Association between hospice care and psychological outcomes in Alzheimer's spousal caregivers.

Irwin, Scott A.; Mausbach, Brent T.; Koo, Derek; Fairman, Nathan; Roepke-Buehler, Susan K.; Chattillion, Elizabeth A.; Dimsdale, Joel E.; Patterson, Thomas L.; Ancoli-Israel, Sonia; Mills, Paul J.; von Känel, Roland; Ziegler, Michael G.; Grant, Igor (2013). Association between hospice care and psychological outcomes in Alzheimer's spousal caregivers. Journal of palliative medicine, 16(11), pp. 1450-1454. Liebert 10.1089/jpm.2013.0130

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Text J_Palliat_Med_2013.pdf - Published Version Available under License Publisher holds Copyright. This is a copy of an article published in the Journal of palliative medicine© 2013 [copyright Mary Ann Liebert, Inc.]; the Journal of palliative medicine is available online at: http://online.liebertpub.com. Download (122kB) | Preview

CONTEXT

Dementia care giving can lead to increased stress, physical and psychosocial morbidity, and mortality. Anecdotal evidence suggests that hospice care provided to people with dementia and their caregivers may buffer caregivers from some of the adverse outcomes associated with family caregiving in Alzheimer's Disease (AD).

OBJECTIVES

This pilot study examined psychological and physical outcomes among 32 spousal caregivers of patients with AD. It was hypothesized that caregivers who utilized hospice services would demonstrate better outcomes after the death of their spouse than caregivers who did not utilize hospice.

METHODS

The charts of all spousal caregivers enrolled in a larger longitudinal study from 2001 to 2006 (N=120) were reviewed, and participants whose spouse had died were identified. Of these, those who received hospice care (n=10) were compared to those who did not (n=22) for various physiological and psychological measures of stress, both before and after the death of the care recipient. An Analysis of Covariance (ANCOVA), with postdeath scores as the dependent variable and pre-death scores as covariates, was used for all variables.

RESULTS

Significant group differences were found in postdeath depressive symptoms (HAM-D; F(1,29)=6.10, p<0.05) and anxiety symptoms (HAM-A; F(1,29)=5.71, p<0.05). Most psychological outcome variables demonstrated moderate effect sizes with a Cohen's d of>0.5 between groups.

CONCLUSIONS

These data suggest that hospice enrollment may ameliorate the detrimental psychological effects in caregivers who have lost a spouse with Alzheimer's Disease. Based on these pilot data, further prospective investigation is warranted.

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