Change versus stability in depression and social support among caregivers of impaired elders

The demand for informal care of the elderly is rising as a result of advances in medical sciences that extend longevity and increase the prevalence of chronic illness among older adults. Women constitute the majority of family members who shoulder the burden of caregiving for our elders; and, these burdens can ultimately drain caregivers' resources. This drain often leads to the development of depression or other symptoms of distress.;The current study addresses gaps in the literature regarding the social support and emotional well-being of women providing care to impaired elders. Social support was defined and investigated as a multidimensional construct, and these constructs of informal support were also studied among working and non-working caregivers. Furthermore, this study investigated the relationship between depression and subject participation (N = 467) in five interventions designed to alleviate caregiver distress. These interventions included three psychoeducational group interventions and two different forms of brief individual psychotherapy (cognitive behavioral therapy and brief psychodynamic therapy). In all these investigations, the patterns of change in caregiver depression were explored modeling the individual growth of women over 18 months of their caregiving experience. These findings were considered in light of models of caregiver adjustment and the Stress Buffering hypothesis.;On average, caregivers in each intervention improved over the 18 months of assessment. While caregivers in the group interventions did not improve at a significantly greater rate than participants on the wait list, caregivers participating in the individual therapy conditions improved at almost twice the rate of caregivers in either the group intervention or wait list condition. Several factors may have influenced these results including measurement artifacts, dosage differences, individual difference variables, and caregivers' use of multiple formal supports.;The findings point to the need for clinicians, researchers and policy makers to be aware of the wide variability in the adjustment both among different caregivers as well as within individuals across time. The results of the study also highlight the need to listen more closely to the voice of caregivers in creation of measures designed capture the caregiving experience and the development of interventions intended to address caregiver distress.