Max Zubatsky

A caregiver perspective of how Alzheimer's disease and related disorders affect couple intimacy

Objectives: Alzheimers disease and related disorders (ADRD) pose a potential threat to the interpersonal and intimate relationships in couples. The objective of this study was to understand the lived experiences of individuals with a spouse suffering from ADRD and how this diagnosis affects intimacy within these marital relationships. Method: This qualitative study used a phenomenological approach to capture the lived experiences of caregivers of ADRD individuals. A total of 10 interviews were conducted, with six participants recruited from a neurology clinic and four participants drawn from support groups. Structured interviews with open-ended questions were conducted, with thematic units derived from the interview analysis. Results: All participants reported some strain in the ADRD relationship, with different aspects of the disease affecting closeness and connection within the couple. The quality of the marital relationship prior to diagnosis impacted every participant in some fashion as well as having to adjust to ADRD related behaviors. Outside effects on the relationship, coping with the disease and degree of intimacy were additional themes reported from the interviews, with positive and negative attributes given to these themes. Conclusion: Although the caregiving role can be difficult for a spouse, it does not mean that the ADRD has to always negatively impact the marital relationship. Understanding the role that intimacy can play for these couples and how it might contribute to coping strategies for couples affected by ADRD can be a powerful adjunct to other treatments available.

Clinical Training and Practice Patterns of Medical Family Therapists: A National Survey

Medical family therapy (MedFT) has gained momentum as a framework in healthcare for individuals and families. However, little is known about what background training and clinical experiences Medical Family Therapists (MedFTs) have in everyday practice. This study investigated the clinical training of MedFTs and their practices in a variety of care settings. A survey was completed by 80 participants who use a MedFT framework in practice, with descriptive data on curriculum, clinical training, and treatment characteristics. Results reflect that many MedFTs lack formal coursework in key content areas of their graduate training and work primarily with psychological and relational concerns. Future research is needed to explore how MedFTs practice around specific mental health and chronic health conditions.

Medical Family Therapy in Endocrinology

Endocrinology is the study the body’s endocrine system, which is responsible for the production of hormones that serve a variety of functions. The endocrine system normally controls the homeostasis of bodily systems and is responsible for growth, development, reproduction, and responses to various internal and external stimuli. Common types of disorders as a result of endocrine complications (e.g., diabetes mellitus, thyroid disease, Addison’s disease, Cushing’s disease, Grave’s disease) are often related to improper functioning of the pancreas and/or pituitary, thyroid, and adrenal glands. These disorders can affect widespread complications such as increased heart rate, abnormal bone growth, skin changes, elevated blood glucose levels, and severe fatigue and weakness (Melmed, Polonsky, Larsen, & Kronenberg, 2015; Nelson, 2005). Life-threatening effects may include diabetic ketoacidosis, hypoglycemic coma, thyroid storm, acute pancreatitis, and pituitary apoplexy (National Adrenal Diseases Foundation, 2016; Savage, Mah, Weetman, & Newell-Price, 2004).

A Pain to Practice: Attitudes of Medical Family Therapists Working With Patients With Opioid Use Disorder

ABSTRACT The prevalence of patients with opioid misuse in medical settings continues to rise, and it is unknown how much exposure medical family therapists (MedFTs) have in treating this issue. This study explored the attitudes of MedFTs (n = 58) when working with patients struggling with opioid use disorder in clinical practice. Results revealed that 43% of MedFTs had a low comfort level in working with this population and preferred to make referrals to primary care providers. Given that opioid use disorder cases are rising in healthcare settings, emerging mental health professionals would benefit from additional training to effectively treat this population.

Navigating Without a Roadmap Challenges of Early Alzheimer’s Caregivers With Their Health Care Team

Caregivers of individuals with Alzheimer’s disease are willing to make large sacrifices to attend to the everyday demands of their loved one’s health. Many still lack the necessary skills, information, and resources from medical professionals needed to fully execute this role. The aim of this study is to explore the challenges that first-time Alzheimer’s caregivers encountered with members of their health care team around a loved one’s diagnosis. Four focus groups (N = 13) were conducted in a primary care clinic and academic setting, using a semi-structured interview format facilitated by a mental health professional. The authors used thematic analysis to generate three overarching themes regarding lack of information given about the diagnosis, complications with medication management, and level of confidence in their medical team. Medical professionals should consider educating Alzheimer’s disease caregivers during the initial stage of this role, providing greater continuity of care with the family throughout treatment.

Collaborative interventions for Alzheimer's caregivers following a family member's initial diagnosis

AKTIVA-MCI-program is a new interventional training for persons with MCI. It aims to enhance cognitive functioning by increasing the amount of time spent on cognitively stimulating leisure activities like reading, drawing, making music, and playing chess. The program is based on the AKTIVA-intervention for cognitively healthy elderly people and was modified to take account of the special needs of individuals with MCI. In addition to psycho-educational sessions, participants are taught the principles of selfmotivation. Games and exercises, such as role playing or coaching cards were used to enrich the theoretical modules. This presentation reports on the pre-post intervention effects, as implemented in two German university hospitals. Methods:32 people with MCI (18 female; 71.5 years,MMSE1⁄4 28) enrolled in theAKTIVA-MCI study. Over a period of 20 weeks, 12 group sessions took place in small groups and pre and post tests of the main outcomes were carried out. The interventional effects were measured longitudinally using standardized psychometric tests (i.e. MMSE, ADAS-Cog) and questionnaires (i.e. SDS, MAC-Q). In order to measure how frequently participants were involved in cognitively stimulating activities during the intervention, theywere required to complete daily activity protocols. These protocols included 30-item questionnaires rating the frequency of participation in leisure activities on a six point Likert Scale. Results:A comparison of pre-post data indicates that cognitive status, and subjective memory decline remained stable over a 6-month period. The analyses of the daily activity protocols showed several significant outcomes during 15-weeks of the intervention program. The participants watched considerably less television and read more books, did yoga and took part in social events more frequently. Conclusions: These results may indicate that the AKTIVA-MCI-intervention includes strategies that promote a cognitively active lifestyle for people with MCI.