May 1, 2002
STANFORD, Calif. - After a series of strokes left her mother with dementia, Nancy Hagebush moved back home to care for her. In the six years since, she has helped bathe and dress her mother, cook, clean and provide assistance when they travel out of the house. It's a full-time job for the 42-year-old, who has essentially put her own life on hold.
Feeling isolated, Hagebush enrolled in the Coping with Caregiving program offered through the VA Palo Alto Health Care System in conjunction with Stanford University Medical Center. 'The classes helped me a lot,' she said. 'It's a release, a place to go where there are people like you.'
This support and skill-building class has helped hundreds of family members manage the emotional and physical strain that comes from caring for a loved one with Alzheimer's or dementia, and it is now also a vehicle for two clinical studies exploring the effects of family caregiving. Developed by Stanford psychologist Dolores Gallagher-Thompson, PhD, the psychologically oriented classes teach coping skills and bring caregivers together for support.
'It's very practical information,' said Gallagher-Thompson, associate professor in the department of psychiatry at Stanford's School of Medicine, and staff psychologist at the VA. 'It helps them get more control over a situation that seems so overwhelming.'
For Alzheimer's and dementia patients, caregiving responsibilities can last between 10 and 15 years. During that time, caregivers often experience mental health problems such as depression, anxiety and substance abuse, along with physical health problems.
Study details and volunteer information
In the first study, Gallagher-Thompson has teamed up with fellow Stanford researcher David Spiegel, MD, a pioneer in group therapy for breast cancer patients. Together, they will study the effects caregiving has on physical and emotional health. Specifically, they will measure caregivers' levels of a key hormone called cortisol before and after completing the program. The body produces cortisol when faced with stress. This substance helps you regulate day and night fluctuations, aiding alertness and restful sleep. 'In a pilot study of 80 caregivers, we found that they had irregular levels of cortisol, a condition that puts them at greater risk of heart disease and some cancers,' said Gallagher-Thompson.
In the cortisol study, which is funded by the National Institutes of Health and the national and local chapters of the Alzheimer's Association, study participants will be questioned about their perceived level of stress, how depressed and anxious they may be and what coping strategies they use.
The second study, Resources for Enhancing Alzheimer Caregiver's Health (REACH II), is designed to improve the well-being of the Alzheimer caregiver while increasing knowledge and skill in dealing with the patient. This three-year, randomized clinical trial is funded by the National Institute of Aging and the National Institute of Nursing Research. Palo Alto is one of five sites for the study, which includes Birmingham, Ala; Memphis, Tenn.; Miami; and Philadelphia.
In REACH II, caregivers will be assigned to one of two groups. Each will be offered the same information but at different times and in different ways. In one group, a researcher will review educational material and share skills with caregivers during home visits. Additionally, this group will be given a touch-tone screen/phone system that provides access to information from the research team. The other group will receive all educational information and skill-building exercises in group workshops.
For the first study, Stanford is recruiting Caucasian, Hispanic/Latino and Chinese women who are the primary caregivers of an older adult family member with significant memory loss. For the REACH II study, Stanford is seeking men or women who care for an older relative with memory problems and who identify as Caucasian, Hispanic/Latino or African American. For both studies, the relative does not have to be diagnosed as having dementia or Alzheimer's disease to participate. However, they must have memory problems that require care and assistance with managing everyday tasks.
Volunteer for either study may leave a message at the multi-lingual outreach line at (800) 943-4333 and a staff member will call them back. The staff can respond to messages in English, Spanish, Cantonese or Mandarin. Caregivers can also call (650) 617-2774, or contact Gallagher-Thompson directly at (650) 493-5000, ext. 22005.
About Stanford Medicine
Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. For more information, please visit med.stanford.edu.