AD CAREGIVER WELL-BEING--COUNSELING/INSTITUTIONALIZATION

阿尔茨海默病(AD)对老年人的健康有灾难性的影响 患者的配偶，往往导致不适当或过早 养老院安置。我们目前的治疗/对照研究结果 (n=200)建议进行多方面的结构化干预(个人 以及为每个具体情况量身定做的家庭咨询会议，广告 随时进行临时协商，支持团体参与 无限期)对AD照顾者的幸福感有重大影响 并减轻该病的长期社会和经济负担。这个 干预增加了其他家庭成员的参与， 在短期内提高配偶照顾者的社交网络满意度 对他们的身心健康有有益的影响 从长远来看。此外，有超过两倍的数量 来自对照组的疗养院安置比来自治疗组的 一群人。拟议的纵向研究包括扩展我们的 目前的研究，以及对改进后的 干预。我们将衡量以下两个方面的长期后果 通过继续评估所有的护理和干预 每隔六个月进行一次当前研究的对象是否为AD 病人在家或在疗养院，在治疗后两年内 病人已经死亡。我们将评估其潜在的更大功效 通过对其他患者的治疗/对照研究进行改进的干预 由200名配偶照顾者组成的团体。对当前治疗方法的修改 将包括将一次家庭咨询会议推迟到一年后 帮助家属处理病人的变化，并进一步 通过明确考虑到的方式定制家庭咨询 照顾者的个性和他们的优点和缺点 照顾者的社会支持系统。评估范围将扩大到 包括对社会支持、照顾者个性 简介和对照看的财务成本的评估。我们会 进一步建立干预对经济增长影响的因果模型 正式和非正式支助影响人民福祉的机制 对AD患者配偶照顾者和医疗费用的影响 与照顾有关。题材多、篇幅长 许多人将被跟踪的时间将提供一种 非凡的研究资源和必要的统计力量 对长期经济、物质和情感影响的分析 护理和心理社会干预的潜在好处 旨在支持正式和非正式的支持系统 社区。

Alzheimer's disease (AD) has a catastrophic impact on the well-being of the spouses of the patients, often leading to inappropriate or premature nursing home placement. Results of our current treatment/control study (N=200) suggest that a multifaceted structured intervention (individual and family counseling sessions tailored to each specific situation, ad hoc consultation at any time and support group participation indefinitely) has a significant impact on the well-being of AD caregivers and reduces the long-term social and economic burden of the disease. The intervention increases the involvement of other family members and improves spouse caregivers' social network satisfaction in the short term, and has a salutary effect on their physical and mental health in the long term. Furthermore, there have been more than twice as many nursing home placements from the control group than from the treatment group. The proposed longitudinal study includes an extension of our current study, as well as a longitudinal evaluation of an improved intervention. We wil measure the long-term consequences both of caregiving and of the intervention by continuing to assess all the subjects of the current study at six-month intervals whether th AD patient is at home or in a nursing home, and for two years after the patient is deceased. We will assess the potentially greater efficacy of an improved intervention with a treatment/control study of the additional group of 200 spouse caregivers. Modifications to the current treatment will include postponing one family counseling session to one year after intake to help the family deal with changes in the patient, and further custom tailoring the family counseling by explicitly taking into account the caregiver's personality and the strengths and weaknesses of the caregiver's social suppport system. The evaluation will be expanded to include an enriched assessment of social support, a caregiver personality profile and an assessment of the financial cost of caregiving. We will further develop a causal model of the impact of the intervention on the mechanisms by which formal and informal support affects thw well-being of spouse caregivers of AD patients and on the health care costs associated with caregiving. The large number of subjects and the length of time over which many will have been followed will provide an extraordinary research resource and the statistical power necessary for analysis of the long-term economic, physical and emotional implications of caregiving and the potential benefits of a psychosocial intervention designed to buttress the formal and informal support systems in the community.