Dementia News & Events

This week at the Alzheimer Association International Conference (AAIC) in Paris... 

Although much of the AAIC meeting is focused on the science and pharmacological aspects of dementia, there is a lot of information on care giving.  Monday's plenary session was given by Dr. Steven Zarit, a pioneer in this area.  Dr. Zarit covered what works and what doesn't in caregiver support programs.  He emphasized several points.  These included that the caregiver support program should address the ways in which caregivers experience stress.  Sound strategies to address that stress are key.

Although "just talking" helps initially, people benefit from guidance in exploring why they feel stress in the way that they do.  Dr. Zarit emphasized that these programs need to be flexible and not rigid; not every person with dementia has the same symptoms and even the same symptoms give rise to difference levels of stress in different caregivers.  He also emphasized the need to focus on the family as a whole and not just the main caregiver emphasizing that the amount of support provided to people was a critical factor.  For example, the first care giver support programs, introduced thirty years ago, often were limited to a few hours per month.

Dr. Zarit's talk also emphasized a so called "multi-model approach", i.e., the support program should address several factors.  He cited a 2003 study by Dr. Linda Teri and colleagues, published in JAMA (290:2015-2022).  This consisted in implementing an exercise program for the person with dementia, and behavioural management for themselves.  Compared to people who received just routine care, the people who exercised maintained function longer, and their caregivers were less likely to experience depression.  Dr. Zarit also cited some of his own work on the impact of structural programs on behaviour in people with dementia, soon to be published in the Journal of Gerontology: Psychological Sciences.  It suggests that some of the troublesome behaviours experienced by people with dementia arise from their declining ability to stick with an activity.  Even though they cannot stay with the task, they are frustrated by their inability to stick with the task. 

Our team talked about where SymptomGuide^TM might fit in Dr. Zarit's schema. We don't provide direct exploration of how an individual experiences the stress of care giving.  We do offer reassurance that the symptom that stresses caregivers is not unique to them.  We share ways which other caregivers have found to be helpful.  By sharing this - and the symptom tracking - with other family members, caregivers can involve more than one person in understanding how dementia affects the person they care for.  This sharing can be helpful in itself. We also draw attention to a variety of ways in which they seek to reduce stress. Even so, we recognize that we offer only one small part of what needs to be a comprehensive solution.  We encourage caregivers who use this site to take advantage of local resources available to them. For this your local Alzheimer Society/Alzheimer Association chapter will offer invaluable information.