Help Needed for Alzheimer's Caregivers
Patients, Caregivers Would Benefit, but Little Support Now, Studies Show
Nov. 20, 2006 -- Helping the caregiver of a loved one with dementia can help
the patient as well, new research suggests.
Two studies, both published in the Nov. 21 Annals of Internal
Medicine, highlight the importance of supporting family members who care
for patients with Alzheimer's and other forms of dementia.
But support services are rare, and they are not likely to become the norm
unless federal policy makers recognize their value, according to an
"Patients with dementia will probably not be forming a lobby anytime
soon, and their caregivers are too busy. It is time for the medical profession
to advocate on their behalf," write Kenneth E. Covinsky, MD, MPH, and C.
Bree Johnston, MD, MPH, of the San Francisco VA Medical Center.
Covinsky and Johnston fault the Medicare system and other
providers for failing to recognize the needs of home-based dementia patients
and their caregivers, despite the fact that unpaid family and community
caregivers save the system billions of dollars each year.
They also cited as another major public health failing Medicare's failure to
pay for team-based management – with a team of different professionals with the
needed expertise -- for elderly patients with dementia.
"One of the ironies of dementia care is that expensive technological
diagnostic procedures are paid for with no questions asked, but almost nothing
is spent to support caregivers," Covinsky tells WebMD.
"We spend up the wazoo to diagnose this disease, but once it is
diagnosed, patients can't get what they need," he says.
Evaluating Intervention Strategies
One of the new studies is one of the first to really evaluate an
intervention strategy designed to improve the lives of dementia patients and
The Resources for Enhancing Alzheimer's Caregiver Health (REACH) II study
was funded by the National Institute on Aging and the National Institute on
The study looked at 642 Hispanic, black, and white caregivers assigned for
six months to either a group receiving helpful intervention or one not
Intervention consisted of nine 90-minute home visits and three telephone
calls dealing with stress management, depression, and other
aspects of the caregivers' own health, as well as social networking.
Meanwhile, caregivers in the comparison group received a packet of
educational materials about dementia, caregiving, community resources, and
safety. They also had two brief "check-in" telephone calls during the
At the end of the study, caregivers in the intervention group reported
better quality of life than those in the comparison group.
Race did not appear to be a factor in the response to intervention. But
husbands or wives taking care of a spouse seemed especially likely to benefit
from the intervention.
However, the number of patients sent to nursing homes was similar in both
The researchers speculated that longer intervention might be needed to see a
difference in this outcome.