Interventions for Family Caregivers of People with Dementia

Handbook of the Clinical Psychology of Ageing: Second Edition

Volumn , Issue , 2008, Pages 549-569

  Brodaty, Henry ^a   Berman, Karen ^a  

^a PRINCE OF WALES HOSPITAL   (Australia)

Author keywords

CANDID (Counselling and Diagnosis in Dementia) telemedicine service; Caregiver 'second' or 'hidden' patient; Caregiving effects on caregivers; Dementia and increased community awareness; Positive aspects of caring

Indexed keywords

EID: 84883166072     PISSN: None     EISSN: None     Source Type: Book    
DOI: 10.1002/9780470773185.ch32     Document Type: Chapter

References (126)

1. Acton, G.J. & Kang, J. (2001) Interventions to reduce the burden of caregiving for an adult with dementia: a meta-analysis. Research in Nursing and Health, 24(5), 349-60.
2. Anonymous (2005) DASN International-dementia advocacy and support group. Available from www.dasninternational.org/.
3. Anthony-Bergstone, C.R., Zarit, S.H. & Gatz, M. (1988) Symptoms of psychological distress among caregivers of dementia patients. Psychology and Aging, 3, 245-8.
4. Antonucci, T.C. & Hiroko, A. (1991) Convoys of social support: generational issues. Marriage and Family Review, 16, 103-19.
5. Ballinger, B.R. (1984) The effects of opening a geriatric psychiatry day hospital. Acta Psychiatrica Scandinavica, 70, 400-3.
6. Banerjee, S., Murray, J., Foley, B. et al. (2003) Predictors of institutionalisation in people with dementia. Journal of Neurology Neurosugery and Psychiatry, 74, 1315-16.
7. Bass, D.M., McClendon, M.J., Brennan, P.F.&McCarthy, C. (1998) The buffering effect of a computer support network on caregiver strain. Journal of Aging and Health, 10, 20-43.
8. Beach, S.R., Schulz, R., Yee, J.L. & Jackson, S. (2000) Negative and positive health effects of caring for a disabled spouse: longitudinal findings from the caregiver health effects study. Psychology and Aging, 15, 259-71.
9. Bedford, S., Melzer, D., Dening, T. & Lawton, C. (1996) What becomes of people with dementia referred to community psychogeriatric teams? International Journal of Geriatric Psychiatry, 11, 1051-6.
10. Bourgeois, M.S., Burgio, L.D., Schulz, R. et al. (1997) Modifying repetitive verbalizations of community-dwelling patients with AD. Gerontologist, 37, 30-9.
11. Brennan, P.F., Moore, S.M.&Smyth, K.A. (1992) Alzheimer's disease caregivers' uses of a computer network. Western Journal of Nursing Research, 14, 662-73.
12. Brennan, P.F., Moore, S.M. & Smyth, K.A. (1995) The effects of a special computer network on caregivers of persons with Alzheimer's disease. Nursing Research, 44, 166-72.
13. Brodaty, H. (1994) Dementia and the family, in The Family in Clinical Psychiatry (eds S. Bloch, J. Hafner, E. Harari & G.I. Szmukler). Oxford University Press, Oxford, pp. 224-46.
14. Brodaty, H. (1996) Caregivers and behavioral disturbances: effects and interventions. International Psychogeriatrics, 3, 455-8.
15. Brodaty, H. (1998) The family and drug treatments for Alzheimer's disease, in Pharmacotherapy of Alzheimer's Disease (ed. S. Gautier). Martin Dunitz, London, pp. 124-39.
16. Brodaty, H. (2002) The Sydney Dementia Carers Training Program, in Principle and Practice of Geriatric Psychiatry (eds J. Copeland, M.T. Abou-Saleh & D.G. Blazer). John Wiley & Sons, Chichester.
17. Brodaty, H., Green, A. & Graham, N. (2000) Alzheimer's (disease and related disorders) associations and societies: supporting family carers, in Dementia, 2nd edn (eds J. O'Brien, D. Ames & A. Burns). Hodder Arnold, London, pp. 361-7.
18. Brodaty, H., Green, A. & Koschera, A. (2003) Meta-analysis of psychosocial interventions for caregivers of people with dementia. Journal of the American Geriatrics Society, 51(5), 657-64.
19. Brodaty, H., Green, A. & Low, L.-F. (2004) Vascular dementia: consequences for family carer and implications for management, in Cerebrovascular Disease and Dementia: Pathology, Neuropsychiatry and Management (eds J. O'Brien, D. Ames, L. Gustafson et al.), 2nd edn. Martin Dunitz, Trowbridge, pp. 363-78.
20. Brodaty,H.&Gresham, M. (1989) Effect of a training programme to reduce stress in carers of patients with dementia. British Medical Journal, 299, 1375-9.
21. Brodaty, H. & Gresham, M. (1992) Prescribing residential respite care for dementia-effects, sideeffects, indications and dosage. International Journal of Geriatric Psychiatry, 7, 357-62.
