By Scott Wong
Dr. Dolores Gallagher-Thompson tells the three middle-aged women sitting at the table to list in their heads all the sports teams they know. The room is silent. She allows about 30 seconds then asks, “Now, name all the TV shows you can remember.” Thirty more seconds elapse before she asks, “And finally, name all the animals you can think of.”
The mental exercise stops. The group reconvenes.
“I visualized all the critters that I have around my house,” said one woman, slightly amused.
Though it may not have been terribly challenging, for this woman, the exercise has worked. The women, who requested they not be identified, are learning effective ways to manage their stress in one of Gallagher-Thompson’s Caregiver Assistance Programs, which meets weekly on the Stanford University campus.
All three women in the program are caregivers. All three are daughters caring for a father or mother with dementia, a broad term used to describe someone with severe memory loss and impairment in their cognitive functions.
Alzheimer’s disease is a well-known form of dementia, but dementia may also be attributed to a number of related health disorders like stroke, Parkinson’s disease, AIDS or even head trauma.
Dementia, which significantly increases with age, affects 5 percent of people in their 60s; 20 percent of people in their 70s; and 30 percent to 50 percent of those in their 80s.
Recent studies show that those with dementia are not the only ones suffering. One in two caregivers whose family members have dementia suffers from severe depression, said Gallagher-Thompson, director of The Older Adult and Family Center at Stanford University School of Medicine. Gallagher-Thompson, who specializes in geropsychology (the study of the aging process), is also director of the VA Palo Alto Health Care System in Menlo Park.
“Caregiving can be bad for your health,” Gallagher-Thompson said. “There are a lot of health problems that caregivers have, like continued stress and sleep problems.”
One participant, a Chinese woman from New York, talked about the stress her mother undergoes taking care of her husband who lives in a California nursing home. Every day, her mother cooks from scratch and takes him his meals because he won’t eat food at the nursing home. Her mother is exhausted from cooking and traveling.
Gallagher-Thompson said that a change in behavior can help alleviate the mother’s stress, and asks the group to offer a possible solution. They suggest that the mother fax a food order to the father’s favorite restaurant and then pay for the order over the phone or upon picking it up, saving the mother the time and trouble of preparing the food.
Depression from caregiving is more prevalent in women than in men, according to Gallagher-Thompson, perhaps because 75 percent of caregivers are women, mostly wives and daughters. Also, men are generally much more reserved in expressing their emotions than women.
Gallagher-Thompson’s programs particularly focus on assisting African American, Latino, Chinese and Caucasian families, as well as male caregivers. Services are offered in English, Spanish, Cantonese and Mandarin.
The programs are a response to Gallagher-Thompson’s own frustration when as a graduate student in Los Angeles she found herself trying to care for her mother in New York.
“My mother had multiple strokes, and 25 years ago I became a caregiver,” she said. “It was so frustrating that there were no services. I’m a very empirical type of person. I needed to have data, but at that time there were no studies.”
To this day, virtually no studies on how Latino and Chinese participate in or respond to the demands of caregiving exist, Gallagher-Thompson said.
In her 10 years of researching caregiver services, Gallagher-Thompson found that psychoeducational programs, those that implement a small group in a workshop format, are “clearly superior.”
“We think the psychoeducational approach is the way to go,” she said.
All programs follow one theoretical basis: cognitive behavioral theory, meaning how people think or view a particular situation.
“Sometimes it’s the (person’s) perception that has to change, not the situation,” Gallagher-Thompson said.
According to the New York native, who now lives in Los Altos, today’s exercise is just a way of “taking a little mental break.”
Over the next two years, the Caregiver Assistance Programs, which are funded by the National Institute of Aging and the National Office of Alzheimer’s Association,
plan to enroll about 450 participants into their study programs. The programs are free of charge, but participants must meet certain criteria. For example, they must work a minimum of eight hours each week as a caregiver and experience stress.
For more information, call The Older Adult & Family Center at 1-800-943-4333 or visit www.med.stanford.edu/oac.
