DEPRESSION
May 8, 2019

Help for Caregivers of Those with Dementia

Burnout and depression are common among those caring for people with dementia. Enjoying positive moments, however fleeting, makes it better.

Dementia is a devastating disease, not only for the patient, but for families and caregivers. Burnout is exceedingly common among those caring for people with dementia and Alzheimer's disease. When caretakers of people with dementia are helped to focus and build on positive emotions, a study by a team at Northwestern University’s Feinberg School of Medicine and the University of California San Francisco finds, it can reduce depression and anxiety in a matter of weeks.

“The caregivers who learned the skills had less depression, better self-reported physical health, more feelings of happiness and other positive emotions than the control group,” study author, Judith Moskowitz, said in a statement.

Paying attention to positive moments — no mater how small — and practicing kindness help caregivers cope.

Nearly 175 people caring for family members with dementia across the country were randomly assigned to either an intervention group or to a control group. Participants in the intervention group took part in sessions presented by a facilitator via a web conference called Life Enhancing Activities for Family caregivers, or LEAF. The control group was asked to write about their feelings in a journal.

In the LEAF sessions, participants were taught eight different skills, including recognizing positive emotions and savoring them by telling someone about it or writing about it. Others included starting a gratitude journal, listing a personal strength each day, and setting a goal each day. Another task was to report a minor stressful event and then listing the ways in which it could be reframed more positively.

LEAF participants also practiced small acts of kindness throughout the day and reflected on how they can have big positive effects on their emotions. Finally, they learned to practice mindfulness, both by paying close attention to their present experience and by carrying out mindful breathing exercises.

At the end of the six weeks, during which participants had weekly homework assignments to practice what they’d learned, people in the intervention group reported significantly lower levels of anxiety and depression than when they’d started. People in the control group also improved in these measures, but not as much as the LEAF intervention group.

“Doing this study helped me look at my life,” said one participant in the intervention, “not as a big neon sign that says, ‘DEMENTIA’ in front of me, but little bitty things like, ‘We're having a meal with L's sister, and we'll have a great visit.’ I'm seeing the trees are green, the wind is blowing. Yeah, dementia is out there, but I've kind of unplugged the neon sign and scaled down the size of the letters.”

The study is encouraging, given the number of people who are acting as caregivers for family members with dementia, both here in the U.S. and abroad. According to the authors, there are 5.5 million people in the U.S with Alzheimer's disease right now, and this number is predicted to increase to 16 million by the year 2050.

“Nationally we are having a huge increase in informal caregivers,” Moskowitz said. “People are living longer with dementias like Alzheimer's disease, and their long-term care is falling to family members and friends. This intervention is one way we can help reduce the stress and burden and enable them to provide better care.”

The team plans to carry out a study in which the current LEAF intervention will be compared to a version that doesn’t use a facilitator, but instead relies on a self-guided online program. If that’s similarly effective, it would be even easier, and cheaper, to make the program available to the people who need it.

The paper is published in the journal Health Psychology.

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