The decision to place a loved one into long-term elderly care can be gut-wrenching. Finding the right place is difficult, as is not knowing how well the staff is taking care of your spouse, parent, grandparent, or sibling. Still, as the dementia from Alzheimer's disease steals the mental capacity from someone, the burden on the patient's caregiver often becomes so great that no other choice is possible. A new study from the University of Pittsburgh School of Medicine shows just how hard putting a loved-one in institutional care can be for the caregiver.

What the researchers wanted to know: What are the mental and emotional impacts on a caregiver of putting a loved one into long-term, institutionalized care?

What they did: The researchers used data from a previous study done from 1996 to 2000 that looked at whether counseling helped people who care for relatives suffering from Alzheimer's. Though the study included more than 1200 pairs of caregivers and care recipients, only 180 recipients were placed in institutionalized care and were analyzed in depth in this study. The original study asked care-givers and patients a variety of questions relating to emotional and mental health and the duties performed by the caregiver before and after their loved one was in long-term care.

What they found: Caregivers seemed to feel no relief after putting a loved one into institutionalized care, and some became increasingly depressed or anxious—the number of caregivers taking anti-anxiety drugs increased after long-term care placement. Spouses especially tend to stay involved in the institutional care of an Alzheimer's patient, and also are more likely to be anxious or depressed than other caregivers. The researchers speculated that, especially among spouses, long-term care does not relieve the duties of the caregiver—many still groom, feed, and transport their husbands and wives—and may add stress because the caregiver has to interact with the facility staff.

What it means to you: It's important to recognize the emotional toll that putting someone in institutional care can take on the caregiver. Caregivers who received support from family and friends fared better than those who didn't, and this report underscores the need to get help.

Caveats: This study was originally designed to look at the effects of intervention and counseling on caregivers. When these researchers analyzed the data, they combined the group who received counseling with the group that did not, so some of the people received support they probably would not have gotten otherwise. But, if anything, that would have made putting a loved one in long-term care look easier.

Find out more: The Alzheimer's Association has a page with caregiver resources and links that answer various questions.

Read the article: Schulz, R. "Long-Term Care Placement of Dementia Patients and Caregiver Health and Well-Being." Journal of the American Medical Association. Aug. 25, 2004, Vol. 292, No. 8, pp. 961-967.

Abstract online: http://jama.ama-assn.org