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，往往导致不适当的或过早的 养老院安置 我们目前的治疗/对照研究结果 （N=200）表明，多方面的结构化干预（个人） 和家庭咨询会议针对每一个具体情况，广告 随时进行特别咨询，支持团体参与 无限期）对AD护理人员的健康有重大影响 并减轻了该疾病的长期社会和经济负担。 的 干预增加了其他家庭成员的参与， 短期内提高配偶照顾者的社会网络满意度 长期，并对他们的身心健康产生有益的影响， 从长远来看。 此外， 护理之家安置从对照组比从治疗 组 拟议的纵向研究包括我们的扩展 目前的研究，以及一个改进的纵向评价 干预 我们将衡量长期的后果， 通过继续评估所有的 本研究的受试者以6个月的时间间隔， 病人在家或在疗养院，并在两年后， 病人去世了。 我们将评估 一项改进的干预措施，对额外的 200名配偶照顾者。 对当前治疗的修改 将包括将一次家庭咨询会议推迟到一年后 帮助家属应对患者的变化，并进一步 定制家庭咨询，明确考虑到 照顾者的个性和优点和缺点的 照顾者的社会支持系统。 评价将扩大到 包括对社会支持、照顾者个性 的财务成本的评估。 我们将 进一步建立干预措施对儿童健康影响的因果模型， 正式和非正式支助影响妇女福祉的机制 AD患者的配偶照顾者和医疗保健费用 与之相关的。 受试者的数量和长度 许多人将被跟踪的时间将提供一个 非凡的研究资源和必要的统计力量， 对长期经济、身体和情感影响的分析 以及社会心理干预的潜在益处 旨在加强联合国系统内的正式和非正式支助系统， 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.