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
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.
Full-textDOI: · Available from: Mary Sherman Mittelman, Aug 26, 2015
- SourceAvailable from: James E Galvin
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- "Recent studies have even suggested that enhancing the dyadic relationship may help slow Alzheimer's-related decline  and decrease psychosocial costs to carers ; 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  . 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 . "
ABSTRACT: To understand the impact of memory loss on aging in place, this paper investigated dyads where one spouse had been diagnosed with memory loss. In-depth qualitative interviews were conducted with ten couples (N = 20). Grounded theory methods were used to collect, code, and analyze data into themes. Data revealed consensus among and between dyads that it was best to focus on living, rather than what had been or might someday be lost. Nonetheless, differences according to gender and cognitive status (e.g., diagnosed or spouse) were reported. Given population aging, identifying the impact of gender roles and social norms on the potential for aging in place with memory loss is critical. Community services and care practices must be sensitive to the ways that couples prioritized and organized their relationship prior to diagnosis in order to encourage positive patterns of care between couples, foster successful adaptation to changing needs, and support in-home arrangements as long as possible.Journal of aging research 01/2012; 2012:797023. DOI:10.1155/2012/797023
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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. "
ABSTRACT: Despite the high consistency of evidence in favor of person-centered care, little information is available on how person-centered and family-centered interventions are actually provided. The aim of this study is to gain insight into the provision of the effective New York University Caregiver Intervention (NYUCI) in order to enhance its implementation. This is a qualitative study using a grounded theory approach. Group interviews were carried out with three purposefully sampled counselors who had provided the NYUCI. Six themes were identified: (1) family problems, (2) ways to deal with these family problems, (3) barriers encountered by counselors, (4) ways to deal with these barriers, (5) facilitators or rewards of being a counselor, and (6) perceived effectiveness.The problem categories were (a) conflicts within families; (b) past experiences and personality; and (c) daily living with dementia. Ways of helping caregivers deal with these problems included problem clarification from the perspectives of the key players. An important barrier was reluctance to be helped. This was dealt with by acknowledging caregivers' need for control over situations. Additional effects of participation in the NYUCI observed by the counselors were reduction of anger and awareness of more and new options for dealing with dementia. Person- or family-centered care offers new perspectives on problems that are seemingly unmanageable. We hypothesize that seeing new and more options is a direct effect of this person-centered counseling. This might be an important outcome to be measured in future studies.International Psychogeriatrics 03/2010; 22(5):769-77. DOI:10.1017/S1041610210000050 · 1.89 Impact Factor
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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. "
ABSTRACT: The authors evaluated mechanisms of change for a coping and communication-enhancing intervention (CCI) and supportive counseling (SC). They proposed that the effects of CCI on depressive symptoms would be mediated by psychological processes targeted by CCI, namely increases in the following: positive reappraisal, acceptance, planful problem solving, attempts to understand emotional reactions to cancer, emotional expression, seeking of emotional and instrumental support, and self-esteem. The authors hypothesized that the effects of SC on depressive symptoms would be mediated by the processes encouraged by SC, in this case increases in the following: expression of emotions, attempts to understand emotional reactions to cancer, and self-esteem. Three hundred fifty-three women were randomized to a CCI, SC, or usual care control group and completed measures at preintervention and 3, 6, and 9 months later. The effects of CCI were fully mediated by positive reappraisal, problem solving, and self-esteem and partially mediated by emotional expression. The effects of SC were partially mediated by positive reappraisal. These findings provide support for hypothesized mediators for CCI. The authors were less able to identify mediators for SC. Future research might benefit from identifying SC mediators.Journal of Consulting and Clinical Psychology 01/2009; 76(6):1034-45. DOI:10.1037/a0014071 · 4.85 Impact Factor