Behavior disorders and subjective burden among caregivers of demented patients

Virtual Support in Dementia: A Possible Viable Strategy for Caregivers

Background: In the last 10 months, due to the Covid-19 pandemic, several studies have shown that health education and virtual support strategies for caregivers of patients with dementia, in the management of home care, can be viable. Low and middle income countries, in particular, have sought to use these means to reduce the daily burden of caregivers, through virtual meetings of education and support.

Objectives: To present the feasibility of a pilot study on the use of a support action contemplated by the Caad Project–indirect costs of dementia–from HC-FMUSP.

Methods: Observational study in which 93 caregivers were invited to participate in virtual meetings on a frequency of three times/week, lasting 1 h each.

Results: Of the 93 invited family members, and after 3 months, 42 answered eight questions about the effectiveness of the action. High percentages of positive responses regarding program satisfaction ranged from 86 to 100%.

Conclusion: This study showed results of a very simple intervention that suggests that it is possible to offer caregivers of patients with dementia a program that can be used in primary care, in order to understand the difficulty of caregivers in their daily care of patients with dementia, with daily management guidelines on a case-by-case basis, in addition to promoting the implementation of an education strategy about the importance of knowing, and recognizing anatomophysiological changes in the aging process and its implications for the rupture of the imaginary line that involves senescence and senility. This allows the caregiver to feel able to protect his patient and himself by preventing the emergence of common diseases in this age group. Further studies are needed to explore this type of non-pharmacological support.

Indirect cost with dementia: A Brazilian study

Costs with dementia have been the focus of research around the world and indirect costs to the caregiver appear in the literature as responsible for the greatest impact. In Latin American (LA) studies, indirect costs with dementia range from 60% to 75% of family income.

OBJECTIVE

To present preliminary results of the study "Description of the methods and cost analysis with dementia" currently being conducted at the Behavioral and Cognitive Neurology Unit of Hospital de Clínicas of University of São Paulo - HC-FMUSP.

METHODS

A cross-sectional study which, to date, includes interviews of 93 primary caregivers. The research protocol includes a sociodemographic questionnaire, the Functional Assessment Staging (FAST) scale, the Burden Interview (Zarit), an economic classification scale, and the Resource Utilization in Dementia (RUD) scale.

RESULTS

Monthly indirect costs were US$ 1,122.40, US$ 1,508.90 and US$ 1,644.70 stratified into mild, moderate and severe dementia, respectively. The projected annual indirect costs were US$ 13,468.80, US$ 18,106.80 and US$ 19,736.40, representing 69 to 169% of family income.

CONCLUSION

This small sample showed that the impact of indirect costs with dementia in Brazil may be higher than that reported in other Latin American (LA) studies. These initial results may represent an important contribution for further research on costs with dementia in LA.

Dementia caregiver burgen in a brasilian sample: Association to neuropsychiatric symptoms

Taking care of elderly demented individuals, especially when they present behavioral changes, can be very exhaustive for both family and caregivers. Generally, this leads to changes in the family lifestyle, and the caregiver must deal with a range of problems. Information on this topic in Latin America, including Brazil, remains scarce.

Objective

To investigate the relationship between the presence of neuropsychiatric symptoms and the level of caregiver burden in a group of Brazilian elderly with dementia.

Methods

The Brazilian versions of the Zarit Caregiver Burden Interview (ZBI) and of the Neuropsychiatric Inventory (NPI) were administered to a total of 83 family-caregivers of patients with dementia followed at a university-affiliated outpatient clinic. Pearson's correlations were calculated to measure the level of association between the scores on both instruments.

Results

Among the caregivers, 83.1% were women, and had a mean age of 55.6±12.8 years. The ZBI scores ranged from 3 to 79 (mean=31.4). Patients' NPI scores ranged from 0 to 102 (mean=26.9), consistent with a significant degree of behavioral manifestations in most patients. A significant positive correlation was found between ZBI and NPI scores (r=0.402; p=0.000).

Conclusion

The presence and severity of behavioral manifestations assessed by the NPI were associated with a high level of caregiver burden in this sample of Brazilian elderly with dementia.