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Stanford
researchers help caregivers
find relief
in
home-based exercise program
STANFORD, CA -- Taking care of a loved one with dementia can be
emotionally draining and physically taxing, so it's no surprise that
caregivers have higher rates of depression, anxiety, sleep problems,
elevated blood pressure and compromised immunity.
But a study by
researchers at Stanford University Medical Center shows that a home-based
exercise program can yield significant mental and physical benefits for
caregivers, including increased physical fitness and strength, better
sleep, and decreased depression, anxiety and pain.
Lead author Cynthia M. Castro, PhD, research associate at the
Stanford Center for Research in Disease Prevention, explained that
"despite the burdens of caring for their loved ones, our research
showed that these people are really interested in taking care of their own
health, which is important to make sure they can continue fulfilling this
crucial role." The study appears in the June issue of Psychosomatic
Medicine.
More than five million Americans provide in-home, unpaid care for
family members with dementia, saving the health-care system an estimated
$34,500 annually per caregiver. That number is expected to increase as the
nation's elderly population expands.
Castro and her colleagues recruited 51 women, age 50 or over,
each caring for a demented relative living with her at home. The women did
not engage in regular physical activity and provided an average of 70
hours of care per week.
Each participant received an in-person counseling session with a
health educator, who provided instruction on developing a weekly schedule
of up to four 30- to 40-minute sessions of moderate-intensity, home-based
exercise.
During the following 12 months, participants received periodic
phone calls from the counselor, who asked about the participant's activity
level and schedule and provided guidance and referrals as needed. The
caregivers kept weekly activity logs, which they sent to their counselor.
Among the study's most surprising results was the high retention
rate (only six of the 51 women dropped out of the program by the end of
the year) and the participants' strong commitment to the program. Despite
the significant time commitment and the emotional stress of their
caregiving responsibilities, the participants completed 70 percent of
their prescribed exercise sessions each month on average.
The participants' high level of participation shows the
effectiveness of home-based programs featuring regular phone contact with
a counselor, Castro said. "This kind of approach has a lot to
offer," she added. "It's convenient, it fits in with their
schedule, and it doesn't require them to leave home."
In surveys conducted at the end of the study, participants said
they felt better physically and mentally. They reported increased strength
and fitness, decreased pain and better sleep, as well as decreased stress
and depression.
Linda Flores, one of the participants, said the exercise program
was "one of the things that kept me sane" during the two years
she took care of her mother (now deceased), who had Alzheimer's disease.
"It was a taxing, painful experience," she said of seeing her
mother, a retired teacher, lose her memory and grasp on reality -- asking
the same questions over and over, trying to leave the house in the middle
of the night, and repeatedly emptying the linen closet.
Flores started out walking a few times a week, then built up to
running and working out at a gym. "When I'd exercise, I'd come back
feeling invigorated and like I could go on one more day," she said.
"It really helped alleviate the stress." As the program went on,
Flores said, she felt healthier overall and paid more attention to her
diet.
Castro's team also worked with a similar group of 49 caregivers
who participated in an at-home nutrition-counseling program instead of the
exercise program. While researchers expected the nutrition group to
experience less physical benefit, they were surprised to find that
participants in this group stuck to their program just as much and
experienced similar improvements in psychological well-being. Castro
thinks the frequent, supportive contact with a counselor -- a feature of
both groups -- likely accounted for these improvements.
"Just being involved in a program and knowing someone is
checking in with you and cares about your health may be enough to produce
significant psychological benefit," she said.
Castro hopes the findings will spur the creation of similar
home-based health promotion programs by agencies serving dementia patients
and families. "As the number of people with dementia increases, the
number of family caregivers will also grow, so programs like this are
going to be really important," she said. "Caregivers need to
find ways to take care of their own health so they can take care of
someone else."
Stanford University Medical Center integrates research, medical
education and patient care at its three institutions - Stanford University
School of Medicine, Stanford Hospital & Clinics and Lucile Packard
Children's Hospital. For more information, please visit the Web site of
the medical center's Office of Communication & Public Affairs at
http://mednews.stanford.edu .
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