22. Brodaty, H., Gresham, M. & Luscombe, G. (1997) The Prince Henry Hospital dementia caregivers' training programme. International Journal of Geriatric Psychiatry, 12, 183-92.
23. Brodaty, H. & Hadzi-Pavlovic, D. (1990) Psychosocial effects on carers of living with persons with dementia. Australian and New Zealand Journal of Psychiatry, 24, 351-61.
24. Brodaty, H., McGilchrist, C., Harris, L. & Peters, K.E. (1993) Time until institutionalization and death in patients with dementia. Role of caregiver training and risk factors. Archives of Neurology, 50(6), 643-50.
25. Brody, E. M. (1985) Parent care as normative stress. Gerontologist, 25, 19-29.
26. Buckwalter, K. C., Gerdner, L., Kohout, F. et al. (1999) A nursing intervention to decrease depression in family caregivers of persons with dementia. Archives of Psychiatric Nursing, 13, 80-8.
27. Burdz, M. P. (1990) Longitudinal Study on the Impact of Nursing-home Respite on Caregivers and Patients. Unpublished Ph.D. thesis, University of Manitoba, Canada.
28. Burgener, S.C., Bakas, T., Murray, C. et al. (1998) Effective caregiving approaches for patients with Alzheimer's disease. Geriatric Nursing, 19, 121-6.
29. Burgio, L., Lichstein, K.L., Nichols, L. et al. (2001) Judging outcomes in psychosocial interventions for dementia caregivers: the problem of treatment implementation. Gerontologist, 41(4), 481-9.
30. Cantor, M.H. (1979) Neighbours and friends: an overlooked resource in the informal support system. Research on Aging, 1, 434-63.
31. Charlesworth, G. M. (2001) Reviewing psychosocial interventions for family carers of people with dementia. Aging and Mental Health, 5, 104-6.
32. Chiverton, P. & Caine, E. D. (1989) Education to assist spouses in coping with Alzheimer's disease. A controlled trial. Journal of the American Geriatrics Society, 37, 593-8.
33. Cohen, C.A., Colantonio, A. & Vernich, L. (2002) Positive aspects of caregiving: rounding out the caregiver experience. International Journal of Geriatric Psychiatry, 17, 184-8.
34. Cohen, C.A., Gold, D.P., Shulman, K. et al. (1993) Factors determining the decision to institutionalise dementing individuals: a prospective study. Gerontologist, 33, 714-20.
35. Colerick, E.J. & George, L.K. (1986) Predictors of institutionalization among caregivers of patients with Alzheimer's disease. Journal of the American Geriatrics Society, 34, 493-8.
36. Cooke, D.D., McNally, L., Mulligan, K.T. et al. (2001) Psychosocial interventions for caregivers of people with dementia: a systematic review. Aging and Mental Health, 5(2), 120-35.
37. Coon, D.W., Thompson, L., Steffen, A. et al. (2003) Anger and depression management: psychoeducational skill training interventions for women caregivers of a relative with dementia. Gerontologist, 43, 678-89.
38. Cuijpers, P., Hosman, C.M. & Munnichs, J.M. (1996) Change mechanisms of support groups for caregivers of dementia patients. International Psychogeriatrics, 8, 575-87.
39. Eloniemi-Sulvaka, U. & Sivenius, J. (1999) Support programs for demented patients and their carers: the role of dementia family co-ordinator is crucial, in Alzheimers Disease and Related Disorders (eds K. Iqbal, D. Swaab & B. Winblad). John Wiley & Sons, Chichester, pp. 795-802.
40. European Institute of Womens' Health. (2005) Remind Project: Dementia Carex. Challenges for an Aging Europe. Available from www.eurohealth.ie/remind/(accessed 31 August 2007).
41. Family Survival Project. (1984) Annual Reports: Family Survival Program Pilot Project. Family Survival Project, San Francisco.
42. Ferris, S.H., Steinberg, G., Shulman, E. et al. (1987) Institutionalization of Alzheimer's disease patients: reducing precipitating factors through family counseling. Home Health Care Services Quarterly, 8(1), 23-51.
43. Fink, S.V. & Picot, S.F. (1995) Nursing home placement decisions and post-placement experiences of African-American and European-American caregivers. Journal of Gerontological Nursing, 21, 35-42.
44. Finnema, E., Droes, R.M., Ribbe, M. & Van Tilburg, W. (2000) The effects of emotion-oriented approaches in the care for persons suffering from dementia: a reviewof the literature. International Journal of Geriatric Psychiatry, 15(2), 141-61.
45. Fuller, J.,Ward, E., Evans, A. et al. (1979) Dementia: supportive groups for relatives. British Medical Journal, 1, 1684-5.
