Coping Strategies Therapy for Carers of Dementia Patients

Rebecca Lewis December 17, 2014

Depression, anxiety and other mental health problems are common among people caring for relatives with dementia. In a new study by Livingston of University College London, researchers suggest a psychological intervention for family carers. They call it STrAtegies for RelaTives (START).

The programme involves a coping intervention delivered by psychology graduates. In previous short-term studies it has been shown to lower anxiety and depression and improve quality of life for family carers of people with dementia, as well as reduce costs.

Led by Professor Gill Livingston of University College London, the researchers examined its long-term benefits in a trial with 260 carers referred to UK mental health services or a neurological-outpatient dementia service. Carers had no depression at the start, and randomly received either eight sessions of the START program or usual support (medical, psychological, and social services) for the person with dementia.

The intervention was provided by psychology graduates who had no clinical training. They worked directly with family carers, in their homes, aiming to uncover difficulties and give advice on coping strategies such as getting emotional support or relaxation techniques.

When measured after eight months and again at two years, the START group showed significantly better scores on the Hospital Anxiety and Depression Scale. Those in the usual care group were seven times more likely to have clinically significant depression than those who received START.

“The number of people with dementia is rapidly growing, and policy frameworks assume that their families will remain the frontline providers of (unpaid) support,” the team writes.

“START is clinically effective, improving carer mood and anxiety levels for two years. This cost-neutral intervention, which substantially improves family-carers’ mental health and quality of life, should therefore be widely available.”

Livingston said, “Worldwide, there are an estimated 44 million people with dementia, and this figure is likely to double every 20 years. Too often people forget the substantial effect dementia has on family members caring for relatives with dementia.

Previous studies of interventions for family carers suggest that coping strategies and individual (rather than group) therapy might be helpful for depression, but there has been little evidence on the impact on anxiety. These earlier studies had not looked at prevention of depression or anxiety, or measured cost-effectiveness.

The evidence of START’s preventive effect “underlines the fact that carers can benefit from early intervention,” says Professor Banerjee. She concludes, “The START intervention should be offered as individual therapy to all family carers of people with dementia.”

Source of this article: Boosting Dementia Caregivers’ Mental Health