At least 30 percent of persons caring for a dying loved one suffer from major depressive disorder (MDD), a consequence that might be overlooked as care for the terminally ill increasingly shifts from the hospital to the home, according to a Yale researcher.
Earlier studies focused on issues such as fatigue and burden and mainly looked at Alzheimer's caregivers. Few, if any, have looked at rates of MDD among persons caring for terminally ill cancer patients, said Holly Prigerson, associate professor of psychiatry and epidemiology and public health at Yale School of Medicine and lead author of the study.
Prigerson, whose study is published in the May/June issue of the American Journal of Geriatric Psychiatry, and her colleagues, developed a new tool - the Stressful Caregiving Adult Reactions to Experiences of Dying - to evaluate caregivers of a terminally ill family member or friend.
They interviewed 76 caregivers to assess feelings of fear and helplessness that may be evoked by situations such as seeing the patient collapse, become delirious, struggle to swallow or breathe, experience pain, or even appear to be dead. As a result of these and other traumatic experiences, 30 percent of the respondents experienced MDD.
"What we're saying is that simply watching a loved one suffering has its own, discrete negative psychological consequences that can affect the caregiver's well-being," Prigerson said. "What we need to do is take a step back and think about how we can help them deal with the mental health aspect of their experience."
She said the goal, ultimately, is to screen caregivers who are at risk and use the assessment tool to identify ways to minimize the negative consequences that follow from exposure to serious distress in a dying loved one.
Co-authors include Emily Cherlin, Joyce Chen, Stanislav Kasl, Rosemary Hurzeler and Elizabeth Bradley.
The study was funded by grants from the John D. Thompson Institute, the Nathan Cummings Foundation, the National Institute of Mental Health, a Faculty Scholarship from the Project on Death in America, and a pilot grant from the National Institute on Aging, Older Americans Independence Center.
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