0
0

Chapter 30. Working With Families of Older Adults

Lisa P. Gwyther, M.S.W.; Diane E. Meglin, M.S.W.
DOI: 10.1176/appi.books.9781585623754.398345

Sections

Excerpt

No single model exists for working with families of older adults. Clinicians need to provide patients and families with individualized family assessment and treatment, taking into account issues of diversity and heterogeneity. Despite the need for family-specific treatment, there are patterns of family issues that consistently emerge, based on trajectories of psychiatric illness. Perhaps the most specific guidance in the literature comes from meta-analyses of clinical research on families of older adults with progressive degenerative dementias (Gallagher-Thompson and Coon 2007; Pinquart and Sorenson 2006b; Sorensen et al. 2002).

Your session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
 
Username
Password
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Table Reference Number
Table 30–1. Key messages for family caregivers
Table Reference Number
Table 30–2. Signs of decline in driving skills

References

Belle SH, Burgio L, Burns R, et al: Enhancing the quality of life of dementia caregivers from different ethnic or racial groups: a randomized, controlled trial. Ann Intern Med 145:727–738, 2006
[PubMed]
 
Brodaty H, Luscombe G: Psychological morbidity in caregivers is associated with depression in patients with dementia. Alzheimer Dis Assoc Disord 1:62–70, 1998
 
Burgio L, Stevens A, Guy D, et al: Impact of two psychosocial interventions on white and African-American family caregivers of individuals with dementia. Gerontologist 43:568–579, 2003
[PubMed]
 
Burton LC, Newsom JT, Schulz R, et al: Preventive health behaviors among spousal caregivers. Prev Med 26:162–169, 1997
[PubMed]
 
Callahan CM, Boustani MA, Unverzagt FW, et al: Effectiveness of collaborative care for older adults with Alzheimer disease in primary care: a randomized controlled trial. JAMA 295:2148–2157, 2006
[PubMed]
 
Coon DW, Thompson L, Steffen A, et al: Anger and depression management: psychoeducational skill training intervention for women caregivers of a relative with dementia. Gerontologist 43:678–689, 2003
[PubMed]
 
Derence K: Dementia-specific respite: the key to effective caregiver support. N C Med J 66:48–51, 2005
[PubMed]
 
Eisdorfer C, Czaja SJ, Loewenstein DA, et al: The effect of a family therapy and technology-based intervention on caregiver depression. Gerontologist 43:521–531, 2003
[PubMed]
 
Fortinsky RH, Kercher K, Burant CJ: Measurement and correlates of family caregiver self-efficacy for managing dementia. Aging Ment Health 6:153–160, 2002a
 
Fortinsky RH, Unson CG, Garcia RI: Helping family caregivers by linking primary care physicians with community-based dementia care services. Dementia 1:227–240, 2002b
 
Fulmer T, Paveza G, Van de Weerd C, et al: Dyadic vulnerability and risk profiling for elder neglect. Gerontologist 45:525–534, 2005
[PubMed]
 
Gallagher-Thompson D, Coon DW: Evidence-based psychological treatments for distress in family caregivers of older adults. Psychol Aging 22:37–51, 2007
[PubMed]
 
Gitlin LN, Reever K, Dennis MP, et al: Enhancing quality of life of families who use adult day services: short-and long-term effects of the Adult Day Services Plus Program. Gerontologist 46:630–639, 2006
[PubMed]
 
Gwyther LP: Family issues in dementia: finding a new normal. Neurol Clin 18:993–1010, 2000
[PubMed]
 
Gwyther LP: Family care and Alzheimer's disease: What do we know? What can we do? N C Med J 66:39–44, 2005
 
Hepburn K, Lewis M, Tornatore J, et al: The Savvy Caregiver program: the demonstrated effectiveness of a transportable dementia caregiver psychoeducation program. J Gerontol Nurs 33:30–36, 2007
[PubMed]
 
Hughes SL, Giobie-Hurder A, Weaver FM, et al: Relationships between caregiver burden and health-related quality of life. Gerontologist 39:534–545, 1999
[PubMed]
 
Kaufer DI, Cummings JL, Christine D, et al: Assessing the impact of neuropsychiatric symptoms in Alzheimer's disease: the Neuropsychiatric Inventory Caregiver Distress Scale. J Am Geriatr Soc 46:210–215, 1998
[PubMed]
 
King AC, Brassington G: Enhancing physical and psychological functioning in older family caregivers: the role of regular physical activity. Ann Behav Med 19:91–100, 1997
[PubMed]
 
Langa KM, Chernew ME, Kabeto MU, et al: National estimates of the quantity and cost of informal caregiving for the elderly with dementia. J Gen Intern Med 16:770–776, 2001
[PubMed]
 
Lyketsos CG, Steinberg M, Tschanz JT, et al: Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. Am J Psychiatry 157:708–714, 2000
[PubMed]
 
McCurry SM, Gibbons LE, Logsdon RG, et al: Nighttime insomnia treatment and education for Alzheimer's disease: a randomized controlled trial. J Am Geriatr Soc 53:793–802, 2005a
 
