Differences in Burden Severity in Adult-Child Family Caregivers and Spousal Caregivers of Persons with Dementia.

Researchers are continuing to focus on the nature and sources of burden of family caregivers of persons living with dementia. Caregiving stress and burden are assessed and addressed by social workers, including at high-risk times such as hospitalization. This study tested whether adult-child family caregivers experience greater perceived burden than spousal caregivers, accounting for risks of acute stress which can accompany hospitalization for their care recipient, where social workers may be meeting with family caregivers for the first time. Family caregivers (N = 76; n = 42 adult-child; n = 34 spouse) were recruited during care-recipient clinical treatment. The settings of care included an outpatient memory care program and an inpatient geriatric psychiatry service. Results showed that adult-child caregivers reported greater burden as compared with spousal caregivers, but no differences regarding depressive symptoms, perceived stress, or grief. After controlling for demographics and location of care, being an adult-child caregiver remained a predictor of greater burden severity. Being an adult-child family caregiver may place an individual at increased risk for experiencing high burden. These findings suggest socials workers should consider how adult-child caregivers may benefit from strategies to address and reduce burden, beyond those typically offered to spousal caregivers.

Yoga for Depression and Anxiety: A Review of Published Research and Implications for Healthcare Providers.

(Reprinted with permission from Rhode Island Medical Journal, 20-22, 2016).

Perceptions of hatha yoga amongst persistently depressed individuals enrolled in a trial of yoga for depression.

OBJECTIVES: To understand depressed individuals' experiences in a 10-week hatha yoga program. DESIGN: In a randomized controlled trial, participants were assigned to either 10 weeks of hatha yoga classes or a health education control group. This report includes responses from participants in yoga classes. At the start of classes, average depression symptom severity level was moderate. MAIN OUTCOME MEASURES: After 10 weeks of yoga classes, we asked participants (n=50) to provide written responses to open-ended questions about what they liked about classes, what they did not like or did not find helpful, and what they learned. We analyzed qualitative data using thematic analysis. RESULTS AND CONCLUSIONS: Elements of yoga classes that may increase acceptability for depressed individuals include having instructors who promote a non-competitive and non-judgmental atmosphere, who are knowledgeable and able to provide individualized attention, and who are kind and warm. Including depression-related themes in classes, teaching mindfulness, teaching breathing exercises, and providing guidance for translating class into home practice may help to make yoga effective for targeting depression. Participants' comments reinforced the importance of aspects of mindfulness, such as attention to the present moment and acceptance of one's self and one's experience, as potential mechanisms of action. Other potential mechanisms include use of breathing practices in everyday life and the biological mechanisms that underlie the positive impact of yogic breathing. The most serious concern highlighted by a few participants was the concern that the yoga classes were too difficult given their physical abilities.

Yoga for Depression and Anxiety: A Review of Published Research and Implications for Healthcare Providers.

There is increasing interest in the use of yoga as way to manage or treat depression and anxiety. Yoga is afford- able, appealing, and accessible for many people, and there are plausible cognitive/affective and biologic mechanisms by which yoga could have a positive impact on depression and anxiety. There is indeed preliminary evidence that yoga may be helpful for these problems, and there are several ongoing larger-scale randomized clinical trials. The current evidence base is strongest for yoga as efficacious in reducing symptoms of unipolar depression. However, there may be risks to engaging in yoga as well. Healthcare providers can help patients evaluate whether a particular community-based yoga class is helpful and safe for them.

A survey of Parkinson's disease patients: most bothersome symptoms and coping preferences.

BACKGROUND: Treatment for Parkinson's disease (PD) is symptomatic. Health professionals must therefore understand which of the many motor and non-motor problems that patients experience are the most troublesome, and what types of assistance patients believe would best help them cope with these problems. OBJECTIVE: To identify and understand potential issues of importance to patients with Parkinson's Disease. METHODS: We conducted surveys with 75 patients with PD in a Movement Disorders Program. We asked about: the two most bothersome PD-related problems, methods for coping with these problems, what motor and non-motor PD-related problems patients needed the most help with, and what a comprehensive assistance program for PD patients and caregivers should include. We used qualitative data analysis techniques to summarize responses. RESULTS: The most bothersome problems cited were: tremors, lack of mobility, pain, imbalance, lack of energy/fatigue, having to give up previously enjoyed activities, dysarthria, and anxiety or depression. Frequently cited ways to cope with different types of problems included medications, physical activity, instrumental or practical support, and emotional support. When asked specifically about which non-motor problems elicited the most need for help, respondents most commonly mentioned depression and anxiety, "nothing," or cognitive problems. Participants suggested that a comprehensive assistance program for people with PD and their caregivers should include education, physical activity, and emotional support. CONCLUSIONS: RESULTS from this survey highlight the diversity of patient experiences with PD, and the importance of strategies for coping with both motor and non-motor symptoms associated with Parkinson's Disease (in addition to medications).