

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