Taking Care of the Caregivers
Family caregivers who take care of a relative with dementia at home are exposed to numerous stressful events of long duration, such as the management of difficult behaviors, the provision of constant supervision, and the lack of an intimate relationship with the sick relative. Numerous studies have shown that caring for a relative with dementia has deleterious effects on the psychological well-being of family caregivers and leads to social isolation (Schulz, O’Brien, Bookwala, & Fleissner, 1995). One option often used to alleviate these effects is to offer support groups to the caregivers. These support groups are usually of short duration (six to eight meetings) and focus on the following three elements: information about Alzheimer’s Disease (AD), development of skills to deal with the relative’s behaviors, and mutual support through expression of emotions among the group members (Lavoie, 1995). However, critical reviews of outcomes studies have indicated that the positive effects of support groups on the caregivers’ well-being are quite modest, although caregivers generally appreciate them (Bourgeois, Schulz, & Burgio, 1996; Knight, Lutzky, & Macofsky-Urban, 1993; Lavoie, 1995; Lévesque & Lauzon, 2000). The same critical reviews report that apart from some methodological limits of the outcomes studies (e.g., small sample size), there is a lack of theoretical underpinnings to guide the development of
support group interventions, and their short duration precludes deep discussion on the various topics covered during the sessions. Moreover, according to a meta-analytic review (Knight et al., 1993), individual interventions seem to be more effective than group interventions with regard to the caregivers’ well-being. There is also a recent trend to develop multimodal interventions that incorporate family meetings in addition to group or individual encounters (Mittelman et al., 1995; Zarit, Anthony, & Boutselis, 1987) because it is well recognized that the entire family system is affected by caregiving. Evaluative studies of these programs reveal positive effects on the caregivers’ well-being (Mittelman et al., 1995; Whitlach, Zarit, & von Eye, 1991).