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Cited by 259Dementia and Cognitive Impairment ResearchNursing care and researchFamily Caregiving in Mental Illness

Effect of a training programme to reduce stress in carers of patients with dementia.

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Brodaty, H., Gresham, M.·1989·BMJ
DOI 10.1136/bmj.299.6712.1375PMC PMC1838247
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Abstract

OBJECTIVE--To reduce the psychological stress and improve the skills in coping of people who care for relatives with dementia. DESIGN--Assessment and suitability of carers by questionnaire; assessment of patients and carers in a hospital outpatient clinic; allocation to groups according to date of application to study. Linkage of groups of four carers and programme coordinator by telephone conference calls over 12 months after programmes. Reassessment at three, six, 12, and, for those in the "wait list" group, 18 months. SETTING--The programmes were conducted in the psychiatry unit of a Sydney teaching hospital. SUBJECTS--Eligible patients were less than 80 years old, had mild to moderate dementia, and lived at home with their carer. Of the 96 patient-carer pairs in the study, 33 were in the dementia carers' programme group, 31 were in the memory retraining group, and 32 were in the wait list group. INTERVENTIONS--Carers in the dementia carers' programme received training in coping with the difficulties of looking after patients with dementia while the patients had sessions in subjects such as memory retraining. In the memory retraining programme patients were admitted and received the patient component of the carers' programme while their carers had 10 days' respite. In the wait list group carers waited six months before undertaking the carers' programme. MAIN OUTCOME MEASURES--Effect of the programmes on carers' general health questionnaire scores and the rate of placement of patients in institutions. RESULTS--At 12 months' follow up the carers' programme had resulted in significantly lower psychological stress among carers than the memory retraining programme (mean (SD) general health questionnaire scores at 0 months were 6.31 (6.23) and 3.60 (6.25) respectively, and at 12 months were 4.69 (5.58) and 7.40 (9.39); p less than 0.05.) In the wait list group distress scores remained stable, even after the carers and patients had undertaken the carers' programme. Patients deteriorated over 12 months regardless of group allocation, but at 30 months, allowing for patients who died and could not be included in the analysis, 65% of patients in the carers' programme group were still living at home compared with 26% in the memory retraining programme group. CONCLUSION--The intensive intervention programme described for carers of patients with dementia can reduce the psychological morbidity of the carer and delay the placement of the patient in an institution without increasing the use of health services by either patient or carer.

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  • The psychological morbidity of carers predicts a breakdown in care and therefore the need for placement in a care home as well as elder abuse.

    “The psychological morbidity of carers predicts a breakdown in care and therefore the need for placement in a care home5as well as elder abuse.6”

    From Clinical effectiveness of a manual based coping strategy programme (START, STrAtegies for RelaTives) in promoting the mental health of carers of family members with dementia: pragmatic randomised controlled trial (2013) · cites this paper as [5]

    The Results and Discussion report that carers who received training had lower psychological morbidity and that patients in their care were less likely to be placed in institutions, mainly nursing homes. The paper does not establish that carers’ psychological morbidity predicts a breakdown in care or a need for placement. The elder-abuse clause carries a separate citation and is not attributed to this source. Page numbers are not available in our copy. (LLM, conf=0.84)

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Research works printed but not linked: 3

  1. Brodatv H, Hadzi-Pavlovic D. The psychosocial effects on carers of liing with dementia. lust N ZJ Psvchiatry (in press).
  2. Brodaty H, Griffin D, Hadzi-Pavlovic D. A survey of dementia carers: how doctors communicate with dementia patients and their carers; the problem behaviours of dementia; and factors associated with institutionalisation. A ust N Z3J Psychiatry (in press).
  3. Goldberg D. 7'he detection of psychiatric illness by questionnaire. New York: Oxford University Press, 1972.

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Authors
Brodaty, H., & Gresham, M.
ORCID
Venue
BMJ
Publisher
BMJ
Published
1989-12-02
Volume
299
Issue
6712
Pages
1375-1379
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
DOI
10.1136/bmj.299.6712.1375
PMC
PMC1838247
OpenAlex
W1995993981
Cited by
259
References
31
Citations by year
2025: 1 · 2024: 1 · 2022: 3 · 2021: 2 · 2020: 8 · 2019: 2 · 2018: 3 · 2017: 6 · 2016: 3 · 2015: 3 · 2014: 7 · 2013: 8 · 2012: 4
FWCI
7.37
Type
journal article
Language
en
Open access
Licence
www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
Locations
  • BMJ (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Health Professions › Pharmacy › Nursing care and research
  • Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
Keywords
dementia caregivers, caregiver stress, memory retraining, respite care, institutional placement, home care, psychological distress, family caregivers, General Health Questionnaire, clinical deterioration, community-based intervention, memory clinics, waitlist control, intervention cost-effectiveness
MeSH terms
Adaptation, Psychological, Dementia, Health Education, Home Nursing, Humans, Institutionalization, Stress, Psychological, Time Factors

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