Caring for someone living with dementia is complex, physically demanding and emotionally challenging, even for professional carers, but particularly so for family members.

It’s not surprising that caregivers have a higher risk of developing depression, anxiety and even dying, the leaders of a research project say.

Carers are often largely alone, they may be seniors themselves, they may struggle financially, and they may even have their own health problems.

New research out of the US has found that teaching carers to cope with stress by focussing on positive emotions can reduce their levels of anxiety and depression.

The research, which was conducted by Northwestern Medicine and University of California San Francisco, showed that after learning eight skills, carers self-reported better physical health and a more positive attitude towards caregiving.

The eight techniques that can increase positive emotions

The eight skills the caregivers were taught were:

  1. To recognise one positive event each day.
  1. To savour that positive event and log it in a journal, or tell someone about it.
  1. Keep a daily gratitude journal.
  1. List a personal strength each day, and note how you use the strength.
  1. Set an attainable goal each day and note its progress.
  1. Report a relatively minor stressor each day, then list ways in which the event can be positively reappraised or reframed.
  1. Practice a small act of kindness each day.
  1. Practice mindfulness, for example by paying attention to everyday experiences and concentrating on your breathing.

“The caregivers who learned the skills had less depression, better self-reported physical health, more feelings of happiness and other positive emotions than the control group,” sai lead study author, Judith Moskowitz, professor of medical social sciences at Northwestern University Feinberg School of Medicine.

“The techniquest have brought about a serenity”

One participant wrote, “The LEAF study and the techniques I learned by participating in it have brought about a serenity and calmness to my life and to that of my husband. We have both benefitted from my changed attitude.”

Another said, “Doing this study helped me look at my life, not as a big neon sign that says, ‘DEMENTIA’ in front of me, but little bitty things like, ‘We’re having a meal with L’s sister, and we’ll have a great visit.’ I’m seeing the trees are green, the wind is blowing. Yeah, dementia is out there, but I’ve kind of unplugged the neon sign and scaled down the size of the letters.”

The study

The study involved 170 dementia caregivers from across the US, who were broken up into two groups: the intervention group which learned the positive emotion skills, and the control group, which only filled out a daily questionnaire about their emotions.

The skills program is called LEAF, Life Enhancing Activities for Family caregivers.

The group that learnt the skills were taught by web conference, which meant the program could be delivered to caregivers in rural areas.

Every six weeks, the caregivers reviewed their skills and they also did homework each day to practice the skills.

One example of homework was having to go out and perform an act of kindness.

All participants in the study filled out a questionnaire about their depression, anxiety, physical health and caregiver burden at both the beginning and the end of the study.

Those who learnt the skills recorded a 7 per cent larger decrease in depression and a 9 per cent larger decrease in anxiety compared to the control group.

After the training, the intervention group’s results fell into ‘normal’ rates for the population for depressive symptoms, but those in the control group remained in the mild to moderate range.

Skills are easy to implement and affordable

One of the key advantages of learning the eight skills is they can be easily implemented and even learned at home, making them both accessible and affordable.

Dementia Australia estimates there are currently 1.5 million carers in Australia looking after someone living with dementia, and that figure is set to rise in the decades ahead.

Moskowitz acknowledged that she wasn’t sure how many caregivers would be able to complete the program because “they are such a stressed, burdened group”.

But she said the participants in the study were “engaged and committed”, which reflected how much they appreciated learning ways increase their positive thoughts and feelings.

The research has been published in Health Psychology.

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