Counsellors contact dementia caregivers--predictors of utilisation in a longitudinal study.
BACKGROUND
Counselling of family members is an established procedure in the support of dementia patients' relatives. In absence of widespread specialised dementia care services in most countries, however, counselling services are often not taken up or only very late in the course of the disease.


OBJECTIVE
In order to promote acceptance of this service, a new counselling concept was implemented where general practitioners recommended family counsellors, who then actively contacted the family caregivers to offer counselling ("Counsellors Contact Caregivers", CCC). The research questions were: To what extent can the rate of family counselling be increased by CCC? What are the predictors for usage of this form of family counselling?


METHODS
The study started in June 2006 in Middle Franconia for patients with mild to moderate dementia. At baseline, 110 family caregivers were offered counselling based on the CCC guideline. Data was analysed from 97 patient-caregiver dyads who received counselling for one year. The mean age of the patients with dementia (67 women and 30 men) was 80.7 years (SD = 6.2). The mean age of their primary family caregivers (68 women, 23 men) was 60.8 years (SD = 13.8).


RESULTS
35 family members (36%) made use of more extensive counselling (more than one personal contact). By contrast, 29 family members (30%) had no personal contact or only one personal contact (33 cases, 34%). The factors "spouse" (p = .001) and "degree of care" (p = .005) were identified as significant predictors for acceptance of extensive counselling.


CONCLUSIONS
Actively contacting patients and their caregivers is a successful means of establishing early and frequent contact with family members of patients with mild to moderate dementia. Use of extensive counselling is made especially by spouses of patients requiring intensified care.


BACKGROUND
ISRCTN68329593.
Grossfeld-Schmitz
Maria
M
Psychiatric University Hospital Erlangen, Department of Medical Psychology and Medical Sociology, Schwabachanlage 6, 91054 Erlangen, Germany.
Donath
Carolin
C
Holle
Rolf
R
Lauterberg
Joerg
J
Ruckdaeschel
Stephan
S
Mehlig
Hilmar
H
Marx
Peter
P
Wunder
Sonja
S
Grässel
Elmar
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003376:Counseling / Q000379:methods*; D003704:Dementia / Q000523:psychology* / Q000628:therapy*; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012944:Social Support
J Psychiatr Res. 1975 Nov;12(3):189-98
1202204
Int J Geriatr Psychiatry. 2000 May;15(5):451-7
10822244
BMC Geriatr. 2005 Sep 08;5:11
16150147
Health Care Financ Rev. 1997 Fall;19(1):105-20
10179994
Z Gerontol Geriatr. 2004 Aug;37(4):316-26
15338161
Am J Geriatr Psychiatry. 2004 May-Jun;12(3):240-9
15126224
J Geriatr Psychiatry Neurol. 2001 Winter;14(4):179-87
11794446
Int Psychogeriatr. 2008 Dec;20(6):1160-76
18606044
Scand J Soc Med. 1993 Dec;21(4):247-55
8310277
Int Psychogeriatr. 1996 Winter;8(4):525-47
9147168
Drugs Aging. 2002;19(3):203-15
12027778
BMC Health Serv Res. 2009 Jun 06;9:91
19500383
J Am Acad Nurse Pract. 2008 Aug;20(8):423-8
18786017
Gerontologist. 2003 Aug;43(4):521-31
12937331
Dement Geriatr Cogn Disord. 1998 Mar-Apr;9(2):111-6
9524803
Neurology. 2006 Nov 14;67(9):1592-9
17101889
Int J Geriatr Psychiatry. 2000 Sep;15(9):838-47
10984731
Int J Geriatr Psychiatry. 1999 Nov;14(11):915-24
10556862
Soc Work. 1999 Nov;44(6):535-48
10568026
BMC Public Health. 2005 Dec 12;5:133
16343336
Z Gerontol Geriatr. 2006 Dec;39(6):429-42
17160738