Counseling intervention effects on Alzheimer's caregiver burden

Counseling and Support for Alzheimer's Patients

Premise of the Article

The article describes a study that was conducted to determine whether counseling intervention could provide some relief for families who care for an ultimately institutionalize family members with Alzheimer's disease. Research questions include whether institutionalization alone relieves the burden and depressive symptoms within the family, and whether counseling would do much more towards such relief. The hypothesis appears to be that counseling intervention would indeed provide a higher degree of relief than only institutionalization. The article is useful in terms of treating not only those who are institutionalized, but also understanding the background concerns within the family involved; better care can be provided for the sick when their background is understood.

Population Sample

A sample of 406 spouses of persons with a clinical diagnosis of Alzheimer's disease was recruited through a number channels, including the NYU-ADRC, Alzheimer's Association chapters, physician, public media announcements, and community providers who referred them. This size and nature of this sample are appropriate for the study, as it was taken at random from relevant and representative settings.

Data Collection Instruments and Tools

Three measures were used to collect and measure data: Nursing Home Admission (NHA), Bruden, and Depressive Symptoms. The first item was retrieved from interviews, NYU-ADRC records, and telephone interviews with caregivers and family members. Burden was measured by means of the Zarit Burden Interview, a widely-used instrument to measure caregiving burden. Depressive Symptoms were determined by means of a 30-item Geriatric Depression Scale (GDS). Validity and reliability are compromised by a lack of racial diversity in the population, and by a lack of specific measures to determine stress or related experiences of the transition to caregiving facilities. Validity and reliability are important components of any study, as these provide a sense of authenticity to the research and its findings.

Presentation of Data

Data are presented by means of two figures and three tables. The data appear to be very clearly explicated. The axes in the figures are all clearly marked, and the lines differentiated to indicate the data of concern. The tables clarify the information narrated in the document.

Limitations of Statistical Methods

Limitations include the lack of ethnic diversity in the sample population. Different cultures would respond differently to the burden of care and to counseling intervention. Furthermore, only spouse caregivers were targeted for the research, which limits the application of the data to households where children or other family members act as caregivers.

Study Outcomes

The outcome of the study was significant, as it revealed that institutionalizing patients with Alzheimer's disease has a positive effect upon the depression and relief levels of the caregivers involved. Counselling proved to have a positive effect in terms of making caregivers aware of the possibilities and benefits relating to institutionalization for patients who need it.

As mentioned generalizability is compromised by the homogeneous nature of the population sample. What I would do in subsequent studies is to collect population samples from several sectors of society, with the only requirement being caregiver capacity for patients with Alzheimer's disease. Furthermore, I might also investigate samples of populations who have already institutionalized their family members to obtain a more global result.

Conclusion: Lessons Learned

I learned several interesting things, particularly regarding the technical side of the study involved. Each procedure seems to be very well constructed and thought through, as well as being related to the statistical procedures for measurement.

What I found most interesting was the three measurements implemented as a basis for the study. These instruments help greatly towards establishing a sound basis for the study and to implement further statistical analyses of the results. In general, I was impressed with the study and I find it very relevant in a profession where the aim is to reduce suffering.

Source

Gaugler, J.E., Roth, D.L., Haley, W.E., & Mittleman, M.S. (2008). 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. Journal of American Geriatric Society, 56(3), 421-428