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Posted: February 26, 2008

Caregivers Need Help Coping with Loved One's Mild Memory Loss

The age-related memory condition known as mild cognitive impairment is more disruptive of day-to-day life and relationships than once believed and grows worse with time, gerontology researchers at Virginia Tech have discovered.
 
VT researchers set out to determine the issues and needs of families responding to mild cognitive impairment, also known as MCI. After interviews with 99 families, “Primary family members reported that their relatives were experiencing memory-related changes that interfere with their daily activities and responsibilities, decision-making processes, and relationships,” the researchers said.
 
“For the first three-year study, we interviewed each family member twice,” said Karen Roberto, director of the Center for Gerontology at Virginia Tech. “The first time was within six months of receiving the diagnosis. For instance, we asked why they went to the memory clinic.”
 
The research identified three types of responses from people diagnosed with MCI. “Some elders were strategists; their memory loss was apparent to them and they wanted to find out all they could about what it is, why it is occurring, and what they could do about it. They had already begun working through potential changes in their lives,” the researchers report.
 
Older adults in the second group appeared more uncertain. They did not appear to recognize that they have memory changes and did not understand why they needed to be tested. And a few older adults appeared troubled by their condition. “They are not accepting of the memory changes,” Roberto’s team said. “Although they did not acknowledge problems willingly, we sensed that they realize things were not quite right.”
 
The second interview was a year later to learn how families were coping.
 
“Care partners reported distress at having to take on the other person’s responsibilities, or at the changes in the marriage or parent-child relationship. There was also frustration at the changes in daily routine,” Roberto said.
 
“The care partner experiences a loss of independence and a loss of time for personal interests,” said co-researcher Dr. Rosemary Blieszner, associate director of the gerontology center. “The definition of MCI has been that it does not significantly affect daily life -- but sometimes that is not true.”
 
The team’s finding is significant because problems early in caregiving have long-term implications for the individual providing care and their feelings of burden and depression, if MCI progresses to Alzheimer’s disease. “Professionals need to provide information, assistance, coping strategies, and support to family members at this stage in the care process rather than waiting until Alzheimer’s disease is diagnosed,” the researchers advised the Alzheimer’s Association, which funded the study.
 
The researchers also asked the families the type of information they would like to have. In response, VT’s Center for Gerontology published a brochure for family caregivers, “Mild Cognitive Impairment – What do we do now?” The brochure is available free for downloading at www.gerontology.vt.edu/docs/Gerontology_MCI_final.pdf.
 
The brochure contains information on how to recognize symptoms and when to seek a professional diagnosis. The researchers emphasize that contrary to common belief, memory loss is not a normal part of aging, which is why diagnosis is important to rule out other conditions, as well as to provide treatment.
 
Also in the brochure, both family members and professionals offer strategies for compensating for memory loss and advice to the care partner on how to care for oneself. And the VT brochure suggests how to prepare for the future.
 
There were 99 economically diverse families in the original study. “A family is three people,” explained Roberto. “One member is 60 or older, with MCI, and able to be interviewed. The second is the primary care partner -- as distinguished from caregiver. So this is not a professional caregiver but a family member, usually the spouse. The third family member is the secondary care partner and usually not living in the home, such as an adult child, friend, or sibling.”
 
The second three-year phase of the study began last October. “We continue to follow the families and look at incidence of transition from MCI to Alzheimer's,” Roberto said. “And we are adding 40 families that reflect racial and ethnic diversity.”

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