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Depressed caregivers of relatives with dementia feel better after relative dies

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  • Rosemary Amey
    http://theglobeandmail.com/servlet/story/RTGAM.20031112.wcare1112/BNStory/International/ Wednesday, Nov. 12, 2003 Caregiver depression often eased by patient s
    Message 1 of 1 , Nov 12, 2003
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      Wednesday, Nov. 12, 2003

      Caregiver depression often eased by patient's death: study

      Globe and Mail Update

      People caring for dying relatives with dementia often feel a sense of relief
      when the patient finally dies and can quickly show markedly lower levels of
      depression, say scientists who tracked more than 200 caregivers as they
      handled the death of a family member.

      The findings sparked speculation that it may, in fact, be better for
      supporters to intervene with caregivers before their charge has actually
      died, says lead author Richard Schulz, a professor of psychiatry at the
      University of Pittsburgh.

      “One of the implications of this study is that it gives us a greater
      understanding of the bereavement process,” Dr. Schulz said.

      “A person's reaction to death is altered by the context in which the death
      occurs. It is possible that caregivers who know their loved one is on a
      trajectory towards death grieve for that person before death, and that may
      be the time when they need the most support.”

      Dr. Schulz, who also is associate director of his school's Institute on
      Aging, notes that the health care system is greatly helped by the thousands
      of hours of care provided at home by family members, but warns that the
      numbers of elderly with dementia are going to explode over the next few

      “The caregivers themselves endure both emotional and financial stress ...
      this study should serve as notice that we as a society may need to reassess
      how we support family caregivers.”

      Dr. Schulz and his team tracked 217 family caregivers for one year prior to
      their charge's death and for one year after. Roughly half of the study group
      were people who spent more time caring for their relative than the typical
      person spends at a job. Responsible for tasks ranging from meal-preparation
      to bathing to dressing, more than half of the caregivers said they felt that
      they were “on duty” 24 hours a day.

      According to their research – which appeared Wednesday in a special issue of
      the New England Journal of Medicine – these caregivers showed marked
      symptoms of depression while caring for the relative with dementia. They
      were found to be under stress in part because many curtailed their
      employment to provide care, but in many cases also because they felt their
      patient was suffering.

      When checked three months after the death of the patient these symptoms of
      depression were “clinically lower.” At the end of a full year the symptoms
      were judged to have showed “significant declines.”

      These reduced levels of depression were not as apparent when the patient is
      removed to an institution, rather than dying, the researchers say, which
      suggests that the sense of relief is not necessarily tied to a desire simply
      to have the person off their hands.

      According to Dr. Schulz, the findings suggest that people are depressed and
      anxious because their loved one is suffering and there is nothing that seems
      capable of relieving their torment. Death is seen as a relief to the loved
      one, which consequently bring relief to the care-giver.

      “We found that caregivers of patients who were institutionalized did not
      experience the improvement in depression that we observed among those whose
      relatives had died,” he said. “This shows that getting over depression
      related to caregiving is less about being relieved of the burden of in-home
      care and more about the process of coming to terms with the loss.”
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