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------=_NextPart_01C7DF85.81F797C0 Content-Location: file:///C:/64432D13/EvidenceBasedApproaches_files/pres.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" ------=_NextPart_01C7DF85.81F797C0 Content-Location: file:///C:/64432D13/EvidenceBasedApproaches_files/slide0001.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" EVIDENCE-BASED APPROACHES TO CARING FOR FAMILY CAREGIVERS OF ALZHEIMER’S PATIENTS
EVIDENCE-BASED APPROACHES TO CARING = FOR FAMILY CAREGIVERS
Barry J. Jacobs, Psy.D.
<= span style=3D'font-size:88%'>Crozer-Keystone Family Medicine = Residency Program, Springfield, PA
www.emotionalsurvivalguide.com
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TODAY’S TALK
<= span style=3D'mso-special-format:bullet;color:#CCCCFF;mso-color-index:4;positio= n: absolute;left:-4.43%;font-family:Wingdings'>lFamily caregiving statistics
<= span style=3D'mso-special-format:bullet;color:#CCCCFF;mso-color-index:4;positio= n: absolute;left:-4.23%;font-family:Wingdings'>lHealth effects of long-term caregiving
lEffects on patient outcomes of caregiving
<= span style=3D'mso-special-format:bullet;color:#CCCCFF;mso-color-index:4;positio= n: absolute;left:-4.43%;font-family:Wingdings'>lCaregiver coping <= /span>
<= span style=3D'mso-special-format:bullet;color:#CCCCFF;mso-color-index:4;positio= n: absolute;left:-4.43%;font-family:Wingdings'>lEvidence-based interventions
<= span style=3D'mso-special-format:bullet;color:#CCCCFF;mso-color-index:4;positio= n: absolute;left:-4.43%;font-family:Wingdings'>lRoles for the family physician
<= span style=3D'mso-special-format:bullet;color:#CCCCFF;mso-color-index:4;positio= n: absolute;left:-4.43%;font-family:Wingdings'>lOne psychologist’= ;s suggestions
<= span style=3D'mso-special-format:bullet;color:#CCCCFF;mso-color-index:4;positio= n: absolute;left:-4.43%;font-family:Wingdings'>lResources
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CAREGIVING STATS
<= span style=3D'mso-special-format:bullet;color:#CCCCFF;mso-color-index:4;positio= n: absolute;left:-3.75%;font-family:Wingdings'>lDepending on definitio= ns, estimates range from 9-54 million American caregivers; = most cite 25 million people regularly providing care; number growing as population ages, medicine advances =
<= span style=3D'mso-special-format:bullet;color:#CCCCFF;mso-color-index:4;positio= n: absolute;left:-3.99%;font-family:Wingdings'>lAlzheimer’s Association: 4.5 million Alz. patients; by 2050, 11.5-= 16 million
<= span style=3D'mso-special-format:bullet;color:#CCCCFF;mso-color-index:4;positio= n: absolute;left:-4.43%;font-family:Wingdings'>lAvg. lifespan post-dx:= 7-8 years
<= span style=3D'mso-special-format:bullet;color:#CCCCFF;mso-color-index:4;positio= n: absolute;left:-3.92%;font-family:Wingdings'>l7 of 10 cared for at h= ome by family, pros
l
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HEALTH EFFECTS OF CAREGIVING
lSchulz & Martire (2004): strongest evidence: higher prevalence of depression = & anxiety, decreased immune system functioning, decreased use= of preventative medical services; other evidence: insomnia, musculoskeletal problems, greater cardiovascular reactivity, increased mortality
<= span style=3D'mso-special-format:bullet;color:#CCCCFF;mso-color-index:4;positio= n: absolute;left:-3.74%;font-family:Wingdings'>lConclusion: growing pu= blic health concern
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HEALTH EFFECTS (cont.)
lBUT: Not all effects of caring for patients <= /span>with Alzheimer’s patients are negative
lSanders (2005)—caregiving causes “strain and gains”; latter includes spiritual gro= wth, personal growth, and feelings of mastery
lBoerner et al (2004)—pre-loss caregiving benefit associated with higher levels of post-loss depression and grief
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EFFECT= S ON PATIENT OUTCOMES
<= span style=3D'font-size:88%'>lResearch in early stages, inconclusive =
lBrodary (1993, 1997): Caregiver training/counseling associated with increased survival time for care-recipient
lMittleman (1996): Caregiver coping, support associated with significant delay in care-<= /span>recipient institutionalization <= /div>
<= span style=3D'font-size:88%'>lMcClendon et al (2004): Use of wishing, fantasizing coping associated with shorter care-recipient survival time—multiple potential <= /span>reasons why
l
------=_NextPart_01C7DF85.81F797C0 Content-Location: file:///C:/64432D13/EvidenceBasedApproaches_files/slide0007.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" EVIDENCE-BASED APPROACHES TO CARING FOR FAMILY CAREGIVERS OF ALZHEIMER’S PATIENTS
CAREGIVER COPING
lSchulz & Martire (2004): only moderate = correlation with disease progression; keys: = difficult behaviors, patient dependence for ADLS&#= 13;
<= span style=3D'font-size:88%'>lMyriad other factors: caregiver gender (females more likely to become depressed/anxious), race (whites more stressed than African-Americans), culture (Hispanics cope better), family position <= /span>(spouses more affected than children), education (less than h.s., less burden), social supports, appraisals, personality attributes (e.g.= , optimism), coping styles (e.g., problem-solving) <= /span>quality of caregiver/patient relationship