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Change in Indices of Distress Among Latino and Anglo Female Caregivers of Elderly Relatives With Dementia: Site-Specific Results From the REACH National Collaborative Study

Correspondence: Address correspondence to Dolores Gallagher-Thompson, PhD, Director, Older Adult and Family Center, and Associate Professor of Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine and VA Palo Alto Health Care System, 795 Willow Road, mail code 182C/MP, Menlo Park, CA 94025. E-mail: dolorest{at}stanford.edu

Purpose: Few empirical studies have compared the efficacy between psychoeducational (skill-building) approaches for reducing caregivers' psychological distress and interventions modeled after typical community-based support groups. We compare the impact of two distinct interventions on Anglo and Latino caregivers of elderly relatives with dementia. Design and Methods: The change from preassessment to postassessment (baseline to 3 months) for 213 female caregivers (122 Anglo and 91 Latino) is presented. They were seen weekly for 10 weeks in either the Coping With Caregiving psychoeducational program (instruction and practice in small groups to learn specific cognitive and behavioral skills) or in the Enhanced Support Group condition (guided discussion and empathic listening to develop reciprocal support within the group). Both programs were tailored to be sensitive to the cultural concerns of Anglo and Latino caregivers, and they were delivered in either English or Spanish by trained interventionists. Results: Overall, participants in the Coping With Caregiving condition reported a significant reduction in depressive symptoms, increased use of adaptive coping strategies, and a trend toward decreased use of negative coping strategies when compared with those in the Enhanced Support Group condition. Results were similar for both ethnic groups: there were no main effects for ethnicity, and no significant ethnicity by treatment interaction effects. Implications: This study provides empirical support that female caregivers benefit more from a skill-building approach to managing their distress than from support group membership alone. We find it very encouraging that the Latino caregivers responded well on key outcome variables, suggesting that Latinos will participate in clinical research and will benefit from their involvement when services are provided to meet their specific needs.

Key Words: Alzheimer's caregiving • Interventions • Latino issues • Coping

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