On average, Alzheimer’s disease progresses in stages over eight to 10 years after diagnosis. Early diagnosis and treatment allows patients and their families time to plan for the future and has proven to preserve function longer. This trend may allow the patient to stay in the home setting longer.Caregivers of Alzheimer’s patients are most commonly the spouse or a child. Their responsibilities may include: assisting in day-to-day activities; providing meals; aiding in personal care; supervising medication; planning and managing legal and financial affairs; creating a safe environment; communicating to other concerned parties; contracting or procuring services; and decision making/problem solving.
A recent report by the AARP Public Policy Institute entitled Valuing the Invaluable: 2011 Update of The Economic Value of Family Caregiving in 2009 estimates the economic value of unpaid contributions to family caregivers of adults living with limitations was $450 billion in 2009, which was nearly four times Medicaid long-term services and supports spending during the same period.
The emotional and physical health cost to caregivers is incalculable. The same study also notes these research findings:
• Between 40 – 70 percent of family caregivers of older adults have clinically significant symptoms of depression, with about one-fourth to one-half of these caregivers meeting the diagnostic criteria for major depression.
• Caregivers have poorer physical health than non-caregivers, with an estimated 17 – 35 percent of family caregivers perceiving their health as fair to poor.
• Caring for a spouse with Alzheimer’s is particularly stressful and associated with depression, physical health problems, sleep problems, social isolation, mortality and a greater risk of the caregiver developing dementia.
• Caregivers of people with dementia were more likely to have an emergency department visit or hospitalization in the previous six months if they were depressed or were taking care of individuals with heavy needs.
Both physical and mental health problems in caregivers’ lives can severely reduce their effectiveness in meeting patients’ needs. These conditions need to be treated as early as possible and community resources for caregiving assistance should be utilized.
Holy Cross Hospital in Fort Lauderdale has created a Care Management Program to assist seniors in staying in their homes offering assistance to families who live locally or in other regions of the country.
Holy Cross care managers coordinate a number of services including assistance for personal care, grocery shopping, meal preparation, diet and medication management, escort and transportation to doctors’ visits and prescription pick up. Care managers can also oversee housekeeping, arrange for household reports and help with paying bills and completing medical forms.
In addition to monitoring the health of the caregivers by providing treatment and support, physicians and hospitals must integrate caregivers into the care team of the person with Alzheimer’s. By shifting the care-giving model from a "person-centered" approach to a "person- and family-centered" approach, caregivers become more than a resource. As partners in the care team they can be viewed as individuals who may need training and support.
