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Spouse caregivers of Alzheimer's patients - patients themselves?


A study at the Philadelphia Geriatric Center, supported by the National Institute of Mental Health, recently examined the impact of caregiving on the mental and physical health of 101 males and 214 females who were providing home care to a spouse diagnosed with Alzheimer's disease or a related condition. The caregivers' ages ranged from 45 to somewhat over 75 years.

In regard to physical health, all indicators suggest that the health of spouse caregivers is substantially poorer than that of older people in the general population. Although medical services used, including visits to physicians and hospital stays, were comparable to those of the general population, more caregiving spouses had diabetes, arthritis, ulcers and anemia than others in the population in the same age groups. Women caregivers had more heart disease and hypertension than age mates.

The Philadelphia study generally regarded spouse caregivers as being more depressed, presenting higher levels of negative affect, more likely to use psychotropic drugs, and having more symptoms of psychological distress than noncaregiving men and women. "Perhaps the most startling finding is the frequency with which caregivers report their own health as the same as or worse than the health of the spouse for whom they are providing care," write the study's coordinators, Drs. R. A. Pruchno and S. L. Potashnik. "It is possible that the `caregiver' is actually the `care organizer,' the person who coordinates life within the household. The role of the impaired spouse, at least until the very end of the disease, is not merely as a passive `care receiver,' but as `care partner.'" Geriatric Society, August 1989; 37:8:697.)

The various implications of this study include (1) the need for other family members to assume a caring role with both partners in the Alzheimer family, (2) the importance of family physicians and other health workers to examine the spouse, as well as the primary patient, during checkups, (3) the expansion of community services to aid caregivers in getting sufficient rest and relief, and (4) the need for continued research into the phenomenon of spouse illness in severely limiting diseases. Certainly caregivers need to know of the multiple services and supports available in the local community to provide assistance. Learning how to access community services can be a primary tool in learning how to survive a catastrophic spousal illness. Family physicians, local public health agencies and the Visiting Nurses' Association may help to locate necessary support groups and other community services. From a community perspective, the need to look at the couple as both suffering from the effects of Alzheimer's disease is a crucial starting point in limiting further family disability.
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Publication:Medical Update
Date:Oct 1, 1989
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