Family & Friends: Best Detectors, Worst Stressors
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Family members and close friends are more sensitive to early signs of Alzheimer's dementia than traditional screening tests, according to researchers at Washington University School of Medicine in St. Louis.
Paradoxically, the same family and friends tend to be the source of the most stress and the greatest threat to a caregiver's own health and well-being. Surprising new research from Northwestern Medicine shows that it is all to common for family and friends to have a lack of understanding and too little time to offer much-needed help.
Caregiver Stress
"Often families aren't really understanding, or families might blame a caregiver for not doing more than they're doing," said Rosemarie King, the study's lead investigator and research professor in physical medicine and rehabilitation at Northwestern University Feinberg School of Medicine. "We had one caregiver in our study ask if we could send her a write-up that she could just hand to family members to explain how harassed and stressed caregivers are."
The next most stressful problem category was the difficulty caregivers experienced in trying to sustain themselves and their families. Social isolation and changes in their relationship with the stroke survivor also top caregivers' concerns.
Astonishingly, the patient was the lowest source of stress. According to Dr. King, "The least stressful area was patient-related problems. Not that those problems aren't stressful, they were just not as stressful for this group of caregivers." The results are critical, King noted, because other studies, mostly of Alzheimer's caregivers, show stress and depression seem to be associated with increased mortality.
Tips for Family & Friends
Dr. King offers a few tips for friends and family that may ease caregiver stress:
- Encourage online or in-person caregiver support groups.
- Invite the caregiver to join you at a social event.
- Ask the caregiver how she is doing and express concern for her well-being.
- Be a sounding board; let the caregiver bounce ideas off of you.
- Stay with the patient for a few hours, so the caregiver can get out of the house.
- Offer to help with specific everyday tasks, such as shopping for groceries for the caregiver or bringing prepared meals to the home.
Family & Friends Detect Dementias Such as Alzheimer's
"It's not economically feasible to screen everyone for Alzheimer's disease biomarkers," says John C. Morris, MD, director of the Charles F. and Joanne Knight Alzheimer's Disease Research Center at Washington University School of Medicine.
Dr. Morris recommends family and friends use a quick screens such as the "AD8" which can be filled out in less than five minutes. Such quick tests give a brief and very low-cost alternative that takes a few minutes of time from friends or family. They screen for dementias such as Alzheimer's and thus identify those individuals who need follow-up evaluations to determine if there truly are signs of Alzheimer's.
According to Morris, the Harvey A. and Dorismae Hacker Friedman Distinguished Professor of Neurology, the difficulty with traditional early-stage dementia screening tools is that they only give a snapshot of a person's cognitive abilities at one point in time - when they're being tested. Asking the individual if his or her mental abilities have changed doesn't necessarily produce accurate results either, Morris says, because persons with early-stage dementia often lack insight into their problem.
According to Morris, family and friends who have regular exposure to the individual provide the most accurate assessments.
"These (family and friends) can give us the retrospective perspective we need to know that a person's mental abilities have begun to meaningfully decline, indicating that additional testing is needed," Dr. Morris says.
Click here to try the AD8 Alzheimer's Test.
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More Information
Notes on Detection:
- Galvin JE, Fagan AM, Holtzman DM, Mintun MA, Morris JC. Relationship of dementia screening tests with biomarkers of Alzheimer's disease. Brain, online Sept. 10, 2010.
- Funding from the National Institute on Ageing and the National Institutes of Health supported this research.
Notes on Caregiver Stress:
The findings were presented at the Association of Rehabilitation Nurses annual educational conference Sept. 29 to Oct. 2 in Orlando, FL.
Source:
Michael C. Purdy
Washington University School of Medicine
Erin White
Northwestern University
.
