Coping skills improve caregivers' well being

January 26, 2006 - 0:0
NEW YORK (Reuters Health) -- A program that has been useful in improving the well being of caregivers of Alzheimer's disease patients similarly benefit caregivers of cancer patients receiving end-of-life care, new study findings show.

"A short-term intervention provided to caregivers of hospice patients with advanced cancer can improve their quality of life and decrease their sense of burden," study author Dr. Susan C. McMillan, of the University of South Florida in Tampa, told Reuters Health.

"My heart goes out to them because of the struggle they're in," she said, referring to the caregivers of cancer patients in hospice care. She added that "in many cases they're alone in their struggle."

Research shows that as many as 52 million people in the United States provide some type of assistance to an ill or disabled family member. These caregivers experience high levels of stress, which may make them more susceptible to various health problems, like depression, according to previous investigators

Yet, studies show that the well being of stressed out caregivers, particularly those caring for family members with Alzheimer's disease or similar conditions, can be improved through their participation in programs that teach problem-solving and coping skills.

To investigate whether the same is true for caregivers of cancer patients receiving hospice care, McMillan and her team studied 354 family caregivers of patients in a community hospice, dividing the caregivers and their patients into three groups.

The first group received standard hospice care; the second group received standard care and three visits from a nurse and home health aide for emotional support; and the last group received standard care and three visits in which they were taught coping skills, including how to assess and manage their family member's symptoms. Study data were collected by the hospice staff.

During follow-up, 30 days later, caregivers who were taught coping skills reported greater improvements in their quality of life than did caregivers in the other two groups, the investigators report in the journal Cancer. Caregivers taught coping skills were also less stressed by their family member's pain, shortness of breath or other symptoms, and were less stressed by their caregiving tasks, which included assisting their family members with meals and intimate care, the report indicates.

"In a practical sense, this means that caregivers were better able to tolerate patient symptoms such as pain and constipation, or tasks such as providing personal care, even when hospice care did not eliminate symptoms or remove the need for care," the authors write.

Further, the results reveal that the coping intervention was more beneficial than the mere provision of emotional support.

"Emotional support alone may be appreciated by caregivers, but it appears to be ineffective in improving caregiver quality of life or caregiver burden due to patient symptoms," the researchers note.

Describing the "helpless" feelings of caregivers who see a family member experiencing shortness of breath, or some other symptom, McMillan said, to "give them tools to help the patient for whom they're providing care...just makes them feel better about the whole experience."

In light of the findings, "structured caregiver skill-training interventions for caregivers are promising even in the difficult environment of end-of-life care and for families already receiving benefits of hospice care," she and her colleagues conclude.