William E. Haley

Psychological, Social, and Health Consequences of Caring for a Relative with Senile Dementia

While providing home care for a family member with senile dementia is clearly extremely stressful, there has been little controlled research assessing the specific effects of this stress on caregiver psychological, social, and health functioning. To address this question, 44 primary caregivers of senile dementia patients and 44 matched controls completed a series of questionnaires and interview assessments. Caregivers reported significantly higher levels of depression and negative affect toward their relatives, and lower overall life satisfaction than controls. Caregivers also had significant impairment of their social activities, including visits with friends, vacations, and church attendance when compared with controls. Caregivers expressed less satisfaction with their social networks than did controls, but the groups did not differ in objective size of social network or number of network contacts. Caregivers reported poorer health, more prescription medication use, and higher utilization of health care than controls. Results clearly indicate the serious and wide‐ranging effects of the stress of caregiving, and reinforce the importance of providing comprehensive services for caregiving families.

Depression in chronic pain patients: relation to pain, activity, and sex differences

&NA; Depression is commonly reported among chronic pain patients and receiving increased attention from clinicians and researchers. There is, however, little empirical evidence concerning variables that differentiate depressed from non‐depressed chronic pain patients, and whether depression is related to factors such as gender, pain report, and activity. As part of a study to address these questions, 63 chronic pain patients completed daily diaries of activity, pain levels, and medication intake, and completed questionnaires and interviews assessing depression, medical history, and demographic variables. Male and female depressed and non‐depressed chronic pain patients did not differ on demographic and medical history data, but sex differences were found in patterns of the relationships of depression, activity, and pain. For women, depression was closely related to pain report, whereas for men depression was more strongly related to impairment of activity. Pain report was related only minimally to activity for male and female patients. Implications of the results of behavioral research on depression in chronic pain patients are discussed. Researchers are urged to carefully consider sex differences in future research with chronic pain patients.

Mental and Physical Health of Male Caregivers of a Spouse with Alzheimer's Disease

Fifty-two male spouse caregivers of patients with Alzheimers disease and 53 demographically equated controls completed multidimensional assessments of mental and physical health. Results indicate that compared with noncaregiving men, male spouse caregivers have poorer mental and physical health, but only within limited domains of health outcomes. In particular, caregiving men showed higher levels of depression, respiratory system symptoms, and poorer levels of health habits, but did not differ from noncaregiving men on other indexes of physical and mental health. The importance of focusing on understudied specific subgroups of caregivers, such as male spouses, as well as using multidimensional instead of summary measures of mental and physical health are emphasized

Age and health bias in practicing clinical psychologists

Although ageism is widely cited as a problem in mental health delivery, it is unknown whether practitioner biases are related to factors such as physical health. A randomly drawn national sample of experienced practicing doctoral-level psychologists (N = 371) responded to detailed vignettes of a client presenting with symptoms of depression, in which age (35 years or 70 years) and health (unremarkable or poor) were manipulated. Respondents completed ratings involving professional and interpersonal judgments about the hypothetical client. Results revealed some evidence for age bias, but much stronger effects indicating health biases regardless of client age. Because depressed older persons often present with concomitant health problems, health bias among clinicians is especially relevant for older patients. Implications for service delivery to older adults, and individuals with health problems, are discussed.

Relationship of severity of dementia to caregiving stressors.

In studies of individual differences and longitudinal changes in stress and coping among dementia caregivers, assessing severity of patient impairment is critically important. It is proposed that with the progression of dementia, cognitive impairment may steadily increase, but other stressful behavioral symptoms peak at various stages of dementia. Cross-sectional data from 49 caregiving families and longitudinal follow-up data from 48 families suggest that instrumental self-care deficits begin early in dementia, and basic self-care deficits increase with dementia severity, but that many distressing behavioral symptoms decrease in late dementia. Assessments of dementia patient severity should be multidimensional, and increases and decreases in various dementia patient stressors over time should be considered as factors influencing caregiver coping.

Cognitive-Behavioral Interventions for Age-Related Memory Impairment

Annie Smith is a 72-year-old widowed woman who responded to an advertisement for volunteers interested in learning skills to improve their memory functions. Although she continues to live an active and independent life, managing all of her own household and financial affairs and volunteering two days per week at a local hospital, she reports a number of memory problems that are sources of embarrassment and inconvenience in her daily life. Most of these problems are focused around several situations that are important to her. First, at church, she finds herself having difficulty remembering the names of some of the other members of her congregation. When in a crowd of people, she often has trouble remembering what people have told her; she may lose her train of thought or have trouble finding the right words. On several occasions, she has forgotten to put her money into her purse before going to church, and has been embarrassed at being unable to give her offering. Mrs. Smith has played bridge with a small group of women on a weekly basis over the past 12 years. Lately, she notes that she forgets the cards which have been played, and has occasionally even forgotten the bid. While she used to take pride in her ability to do her grocery shopping completely from memory, lately she has relied on making hurried lists on scraps of paper, which she frequently cannot find in her purse. She also misplaces important objects, such as her eyeglasses or purse, while at home. Sometimes she spends hours looking for lost bills or objects. She is also distressed that she is unable to remember friends’ telephone numbers, and relies on her address book for all of this information.