The NYU Caregiver Intervention

Summary:  The New York University Caregiver Intervention lessens caregiver depression, reduces caregiver concern about behavioral symptoms and delays institutionalization.  The program may be coming soon to a community center near you.

  Mary Mittelman, Dr.P.H.

In my last post, I wrote about the evidence that a program of caregiver education and support lessens caregiver depression and lengthens the time a person with dementia can be cared for at home, rather than in an institution.   One such program has been studied extensively by Mary Mittelman and her colleagues.  Dr. Mittelman is Director of Psychosocial Research and Support, Center of Excellence on Brain Aging and Research Professor Department of Psychiatry at New York University.  She is also co- author of Counseling the Alzheimer’s Caregiver: A Resource for Health Care Professionals.

In a clinical trial ranging over 23 years and involving more than 400 caregivers of spouses diagnosed with Alzheimer’s, Dr. Mittelman and her colleagues (including Bill Haley at the University of South Florida) compared caregivers receiving intensive  education and support to those receiving “usual care.”

The caregivers receiving “usual care” could take advantage of New York University’s Alzheimer Disease Center counseling, information and advice as needed.  Those participating in what has become known as the New York University Caregiver Intervention program (NYUCI) received:

• two sessions of individual counseling for caregivers
• four sessions of family counseling (these did not include the person diagnosed with Alzheimer’s)
• participation in a support group
• telephone counseling as needed.

Dr. Mittelman and her colleagues found that caregivers enrolled in the NYUCI:

• had fewer symptoms of depression than the control group, even though the control group received more services than the typical caregiver who does not have access to services in a university setting.  The benefit over the control group continued for more than 3 years.
• were not as bothered by their spouses' behavioral symptoms as those in the control group
• on average, were able to keep their spouses at home, rather than in an institution, about a year and a half longer.

Most caregivers don’t have access to programs like NYUCI, so Dr. Mittelman is now focused on making it more broadly available.  She is advising demonstration programs in California, Georgia, Minnesota and Nevada, as well as in Veterans Administration centers in Bedford, Massachusetts and New York City.   Communities in Florida, Utah and Wisconsin will begin to offer the program in the coming months.  As part of this effort, she has also developed web-based NYUCI training for professionals.

Most of the headlines about Alzheimer’s and dementia involve the search for a cure, but Dr. Mittelman says researchers should also focus on psychosocial interventions while we wait for science to advance.  It makes sense to take action on a personal level too.   “While there is no cure, there’s much you can do to make life better for the next fifteen to twenty years,” she says.

Comments

[richard taylor]

Hello, and thanks as usual for your report. I couldn't agree more about the need for more social/psycho research.Much of what is now being researched confirms, at least for me, the obvious. Perhaps that is not how others see it though.
We also need somewhere/someone who collects all or most of these studies and publishes someway a best practices index. There is so much that has been discovered, but most researchers move from grant to grant and topic to topic, and no one(s) seem willing to devote their energies to translational work.

Richard