Stress and Caring for Individuals with Alzheimer's Disease

By Kim Deng

Caring for an individual with Alzheimer's Disease (AD) is stressful, and studies show that this stress has an impact on both the physical and mental health of the caregiver. However, many questions remain about the characteristics of AD patients and their caregivers that contribute to this stress and how it impacts caregivers' use of health care resources.

Researchers in Indiana studied the impact of stress on the physical and mental health of the caregivers in a study that included 153 AD patients and their caregivers who attended two large, urban university-affiliated primary care practices. Patients underwent extensive testing to observe the degree of cognitive impairment, behavioral and psychological symptoms, medical comorbidities, and functional abilities. Caregivers were assessed for depressive symptoms as indicated in the DSM-IV. The caregivers' emergency department visits or hospitalizations in the previous six months were also recorded.

Researchers found that a patient's function and the behavior and psychological symptoms of dementia (BPSD) were indeed associated with how often acute care services were utilized by their caregivers. However, there is no association between a patient's level of cognitive impairment and a caregiver’s medical care. Almost a quarter (24%) of the caregivers in the study sought medical care during the previous six months of caring for their patient. This amount is an indicator of how difficult it is to manage and care for patients suffering from dementia. For that reason, our medical system needs to better address and treat the BPSD of the demented patient in an effort to lessen caregiver stress.

It is not the patient's loss of cognitive function that stresses caregivers which they expect are prepared to care for; rather, the agitation, aggression, and other symptoms of the patient contribute most heavily to caregiver stress and burden.

In addition, the study found that caregivers with more depressive symptoms were more likely to utilize health care resources. A significant amount of stress is produced that impacts both the medical and psychological well being of caregivers. Therefore, our primary care system needs to change its approach to providing medical care to AD patients. Rather than caring only for the demented patient, primary care providers will need to expand their definition of "patient" to include the caregiver as well. To truly impact the care of the AD patient and caregiver, it is suggested that our medical system needs to include assessment and treatment of psychological symptoms of the caregiver, too.

Source: Schubert, C.C., Boustani, M., Callahan, C.M., Perkins, A.J., Hui, S. and Hendrie, H.C. (2008). Acute Care Utilization by Dementia Caregivers Within Urban Primary Care Practices. Journal of General Internal Medicine. Volume 23, number 11, November 2008.

Like the new format? Tell us what you think: askaia@matherlifeways.com