Dimitra Loukissa

Caring for Self While Caring for Others: The Two-Track Life of Coping with Alzheimer's Disease

Relationships between depressive symptoms and altered immune function have been documented in the literature; however, the links between depressive symptoms, altered immune function, and changes in physical health are less clear. Although a number of caregiver descriptive studies have examined immunological outcomes, only one intervention study with caregivers of individuals with Alzheimers disease, known to the authors, has included immunological outcomes. The purpose of this pilot study was to assess the effectiveness of a caregiver skill-building intervention to decrease caregiver depressive symptomatology and care-receiver behavioral symptoms; and to assess the feasibility and stability of the delayed type hypersensitivity (DTH) skin test with this population. Caregiver depressive symptoms decreased, while care-receiver behaviors did not. Findings suggested that the DTH skin test could be successfully administered to caregivers of individuals with Alzheimers disease and that this skin test had short-term stability. There were no significant relationships between caregiver depressive symptoms and immune function. Study findings suggest that nurses can play a pivotal role in intervening with family caregivers and potentially decreasing their depressive symptoms.

A Chronic Grief Intervention for Dementia Family Caregivers in Long-Term Care

Dementia caregivers do not relinquish their role after placing family members in long-term care and they experience increased chronic grief. The Chronic Grief Management Intervention (CGMI) is a12-week group-based program that uses guided discussion to deliver knowledge of Alzheimer’s or a related dementia and teach skills in communication, conflict resolution, and chronic grief management in dementia caregivers who placed their family members in long-term care. Using a quasi-experimental design, 83 caregivers from 15 long-term care facilities received either the CGMI (n = 34) or a comparison condition consisting of two check-in calls (n = 49). In this pilot study, we examined the feasibility of implementing the CGMI and evaluated the effects of the intervention on caregivers’ knowledge and skill and their chronic grief and depression. The intervention was feasible and resulted in significant improvement in caregivers’ heartfelt sadness and longing at 3 months and a significant drop in their guilt at the 6-month follow-up.

Older Adult Recipients of Home-Based Mental HealthCare Services: Who Are These Patients and What Services Do They Receive?

The purpose of this study was to develop baseline information concerning older adults who use psychiatric home healthcare services, identify critical components of interventions provided over the course of treatment, and identify outcomes associated with this type of home care. This review focused on patients 65 years or older with Medicare coverage and a primary or secondary diagnosis of depression. Retrospectively, 107 charts were reviewed, beginning with those of patients most recently discharged. These psychiatric home care patients had complex healthcare problems, required family caregivers and multiple home healthcare services, and experienced variable outcomes. These findings support the need for more information regarding specific interventions provided to patients and their family caregivers and what effect these interventions have on patient and caregiver outcomes.