e No. 1 reason for nursing home placement among dementia patients, Sink said, because it becomes too difficult to provide care at home.
The researchers examined data on patients and caregivers from the Medicare Alzheimer's Disease Demonstration and Evaluation (MADDE) study, which was designed to reduce burden and depression in caregivers of patients with dementia. For the study, caregivers were interviewed to get information about their age, education, relationship to the patient, etc. Standard tests were used to assess caregiver depression and burden, and caregivers were asked about neuropsychiatric symptoms in the patients.
The researchers adjusted for variables that could have influenced the results – such as patient characteristics and severity of dementia. They also attempted to control for the possibility that caregivers' reports of neuropsychiatric symptoms didn't reflect the actual symptoms, but were influenced by the caregivers' depression, education or other characteristics.
The final analysis revealed that caregivers who were younger, less educated, more depressed, more burdened or who spent more hours per week giving care reported more of the behaviors in patients.
The youngest caregivers reported 50 percent more of the behaviors than the oldest caregivers. Each of the characteristics was independently linked to more behaviors in patients. For example, caregiver age alone, regardless of education or depression, affected the number of symptoms.
Sink said that understanding more about the caregiver-patient relationship may help researchers develop more effective education tools.
‘We are not trying to blame caregivers, but to better understand the complex puzzle,’ said Sink. ‘If we focus only on the patient, we're not going to solve the problem. We need to develop better, non-drug treatments to handle these behaviors, and more tailored caregiver education may be one answer.’
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