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Predictors of improvement in social support: Five-year effects of a structured intervention for caregivers of spouses with Alzheimer’s disease. Social Science & Medicine, 63, 957-967

Department of Sociology, University of Alabama-Birmingham, Birmingham, AL, USA.
Social Science & Medicine (Impact Factor: 2.56). 09/2006; 63(4):957-67. DOI: 10.1016/j.socscimed.2006.02.020
Source: PubMed

ABSTRACT Those who provide care at home for a spouse with Alzheimer's disease (AD) endure considerable challenges, including social isolation and increasing caregiving responsibilities. We examine the extent to which an intervention that helps spouse-caregivers mobilize their social support network, helps them better adapt to the caregiving role. We used detailed social support information collected from 200 spouse-caregivers participating in a randomized, controlled trial of enhanced social support services in the USA. Using random effects regression models, we found that individuals in the intervention group reported higher levels of satisfaction with their social support network over the first 5 years of the intervention than those in the support group. Higher levels of emotional support, more visits, and having more network members to whom they felt close were all individually predictive of longitudinal changes in social support network satisfaction. We conclude with a discussion of the importance of having psychological respite when caregivers spend their days in the home and are isolated.

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    • "Recent studies have even suggested that enhancing the dyadic relationship may help slow Alzheimer's-related decline [52] and decrease psychosocial costs to carers [53]; thus encouraging positive adaptation to the condition and increasing the likelihood of aging in place. Indeed, even interventions aimed at improving social support and coping skills have effects on both parties, including reduced caregiver depression, improved well-being, and delayed entrance into nursing homes [54] [55]. It is now well documented that diagnosed individuals understand the social and psychological aspects of AD, including social (mis)perceptions of diminished dignity and value [56]. "
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    • "In more detailed analyses of social support information collected from 200 of the spouse-caregivers, it was found that higher levels of emotional support, more visits, and having more network members to whom they felt close were all individually predictive of longitudinal changes in social support network satisfaction (Drentea et al., 2006). The intervention includes six sessions of individual and family counseling, support group participation, and additional counseling by telephone when requested by the primary caregiver or family members following the formal counseling sessions. "
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    • "There were a number of hypothesized mediators which did not mediate CCI's effects. First, given the strong emphasis in CCI sessions on mobilizing existing support by facilitating participants' ability to identify their cancer-specific support needs, recognize internal and external barriers to obtaining effective support, and teaching strategies to obtain needed support, and well as the results of previous studies that have targeted support enhancement (e.g., Drentea et al., 2006), it is surprising that neither the seeking of instrumental nor emotional support constructs served as mediators of CCI's effects. One potential explanation for these findings is that our measure of social support evaluated the seeking of instrumental and emotional support rather than other support indicators which may have been more likely to mediate effects. "
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