How Effective Are Interventions for Caregivers?

"If these interventions were drugs, it is hard to believe that they would not be on the fast track to approval. The magnitude of benefit and quality of evidence supporting these interventions considerably exceed those of currently approved pharmacological therapies” ¹

The editorial comment above in The Annals of Internal Medicine accompanied publication of REACH II and NYUCI clinical trials results (two evidence-based programs for Alzheimer’s caregivers). This conclusion has been supported by other researchers and clinicians: psycho-social interventions for caregivers are more effective than pharmacological interventions in preventing and reducing clinical depression and potentially other negative health outcomes. To not make them widely available to caregivers is shortsighted and a violation of the best principles of public health.

Reviews of caregiver interventions published since 1990 conclude that are large number of interventions achieve important outcomes. Schulz and colleagues (2002) reviewed research published between 1995 and 2001 that included a range of interventions including educational and psychotherapeutic interventions, problem solving, coping skills and behavior management training, support groups, cognitive–behavioral therapy, and other types of counseling. They also reviewed interventions that incorporated adult day care activities, physical exercise, and teaching caregivers to provide memory training for care recipients, as well as environmental and behavioral interventions. Their review found that interventions for caregivers increasingly showed promise of achieving clinically significant outcomes in improving depressive symptoms, and, to a lesser degree, in reducing anxiety, anger, and hostility. Interventions also improved caregiver quality of life, were highly valued by caregivers, and some led to delayed institutionalization of the care recipient. They concluded:

“Such outcomes have potentially far reaching consequences for promoting health and wellness for all those affected by chronic disablement.” (p. 598).

Other reviews have come to similar conclusions. Follow this link to Reviews and Meta Analysis of Caregiver Programs

1 Covinsky, K. and Johnston, B. 2006. Editorial: “Envisioning Better Approaches for Dementia Care” Ann Intern Med, November 21,45:780-781