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FORMER CAREGIVERS STILL SHOW PSYCHOLOGICAL ILLS YEARS AFTER
CAREGIVING ENDS
COLUMBUS, Ohio - The negative psychological impact of caregiving
for a spouse with Alzheimer's or other forms of dementia continues
for years after the spouse dies, new research suggests.
The study by researchers at the Houston VA Medical Center
and Ohio State University found that, even three years after
their spouse had died, former caregivers still showed levels
of depression and loneliness similar to those in current caregivers.
For example, 41 percent of former caregivers showed mild
to severe depression at two to three years after their spouses'
death - not significantly less than the 43 percent depression
rate among current caregivers.
"One assumption has been that the psychological health
of caregivers would improve once the burden of caregiving
ends," said Susan Robinson-Whelen, the lead author of
the study. "However, we found that the negative effects
of long-term caregiving for a spouse with dementia may continue
well beyond the caregiving years."
Robinson-Whelen began studying the health of caregivers as
a post-doctoral fellow in psychiatry at Ohio State. She is
now a researcher at the Center of Excellence on Healthy Aging
with Disabilities at the Houston VA Medical Center. She co-authored
the study with Yuri Tada, Robert MacCallum, Lynanne McGuire
and Janice Kiecolt-Glaser, all of Ohio State. The study appears
in the current issue of the Journal of Abnormal Psychology.
The researchers studied 49 former caregivers, 42 continuing
caregivers and 52 noncaregiving control participants. The
former and current caregivers all cared for a spouse suffering
from some form of dementia, such as Alzheimer's disease. All
the participants were assessed on a variety of psychological
measures for four years. The former caregivers were tested
once before the death of their spouse and three times following
the death.
The most striking finding was that levels of depression did
not
significantly improve even two to three years after caregiving
duties ended, said Kiecolt-Glaser, who is a professor of psychiatry
at Ohio State. While many of the former caregivers showed
evidence of relatively mild depression, it was still enough
to impair their well-being, she said. Researchers were also
concerned that the depression had not significantly decreased
over time.
Kiecolt-Glaser noted that the control group in her study
- those who had never been caregivers -- had a depression
rate of only 15 percent, compared to the rate of over 40 percent
for former and current caregivers. "We didn't see the
improvements you would hope and expect to see after caregiving
has ended," she said.
Results also showed that former caregivers experienced fewer
negative moods -- such as guilt and anger - than did current
caregivers, and did not differ significantly from noncaregivers
in such negative mood states. However, former caregivers did
not see a similar return to normal in how often they felt
positive emotions, such as energy and
enthusiasm. Even two to three years after caregiving ended,
former caregivers reported fewer positive mood states than
noncaregivers.
Moreover, former caregivers also showed higher levels of
loneliness than did non-caregivers. "Most studies suggest
many widowed people see improvements in their psychological
health after a year or so of the death of their spouse,"
Robinson-Whelen said. "However, the former caregivers
in this study still had relatively high levels of
depression and loneliness even several years after the death
of their spouse."
The former caregivers who were most likely to report psychological
problems were those who said they often had recurring, unwanted
thoughts about their caregiving experiences, or who said they
tried to actively avoid such thoughts. Former caregivers who
reported less social support from family and friends also
were more likely to show signs of depression or other problems.
One area where former caregivers did show significant improvement
was stress: after three years, former caregivers showed levels
of stress very similar to those of non-caregivers. "You
would expect that once the daily constant demands of caregiving
were over that stress would go down," she said.
Robinson-Whelen said it is not known whether these results
would apply to caregivers who cared for spouses with problems
other than dementia. However, caring for a spouse with dementia
may create special problems that make adjustment following
death more difficult, she said.
However, the results do show that former caregivers may still
need psychological help and support, even though their caregiving
duties are over.
"Caregiving, especially for a spouse with dementia,
is very difficult and the effects can linger for years,"
she said. "Former caregivers need more attention given
to their needs."
The study was supported by grants from the National Institutes
of Health and the Veterans Affairs Rehabilitation Research
and Development Service.
Contact:
Written by Jeff Grabmeier, (614) 292-8457; grabmeier.1@osu.edu
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