Study: Intensive Counseling Helps Spouses Caring for Alzheimer Patients

Spouses caring for Alzheimer’s patients can significantly reduce their long-term risk of developing depression through short-term intensive counseling sessions, according to a study reported in the May issue of the American Journal of Psychiatry.

The positive impact continued for more than three years after the initial counseling sessions ended and persisted even after those with Alzheimer’s disease died or were placed in nursing homes.

Sidney Stahl, Ph.D., of the National Institute of Aging, which sponsored the study, said the findings provide “striking” evidence that distress and depressive symptoms in family caregivers can be effectively eased and that the benefits can be sustained over a long period of time.

Researchers at the New York University Alzheimer's Disease Center followed 406 spouse-caregivers, split into groups either receiving enhanced counseling and support or usual support.

Those in the enhanced counseling group participated in two individual and four family counseling sessions soon after enrolling in the study. They also attended weekly support groups. After the initial period of intensive counseling, the caregivers and their families were encouraged on an ongoing basis to contact counselors to help them cope with crises and other issues related to caring for someone with Alzheimer’s.

The spouses in the usual care group received the usual support services for families of Alzheimer’s patients at the Center. Unlike those in the enhanced treatment group, these spouses did not receive formal counseling and their family members did not have contact with the counselors. Beyond receiving information about resources, the caregivers in the usual care group could, if they chose, participate in support groups and use the crisis counseling.

Both groups were followed regularly until two years after the death of their husband or wife or until their participation in the study ended.

Symptoms of depression were compared over time between the two groups. When they began the study, the two groups showed comparable levels of depressive symptoms. But after one year, 29.8 percent of caregivers in the intensive counseling and support group had symptoms of clinical depression compared with 45.1 percent of those in the usual care group. Significant differences in the mean number of symptoms were found through the third year of follow-up. The differences gradually diminished over a five-year follow-up period.

"The sustainability of these effects shows that an individualized program of counseling and continuing support is a potent intervention," said lead researcher Mary Mittelman, of New York University. "While support and information are essential, if used in isolation they are insufficient for caregivers and their families."

"While we work to untangle the complex biology of this disease, this important finding may provide a foundation for developing comprehensive support for families and caregivers to help them through these stressful times," said Creighton Phelps, Ph.D. Director of the NIA's Alzheimer's Disease Research Centers Program.

Other sources: National Institute of Aging