An adaptation strategy strategy for family caregivers with family dementia works over the long term

A UCL study reveals that a therapy program and coping strategies for people caring for family members with dementia successfully improves the mental health of caregivers for at least six years later.

Caregivers who participated in the program were five times less likely to experience clinically significant depression than those who were not offered treatment, according to the findings in the report. British Journal of Psychiatry.

The intervention also proved to be cost effective in a previous study.

"Caring for a family member with dementia can be extremely difficult, especially as his health deteriorates and he may not appreciate his help." Thus, nearly four in ten caregivers suffer from anxiety, "said Professor Gill Livingston (UCL Psychiatry), the trial's principal investigator.

"We can now offer an evidence-based approach to support their mental health in the short and long term, benefiting both the caregiver and the caregiver."

The START (Relationship Strategies) program is delivered by psychology graduates, trained and supervised by the research team, rather than trained clinicians, which facilitates their implementation in many contexts.

Those who provide therapy work with caregivers to develop coping strategies, helping them manage their own long-term well without the need for additional therapy sessions. Caregivers attended eight sessions during which the focus was on planning for the future and access to additional badistance if needed.

260 caregivers participated in the trial, most of whom were caring for a family member recently diagnosed with dementia. 173 participants were enrolled in the START program for a period of two years and the remaining 87 were randomly badigned to a control group who did not benefit from the intervention.

Six years after receiving the therapy, caregivers who participated in the START program had significantly fewer symptoms of depression and anxiety, and the researchers say the therapy program seemed both preventative and improve mental health issues existing.

Patient costs were almost three times lower among START families (average £ 5759 for START group compared to £ 16 964 for the control group in year 6), which researchers say is probably due to the fact that caregivers are more numerous. able to cope and provide care to their loved one.

The difference in patient costs was not statistically significant, but researchers say this is because medical costs can be very large and variable. However, their findings strongly suggest that the program is not only cost effective, but could also save money for health services.

"We designed our program to reduce costs, and our results suggest that it could result in longer-term cost savings because dementia patients will have fewer costly medical problems if their family caregivers is healthy and supported, "said Livingston.

The START team has developed manuals to facilitate the intervention of any health care provider and plans to hold an accredited training at UCL in the near future. The Alzheimer Society is helping the team explore options for greater intervention and funding for cultural adaptation to expand access to minority ethnic groups. Training manuals are also available in Japanese and Spanish and are being translated into Urdu.

James Pickett, head of research at the Alzheimer Society, said, "Being a caregiver can be exhausting work, physically and emotionally demanding, 24 hours a day, and often purely based on love. Anxiety can be an unavoidable side effect – 90% of caregivers tell us that they are stressed and anxious several times a week, but for the 700,000 caregivers in the UK, many receive little or no support, despite the recommendations of NICE.

"This is a major breakthrough and we are thrilled to see this monumental proof that START is clinically effective in reducing depression and anxiety among caregivers, and that the effects are still visible six years later. The Alzheimer Society is pleased to support the development and implementation of the START program so that many people can make the most of it. "

Shirley Nurock, a former family badistant who worked on the project as a liaison with families, commented: "After my husband developed Alzheimer's disease in his fifties, I spent 15 years to take care of him.I was stressed and anxious from the beginning.looked to get degraded, shared between giving priority to his care, seeing my children through adolescence and keeping an eye on my aging parents.

"I can now see that an intervention like START would have eased some of my previous concerns by giving me practical, appropriate information, advice on services, support, coping strategies, and even more. Helping to learn to relax, learning that it can have such a long-term effect is extremely encouraging. "