Caregiver interventions in geriatric psychiatry

Family members are an essential resource to older individuals with chronic illness and disability. Without the care and support provided by relatives, it would be difficult and often impossible for persons with disability to remain in the community. Current estimates indicate that more than 40 million Americans provide assistance annually to an adult relative because of illness and disability. There is strong consensus that caring for an individual with disability is burdensome and stressful to most family members and contrib-utes to psychiatric morbidity in the form of elevated rates of depression and anxiety and, in extreme cases, murder-suicide. Research also suggests that the combination of loss, prolonged distress, physical demands of caregiv-ing, and biological vulnerabilities of older caregivers may compromise their physiologic functioning and increase their risk for physical health problems. Findings that document the health effects of elder caregiving have been complemented by scores of intervention studies aimed at addressing the bur-den, distress, and negative health effects associated with caregiving. Although this research has been subjected to periodic review beginning in 1989 [1–11], assessments of the recent literature in this area are lacking. This article exam-ines critically the caregiver intervention studies published between 1999 and 2005. The primary goal was to identify recent randomized controlled trials (RCTs) that evaluated the efficacy toread NIMH P30 of psychosocial an