Caring for a person with dementia can be a very stressful job.. But many caregivers are not using important community resources that can make their job easier and help them maintain both their health and emotional well-being. In fact, only 21 percent of LBD caregivers report using Adult Day Services (ADS). New research into the benefits of ADS may lead more dementia caregivers to consider it.
Researchers, led by Steven H. Zarit, PhD of Pennsylvania State University, extensively interviewed 173 family caregivers of individuals with dementia for 8 consecutive days. On some of those days, the individual with dementia attended ADS and on others the caregiver provided the bulk of the care. The research analyzed the caregivers’ experiences with stress and changes in mood and health, and compared their scores on days their relative attended ADS and days they provided most or all of the care.
Researchers identified behavior and psychological symptoms in the person with dementia as care-related stressors. These are reported by caregivers as the most challenging and upsetting aspects of caregiving. Stressors not related to caregiving were also measured, such as finances, arguments with other people and work-related events.
Positive experiences included sharing a good laugh with someone, a positive experience at work, with a friend or relative or at home. Caregiver mood was also measured during the same time, such as anger, anxiety, depression and positive emotions. Daily health symptoms such as pain, fatigue, gastrointestinal symptoms were also assessed.
On the days using adult day services caregivers had fewer care-related stressors and reported more positive experiences. As caregivers engage in more non-care activities during those days, noncare stressors were higher when the individual with dementia was in ADS. Interestingly, noncare stressors were largely work-related but were also accompanied by more positive experiences as well. This suggests that work may provide an enjoyable outlet for some caregivers.
Caregivers experienced a reduction in their own anger on ADS days. ADS use also had a protective effect on caregivers’ depression. On days when stressors were higher than normal, caregivers’ depression scores were elevated if they were home with their relative, but did not increase if their relative was attended ADS. While anger was lower on ADS days, health symptoms were more frequent.
This may be a result of caregivers having more time to focus on themselves and be more in tune with minor health symptoms they might otherwise ignore.
Long term exposure to stress has negative effects on caregivers’ emotional and physical well-being. Providing caregivers with frequent relief from daily stressors may enable them to more effectively manage stressors when they do arise. This may provide some protection against the effects of chronic stress associated with caregiving. Prior studies have also found that emotional reactivity to stressors is associated with increased risk of illness. The findings of decreased anger and depression suggest that ADS use may lower caregivers’ risk of illness.
The use of ADS benefits both the caregiver and person with dementia. Research indicates people with dementia who use ADS programs show improvements in behavior, mood and sleep. For some ADS may be a helpful non-pharmacological treatment for behavior and mood in dementia.
This study was funded by the National Institute on Aging and was published in The Gerontologist in June, 2013.
Steven H. Zarit. The Effects of Adult Day Services on Family Caregivers' Daily Stress, Affect, and Health: Outcomes From the Daily Stress and Health (DaSH) Study. The Gerontologist. June, 2013. Available at: http://www.ncbi.nlm.nih.gov/pubmed/23690056. Accessed August 5, 2013.