Alzheimer's Caregiving: Risky & Expensive Business

By William K. Summers, MD
© 1999-William K. Summers, MD

Several recent articles have featured the caregivers--the steel magnolias. Thank heaven these unsung heroes are beginning to have their song sung. There are 15 million American adults currently providing care to relatives. That is about one in 15 adults. This is time consuming and expensive. By one estimate $196 billion is spent each year by the family to care for Alzheimer's patients. This constitutes a huge subsidy to the healthcare system for people who are "covered" by Medicare. Are you one of these caregivers? You are if you help with one principle daily activity. Fifty three percent of the caregivers are adult children. Thirty-six percent of the caregivers are wives and husbands. Eleven percent of the time the care is delivered by neighbors, friends, social workers, accountants, and yes .... even lawyers. Fifteen years ago I observed that care giving is burdensome and stressful. I noted that illness and death for the caregiver was as high as the patients. I began listening to the caregivers' issues. I insisting that they get "time out" two afternoons a week. I asked them to take vitamins. Periodically I would check their blood pressure. Recent studies now support my concerns. Depression is increased among caregivers. Immunity measures are compromised in caregivers. They do not participate in preventive health behaviors, such as tri-weekly walks. Body functions deteriorate. Their cuts and wounds heal slowly. Cardiovascular reactivity is worse in caregivers, than in controls. Yes, 31% of dementia patients visit the emergency room each year. Twenty-five percent are admitted to hospital. But, 27% of caregivers also visit the emergency rooms each year. Fourteen percent are admitted to the hospital each year. Recently an elegant study on care giving risk was published in The Journal of the American Medical Association. 392 caregivers age 66-99 were studied for four years. 427 age-matched non-caregivers were the control group. The results were startling. 103 of the participants (12.6%) died over the four years. Specific death risk of a stressed caregiver of a demented patient was increased 68%. What can be done?

If you know a memory-impaired person, offer to be a companion for an afternoon. Let the caregiver go to a movie. Go to the mall. Or just take a nap. Such volunteering could be a life saver.

To your good health.