Frontotemporal dementia: the impact of patient behavioral symptoms on the physical and mental health of family caregivers.

BackgroundProviding informal support to someone with frontotemporal dementia (FTD) could be very stressful. Clarifying the relationship between patient behavioral problems and caregiver health could spur future research on effective symptom management strategies.MethodsSixty-one FTD family caregivers participated in a postal survey.ResultsPatient symptom severity was negatively associated with caregiver mental health (r = -0.26, p < 0.05) but not significantly associated with caregiver physical health. In a regression analysis, caregiver emotional distress from patient behaviors made a statistically significant contribution to caregiver mental health, explaining approximately 10% of its variance.ConclusionThis study underscores the importance of focusing on FTD caregivers' perceived emotional distress from patient behavioral problems and ensuring they are getting the appropriate support they need

Loss as Experienced by Ugandan Grandparent-Caregivers of Children Affected by HIV/AIDS

Despite increasing numbers of studies investigating grandparent-caregivers of children orphaned by HIV/AIDS in sub-Saharan Africa, research on their mental and physical health remains inadequate. We provide a qualitative account of the nature, extent, and relationships among multiple variations of loss emerging from 32 interviews with Ugandan grandparent-caregivers of grandchildren affected by HIV/AIDS. Regardless the type or nature of the loss, participants expressed physical, emotional, and financial distress as a result. This cumulative loss and subsequent grief could potentially be associated with mental and physical health problems. Research to further explore the concept of loss among this vulnerable population is recommended

Positive Impact of an Educational Brochure on Follow-Up for a Formal Hearing Evaluation.

BACKGROUND AND OBJECTIVES: Half of older persons experience serious hearing loss, yet it remains under-assessed in primary care clinics. Providers note time constraints as barriers and patients often minimize or deny their hearing loss. We tested the effectiveness of a simple hearing screen in primary care settings and whether including a brochure describing hearing loss, its consequences, and treatment would increase referrals for formal audiometric assessments. RESEARCH DESIGN AND METHODS: We designed a longitudinal effectiveness study assessing three interventions: Screening alone; Screening plus a brochure handed to the person testing positive; and Screening plus the brochure with a brief review. The screening was accomplished by intake personnel. The results of a positive screen were given to the primary care practitioner. The approach was designed to enable its use across a range of primary care settings. Follow-ups occurred at 4 and 8 months. RESULTS: A total of 111 older adults attending 7 primary care clinics screened positive for having possible hearing loss by intake personnel. A total of 46 received the educational brochure. Physicians discussed test results with two-thirds yet recommended further testing for only half of the participants. Physician recommendations were strongly motivating (OR = 9.12, 95% CI: 3.54-23.52) and those receiving the brochure were still more likely to seek further testing (OR = 2.61, 95% CI: 1.07-6.36) even when physician recommendations were controlled. Additionally, when combined, the 2 options were strongly motivating: all participants receiving both a referral and a brochure sought further testing. DISCUSSION AND IMPLICATIONS: A simple screen and educational brochure on hearing loss improved follow-up for a formal hearing evaluation which may improve hearing health care and minimize negative outcomes. The study also identified barriers to implementation, including how to motivate practitioners and assist intake personnel in integrating hearing screening into their routine intake procedures, supporting further research. Clinical Trials Registration Number: NCT0203713 9

Hearing loss education for older adults in primary care clinics: Benefits of a concise educational brochure

Hearing loss, common in older adults, is associated with negative health outcomes but screening rates in primary care clinics are low and individuals screened or referred often do not follow-through. To address these problems, we worked with 2 primary care clinics to design a simple screening and education protocol for integration into a standard office visit. To assess the effectiveness on the education brochure that was developed, we assessed its impact on individuals age 60 or older who screened positive for possible hearing loss. Ninety-four of 125 screened positive. Seventy-one agreed to participate and were given a brochure along with a brief review of the materials it contained. Of 67 completing follow-up, 23 (34%) sought further testing and 47 (70%) had used the information to enhance communication. A simple educational brochure accompanied by a brief review of its contents may enhance effective use of hearing healthcare services. (147)

