Caregiving in Dementia: Directing Families to Resources

David B. Reuben, MD

Disclosures

March 07, 2016

Editorial Collaboration

Medscape &

Question

What resources are available in the community to train and support caregivers of patients with dementia?

Response from: David B. Reuben, MD
Archstone Foundation Endowed Chair, Department of Medicine, University of California, Los Angeles; Chief, Division of Geriatrics, UCLA Medical Center, Santa Monica, California

Caregivers of people with Alzheimer and other dementias provided an estimated 17.9 billion hours of unpaid care in 2014. The emotional and health toll on these caregivers is enormous; about 40% experience depression, and over one half rate the emotional stress of caregiving as high or very high.[1]

Caregiver training and support are key elements in the successful management of Alzheimer disease and other dementias. A variety of interventions have been demonstrated to be effective. These include psychosocial interventions, such as skills training and counseling/support, and pharmacologic interventions, aimed at treating the patient's dementia or behaviors and thereby reducing caregiver distress.[2] Some programs have been disseminated nationally, including the Savvy Caregiver™ (via video media)[3,4] and Powerful Tools for Caregivers.[5] Others (eg, New York University Caregiver Counseling and Support Intervention[6] and Resources for Enhancing Alzheimer's Caregiver Health [REACH II][7]) have more limited availability or have been offered in the context of research settings.

Several websites are available to provide information and direct caregivers to local resources. Some offer specific resources for caregivers of patients with dementia, whereas others provide more general caregiving training and support.

However, not all resources are available in every community. Moreover, in some areas, the local chapters of the Alzheimer's Association have recently disaffiliated from the national organization and have changed their names while fulfilling the same mission. Thus, finding appropriate Alzheimer- and dementia-specific resources may vary across communities. Social workers and case managers may be helpful in directing families to the best local resources.

For the most part, services are provided by community-based organizations other than health systems. These services are not covered by fee-for-service Medicare; community-based organizations rely on grants, donations, and charges to individual patients.

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