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KMID : 0379220070270010103
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Journal of Korea Gerontological Society
2007 Volume.27 No. 1 p.103 ~ p.119
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The Effects of REACH Interventions on Longitudinal Changes of Caregiver Depression at the Palo Alto Site
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Lee Mi-Jin
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Abstract
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Guided by the stress-coping model, this study builds on current REACH (Resources for Enhancing Alzheimer’s Caregiver Health) literature by examining the effects of interventions on longitudinal changes of caregiver depression. Moreover, this study looks at which factors are associated with longitudinal changes of caregiver depression.
The current study includes a sample of caregivers for elders with Alzheimer’s disease from the Palo Alto site (n=257). Two different active interventions including a cognitive behavioral intervention (Coping with Class: CWC) and a support group (Enhanced Support Group: ESG) were delivered, and active interventions are compared with a minimal support condition (MSC).
Caregiver depression is measured by the twenty CES-D items. The instruments were administered through caregiver interviews at baseline, 6-, 12-, and 18-month follow-ups. Longitudinal changes of caregiver depression during 18 months are expressed as a slope of caregiver depression in multilevel modeling.
The major findings indicate that there is no difference in the slope of caregiver depression between active interventions and MSC. As for the associative factors of caregiver depression, the findings reveal that caregivers with higher socioeconomic status (SES) demonstrate a faster decrease of depression over time whereas the initial caregiver depression does not vary by caregiver SES.
The findings imply that the minimal support rather than active interventions is more recommended for caregivers to reduce caregiver depression because the minimal support is more cost-effective and it is convenient for family caregivers to access. Also, as caregivers with lower SES may have other chronic stressors in addition to caregiving stressors, practitioners need to advocate that caregivers with lower SES need other types of supportive services and programs (e.g., financial support) on the top of caregiver interventions.
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KEYWORD
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REACH interventions, caregiver depression, Longitudinal changes
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