Frontotemporal Dementia: The Impact of Patient Behavioral Symptoms on the Physical and Mental Health of Family Caregivers

Background: Providing informal support to someone with frontotemporal dementia (FTD) could be very stressful. Clarifying the relationship between patient behavioral problems and caregiver health could spur future research on effective symptom management strategies. Methods: Sixty-one FTD family caregivers participated in a postal survey. Results: Patient symptom severity was negatively associated with caregiver mental health (r = –0.26, p Conclusion: This study underscores the importance of focusing on FTD caregivers’ perceived emotional distress from patient behavioral problems and ensuring they are getting the appropriate support they need

Frontotemporal dementia: the impact of patient behavioral symptoms on the physical and mental health of family caregivers.

BackgroundProviding informal support to someone with frontotemporal dementia (FTD) could be very stressful. Clarifying the relationship between patient behavioral problems and caregiver health could spur future research on effective symptom management strategies.MethodsSixty-one FTD family caregivers participated in a postal survey.ResultsPatient symptom severity was negatively associated with caregiver mental health (r = -0.26, p < 0.05) but not significantly associated with caregiver physical health. In a regression analysis, caregiver emotional distress from patient behaviors made a statistically significant contribution to caregiver mental health, explaining approximately 10% of its variance.ConclusionThis study underscores the importance of focusing on FTD caregivers' perceived emotional distress from patient behavioral problems and ensuring they are getting the appropriate support they need

Frontotemporal Dementia: The Impact of Patient Behavioral Symptoms on the Physical and Mental Health of Family Caregivers

BACKGROUND: Providing informal support to someone with frontotemporal dementia (FTD) could be very stressful. Clarifying the relationship between patient behavioral problems and caregiver health could spur future research on effective symptom management strategies. METHODS: Sixty-one FTD family caregivers participated in a postal survey. RESULTS: Patient symptom severity was negatively associated with caregiver mental health (r = −0.26, p < 0.05) but not significantly associated with caregiver physical health. In a regression analysis, caregiver emotional distress from patient behaviors made a statistically significant contribution to caregiver mental health, explaining approximately 10% of its variance. CONCLUSION: This study underscores the importance of focusing on FTD caregivers’ perceived emotional distress from patient behavioral problems and ensuring they are getting the appropriate support they need

Service use by family caregivers in Japan

This paper presents a conceptual framework for understanding how Japanese family caregivers make decisions about the use of formal services such as adult day care, short term hospital stays, and long-term institutionalization. Using grounded theory methodology, 26 Japanese daughters or daughters-in-law who were caring for an elderly demented parent or parent-in-law were interviewed. From these data, an overall process of "navigating among endorsed options" evolved. This process was set in motion when caregivers reached the limit of their tolerance, a point at which they felt they could not continue caregiving under the given arrangement. Caregivers then began to assess three issues which determined whether or not they used formal services: the availability of services; their authority level within the family; and whether or not they could justify their tolerance limit. The availability of a service was determined by the quality of the service, the distance to the service, the sanctions that would incur as a result of using the service, information about the service, and the quantity of the service. The caregivers' authority within the family varied depending on such factors as how much the caregiver was accepted by her married family or the type of family business. This authority level determined whether and how the caregivers could approach other family members in order to obtain their consent to use formal services. Finally, whether the caregivers could justify their tolerance limit depended on the internalization of the societal norm regarding family caregiving, attachment to the care recipient, and the caregiver's belief on how care should be given. Justification of their limit included re-prioritizing the needs of family members, acting in defiance of societal norm, and redefining reality. Each of the three issues was assessed in relation to the others with the final decision to use or not use formal services based on the balance of forces.family caregiving dementia service use Japan daughter caregivers