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Counseling Spouses of Alzheimer’s Patients

Alzheimer’s disease afflicts more than 5.2 million Americans in 2008. And, as aging baby boomers swell the ranks of the over 65s, public health officials expect a steady increase in Alzheimer’s disease.

One area of concern is not often discussed: As more people are affected with Alzheimer’s disease, who will provide the care they need?

Dr. Richard Suzman of the U.S. National Institute on Aging believes policymakers and the rest of society have not fully grasped the magnitude of the future care requirements for all the people who will suffer from Alzheimer’s.

Care for Alzheimer’s patients in the early stages is often provided by family members. Spouses who care for their aging partners are less likely than adult children to tap community supports. This isolation can subject them to greater physical and emotional stress, particularly when the patient cannot be left alone.

Support to spousal caregivers

A study led by Dr. Mary Mittelman of the Silberman Aging and Dementia Research Center at New York University School of Medicine has found that spousal caregivers who receive counseling and support are better able to withstand the stress of providing care.

This counseling of spouses also improves the quality of life for Alzheimer's patients their  placement in nursing homes is delayed by an average of 557 days (or 1½ years) compared to spousal caregivers who do not avail themselves of such counseling and support. Dr. Mittelman estimates that families save at least $60,000 by delaying the nursing home placement.

This finding is the result of a 9½-year study involving 406 spousal caregivers. Half of them were provided six sessions of individual and family counseling in addition to support group participation and availability of telephone counseling. The other half served as control and did not get these interventions.

"Failure to tap community supports when providing care to Alzheimer’s patients can subject the spousal caregiver to greater physical and emotional stress."

The six sessions were spread out over six weeks and included a discussion of what to expect as the disease worsens and lessons in coping skills. The caregivers were allowed to call counselors whenever they felt the need for more advice.

In addition to the deferred placement in nursing homes, the spousal caregivers who received counseling and support experienced an enhanced ability to cope positively with behavior problems in their partners. They also felt less vulnerable to bouts of caregiver depression or less prone to physical health problems.

The techniques for handling the patient’s tendency to wander around, or exhibit aggressive outbursts, or suffer incontinence, or other physical difficulties are not intuitive. These skills need to be taught to family caregivers, says Dr. Mittelman. Without expert instruction, people acquire their handling techniques by trial and error, and this may not be enough.

Similar studies by the U.S. National Institutes of Health and University of Nijmegen Medical Center researchers in the Netherlands agree with Dr. Mittelman’s findings: Quality of life, for both the patient and the spousal caregiver, is improved when family caregivers are counseled and properly trained.