Marla Berg-Weger

Caregiver Health: Health of Caregivers of Alzheimer’s and Other Dementia Patients

Alzheimer’s disease (AD) is the most common type of dementia and is a significant public health problem that will intensify as the population ages. The behavioral and psychological symptoms of dementia (BPSD) present a significant burden to patients, their families, and their caregivers. The majority of care is provided at home by family caregivers. Caring for a person with AD and other dementias is associated with significant risk to the caregiver’s health and well-being. Healthcare providers must recognize that family caregivers often present as secondary patients. Given the importance of these caregivers to patients with AD and other dementias, it is vital to understand the risk factors that impact caregiver health and well-being. Non-pharmacological interventions can reduce the negative impact of caregiver burden on caregiver health, reduce premature institutionalization of patients, and improve quality of life for patients, their families, and their caregivers. This article summarizes recent relevant research concerning AD and dementia caregiver health and psychosocial interventions.

Strengths-Based Practice With Family Caregivers of the Chronically Ill: Qualitative Insights

Using a strengths-based perspective, this paper looks at the experiences of family caregiving to the chronically ill. Qualitative research allows researchers and practitioners to gain a deeper understanding of the family caregiver experience, adding breadth to the assessment and intervention process. Themes generated from a qualitative inquiry on the impact of the care-giving experience for the caregiver are explored and discussed in terms of implications for strengths-based practice, thus providing a positive experience for the caregiver and care recipient.

Using Structural Equation Modeling to Test for Multidimensionality

Unidimensionality is an assumption of many statistical techniques that examine the psychometric properties of measures. In fact, unidimensionality is necessary for construct validity. This article illustrates how structural equation modeling can be used to test the multidimensionality of a measure. By using data collected on a multidimensional measure, we compare an oblique factor model with a higher order factor model. Results indicate that the oblique factor model fit the data significantly better, because the measure is multidimensional. If the measure was unidimensional, then the higher order factor should explain the correlation between the latent variables. Implications for researchers and measurement development are discussed.

Interdisciplinary Collaboration in Social Work Education

This article explores the benefits of teaching geographic information systems (GIS) technology as a tool in social work curricula. GIS software makes customized and interactive maps that can help social workers gain a better understanding of multifaceted communities. The authors present four examples of GIS applications developed by social work graduate students demonstrating the potential of GIS in social work, and they outline steps for teaching GIS in social work practice courses. Employment and other opportunities are also discussed.

Basic Care I: The effect of dementia-specific training on certified nursing assistants and other sraff

This study evaluates the effectiveness of Basic Care I, a dementia-specific training course offered by the St. Louis Alzheimers Association. Using three standardized measures, the effects of the course on knowledge gain, stress level, and sense of work-related self-esteem are examined. Findings suggest that participation in Basic Care I increases retained learning, as 76.4 percent of the sample showed improvement on dementia knowledge scores. The outcomes of stress and self-esteem measures are inconclusive but indicate areas for future study. Implications for program planning are discussed.

Driving Retirement in Older Adults with Dementia.

To characterize the driving and mobility status of older adults with dementia, a questionnaire was mailed to 527 informants; 119 were returned. The majority of patients were diagnosed with dementia of the Alzheimer type. Only 28% were actively driving at the time of survey. Informants rated 53% of current or recently retired drivers as potentially unsafe. Few informants reported using community/educational resources. Individuals with progressive dementia retire from driving for differing reasons, many subsequent to family recognition of impaired driving performance. Opportunities for education and supportive assistance exist but are underutilized.

Baseball reminiscence league: a model for supporting persons with dementia

Reminiscence therapy for persons with dementia improves socialization and quality of life. Herein we report the development of reminiscence groups based around memories of professional baseball. Preliminary feedback suggests that this can be a successful approach to enhancing quality of life for persons with mild to moderate dementia.

Decoding the Miss Daisy Syndrome: An Examination of Subjective Responses to Mobility Change

The subjective responses associated with personal life space and mobility status were explored. Thirty individuals participated in focus groups based on self-rated disability status, current places visited, and availability. Qualitative analyses revealed that most participants equated personal mobility with driving a vehicle. Attitudes concerning mobility status and preparedness for change varied based on disability level and personal experience. Fear of dependence from future mobility loss was prominent in all groups. Few participants acknowledged significant planning for future retirement from driving or other mobility challenges. An understanding of common attitudes, perceptions and meanings can inform professionals who intervene and support older adults experiencing mobility changes.

Depression as a Mediator: Viewing Caregiver Well-Being and Strain in a Different Light

This study examines the relationship between caregiver characteristics and caregiver well-being as comprised of two components, activities of living and basic needs. The role of depression in predicting caregiver well-being is explored using a sample of caregivers of family members with a chronic illness. Using a path-analysis model, multivariate findings suggest that depression explains 56% of the variance in activities of living and 64% in basic needs. Path analysis further identifies depression as a mediator between stress and well-being. Implications for research and practice are highlighted.

Cognitive Stimulation Therapy: A Tool for Your Practice With Persons With Dementia?

To the Editor: As a community of geriatric professionals, we are well aware that most residents in long-term care and a growing percentage of community-dwelling older adults have dementia and are dependent oncare fromothers.Dementia can lead to increasedbehavioral issues, the use of medication, and lack of stimulation.1 Cognitive stimulation therapy (CST) is a brief, evidence-based, psychosocial group intervention program for persons with mild to moderate dementia focusing on implicit information processing,2 which was developed following a review of both reality orientation and evaluation of research.3,4 The UK government guidelines for developing and evaluating dementia interventions5 recommend this program be used with those with mild to moderate dementia. Evidence shows CST enhances cognition and improves the well-being of those with a dementia.6 This group intervention is cost-effective and is currently, in the United Kingdom, the only nonpharmacological intervention recommended to improvecognition.5Another formofCST, SAIDO,has been shown to improve Mini Mental Status Examination scores in nursinghomes.7 Theeffects ofCSTappear tobeof a comparable size to those reported with the currently available antidementia drugs2 and thus we are working to expand this program’s availability in the United States. De Oliviera and colleagues8 conducted a trial of CST in nursing homes and the community. Both groups showed improved performance, but the performance in the nursing home group was greater. Apóstolo et al9 carried out a randomized controlled trial of CST in 56 residents and found an increase in cognition but no improvement in depression. Loraine and colleagues10 combined CST with exercise in the nursing home and found an improvement of cognition. Twenty-four weeks of CST maintenance sessions and individually focused CST also have been developed for use with those with dementia. Weekly maintenance CST (MCST) sessions following the CST program are shown to lead to continuous benefits in cognition, quality of life, and cost-effectiveness.11,12