| Clinical Bottom Line: Support for caregivers delayed nursing home placement of patients with Alzheimer disease by almost a year. |
Clinical Question:In a 75 yr. old woman with CAD who is caring for her 80 yr. old husband with Alzheimer disease, will caregiver support delay time to nursing home placement of her husband?
Search terms: dementia and nursing home placement
The Study:
Caregivers who had spouses with AD living at home and had primary responsibility for their care, had at least 1 relative living in the area and were not participating in ano
ther support group.
Control (N=103): offered the services normally provided by the AD research centre, did not include individual or family counselling; if they requested information about obtaining help at home, they were given names of servic
e providers.
Experimental (N=103): individual and family counselling, weekly support group meetings, continuous availability of counsellors for helping caregivers deal with crises and the changing symptoms of patients
The Evidence:
| Outcome | Control | Experimental | Difference (95% CI) |
| median time to nursing home placement | 1203 days | 874 days | 329 days (47 to 611) |
|---|---|---|---|
| Predictors of placement: | |||
| Predictor | Relative Hazard (95% CI) | ||
| female caregivers | 1.5 (1.03 to 2.14) | ||
| increasing pt age | 1.3 (1.05 to1.68) | ||
| severity of dementia | 26 (3.5 to 185) | ||
| increasing depression in the caregiver | 1.05 (1.02 to 1.07) | ||
| increased negativity of caregiver toward troublesome behaviour | 1.1 (1.08 to 1.14) | ||
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