McCurry SM, Logsdon R, Gibbons LE: Training community consultants to help family members improve dementia care: a randomized controlled trial. Gerontologist 45:802–811, 2005b
 
Mittelman MS, Ferris SH, Shulman E, et al: A family intervention to delay nursing home placement of patients with Alzheimer disease: a randomized controlled trial. JAMA 276:1725–1731, 1996
[PubMed]
 
Mittelman MS, Roth DL, Haley WE, et al: Effects of a caregiver intervention on negative caregiver appraisals of behavior problems in patients with Alzheimer's disease: results of a randomized trial. J Gerontol B Psychol Sci Soc Sci 59:P27–P34, 2004
 
Mittelman MS, Roth DL, Clay OJ, et al: Preserving health of Alzheimer caregivers: impact of a spouse caregiver intervention. Am J Geriatr Psychiatry 15:780–789, 2007
[PubMed]
 
Olin JT, Schneider LS, Katz IR, et al: Provisional diagnostic criteria for depression of Alzheimer's disease. Am J Geriatr Psychiatry 10:125–128, 2002
[PubMed]
 
Ostwald SK, Hepburn KW, Caron W, et al: Reducing caregiver burden: a randomized psychoeducational intervention for caregivers of persons with dementia. Gerontologist 39:299–309, 1999
[PubMed]
 
Pillemer K, Suitor JJ: "It takes one to help one": effects of similar others on the well-being of caregivers. J Gerontol B Psychol Sci Soc Sci 51:S250–S257, 1996
 
Pinquart M, Sorensen S: Ethnic differences in stressors, resources, and psychological outcomes of family caregiving: a meta-analysis. Gerontologist 45:90–106, 2005
[PubMed]
 
Pinquart M, Sorensen S: Gender differences in caregiver stressors, social resources, and health: an updated meta-analysis. J Gerontol B Psychol Sci Soc Sci 61:P33–P45, 2006a
 
Pinquart M, Sorensen S: Helping caregivers of persons with dementia: which interventions work and how large are the effects? Int Psychogeriatr 18:577–595, 2006b
 
Rabins PV, Lyketsos C, Steele C: Practical Dementia Care. Oxford, UK, Oxford University Press, 2006
 
Schulz R, Beach SR: Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. JAMA 282:2215–2219, 1999
[PubMed]
 
Sorensen S, Pinquart M, Duberstein P, et al: How effective are interventions with caregivers? An updated meta-analysis. Gerontologist 42:356–372, 2002
[PubMed]
 
Spangenberg KB, Wagner MT, Hendrix S, et al: Firearm presence in households of patients with Alzheimer's disease and other dementias. J Am Geriatr Soc 47:1183–1186, 1999
[PubMed]
 
Teri L, Logsdon RG, Uomoto J, et al: Behavioral treatment of depression in dementia patients: a controlled clinical trial. J Gerontol B Psychol Sci Soc Sci 52:P159–P166, 1997
 
Teri L, Gibbons LE, McCurry SM, et al: Exercise plus behavioral management in patients with Alzheimer's disease: a randomized controlled trial. JAMA 290:2015–2022, 2003
[PubMed]
 
Tierney MC, Charles J, Naglie G, et al: Risk factors for harm in cognitively impaired seniors who live alone: a prospective study. J Am Geriatr Soc 52:1435–1441, 2004
[PubMed]
 
Tractenberg RE, Weiner MF, Thal LJ: Estimating the prevalence of agitation in community-dwelling persons with Alzheimer's disease. J Neuropsychiatry Clin Neurosci 14:11–18, 2002
[PubMed]
 
Whitlatch CJ, Judge K, Zarit SH, et al: Dyadic intervention for family caregivers and care receivers in early stage dementia. Gerontologist 46:688–694, 2006
[PubMed]
 
Yaffe K, Fox P, Newcomer R, et al: Patient and caregiver characteristics and nursing home placement in patients with dementia. JAMA 287:2090–2097, 2002
[PubMed]
 
Yates ME, Tennstedt S, Chang BH: Contributors to and mediators of psychological well-being for informal caregivers. J Gerontol B Psychol Sci Soc Sci 54:P12–P22, 1999
 
Zarit SH, Stephens MA, Townsend A, et al: Stress reduction for family caregivers: effects of adult day care use. J Gerontol B Psychol Sci Soc Sci 53:S267–S277, 1998
 
+

CME Activity

Add a subscription to complete this activity and earn CME credit.
Sample questions:
1.
For psychiatrists and other mental health professionals working with families, there are a number of clinical reminders that may prove useful. Which of the following is one of those clinical reminders?
2.
Clinical goals for psychiatrists and other mental health professionals working with families of older adults will vary depending on presenting problems and family resources. However, some common goals are applicable to most families. All of the following are examples of these common clinical goals except
3.
Families have certain expectations of psychiatrists. Which of the following is one of these expectations?
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Related Content
Articles
Books
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 37.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 3.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 7.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 9.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 11.  >
Topic Collections
Psychiatric News
PubMed Articles
 
  • Print
  • PDF
  • E-mail
  • Chapter Alerts
  • Get Citation