46. Gallagher-Thompson, D. & DeVries, H. M. (1994) 'Coping with frustration' classes: development and preliminary outcomes with women who care for relatives with dementia. Gerontologist, 34, 548-52.
47. Gitlin, L., Corcoran, M., Winter, L. et al. (2001) A randomized, controlled trial of a home environmental intervention: effect on efficacy and upset in caregivers and on daily function of persons with dementia. Gerontologist, 41, 4-14.
48. Gitlin, L.N., Belle, S.H., Burgio, L.D. et al. (2003) Effect of multicomponent interventions on caregiver burden and depression: the REACH multisite initiative at 6-month follow-up. Psychology and Aging, 18, 361-74.
49. Gonyea, J. G. (1989) Alzheimer's disease support groups: an analysis of their structure, format and perceived benefits. Social Work in Health Care, 14, 61-72.
50. Goodman, C. & Pynoos, J. (1990) A model telephone and information support program for caregivers of Alzheimer's patients. Gerontologist, 30, 399-405.
51. Gwyther, L. P. (1998) Social issues of the Alzheimer's patient and family. American Journal of Medicine, 104, 27.
52. Hagen, B. (2001) Nursing home placement. Factors affecting caregivers' decisions to place family members with dementia. Journal of Gerontological Nursing, 27, 44-53.
53. Haley, W.E., Levine, E.G., Brown, S.L. et al. (1987) Psychological, social, and health consequences of caring for a relative with senile dementia. Journal of the American Geriatrics Society, 35, 405-11.
54. Harvey, R., Roques, P.K., Fox, N.C. & Rossor, M.N. (1998) CANDID-Counselling and diagnosis in dementia: a national telemedicine service supporting the care of younger patients with dementia. International Journal of Geriatric Psychiatry, 6, 381-8.
55. Hepburn, K.W., Tornatore, J., Center, B. & Ostwald, S.W. (2001) Dementia family caregiver training: affecting beliefs about caregiving and caregiver outcomes. Journal of the American Geriatrics Society, 49, 450-7.
56. Hebert, R., Leclerc, G., Bravo, G. et al. (1994) Efficacy of a support group programme for care-givers of demented patients in the community: a randomised controlled trial. Archives Gerontologica Geriatrica, 18, 1-14.
57. Himes, C.L. & Reidy, E.B. (2000) The role of Friends in Caregiving. Research on Aging, 22, 315-36.
58. Jablonski, R.A., Reed, D. & Maas, M.L. (2005) Care intervention for older adults with Alzheimer's disease and related dementias: effect of family involvement on cognitive and functional outcomes in nursing homes. Journal of Gerontological Nursing, 31, 38-48.
59. Jansson, W., Almberg, B., Grafstrom, M. & Winblad, B. (1998) The Circle Model-support for relatives of people with dementia. International Journal of Geriatric Psychiatry, 13, 674-81.
60. Jette, A.M., Tennstedt, S. & Crawford, S. (1995) How does formal and informal community care affect nursing home use? Journals of Gerontology Series B Psychological Sciences and Social Sciences, 50, S4-S12.
61. Kahan, J., Kemp, B., Staples, F.R. & Brummel-Smith, K. (1985) Decreasing the burden in families caring for a relative with a dementing illness.Acontrolled study. Journal of the American Geriatrics Society, 33, 664-70.
62. Kasuya, R.T., Polgar-Bailey, P. & Takeuchi, R. (2000) Caregiver burden and burnout. A guide for primary care physicians. Postgraduate Medicine, 108, 119-23.
63. Kiecolt-Glaser, J.K., Marucha, P.T., Malarkey, W.B., Mercado, A.M. & Glaser, R. (1995) slowing of wound healing by psychological stress. Lancet, 346, 1194-6.
64. Knight, B.G., Lutzky, S.M. & Macofsky-Urban, F. (1993) A meta-analytic review of interventions for caregiver distress: recommendations for future research. Gerontologist, 33(2), 240-8.
65. Kramer, B. J. (2000) Husbands caring for wives with dementia: a longitudinal study of continuity and change. Health and Social Work, 25, 97-107.
66. Lawton, M.P., Brody, E.M. & Saperstein, A.R. (1989) A controlled study of respite service for caregivers of Alzheimer's patients. Gerontologist, 29, 8-16.
67. Lawton, M.P., Rajagopal, D., Brody, E. & Kleban, M.H. (1992) The dynamics of caregiving for a demented elder among black and white families. Journal of Gerontology, 47, S156-164.
68. Lee, H. & Cameron, M. (2004) Respite care for people with dementia and their carers. Cochrane Database of Systematic Reviews, 2.
69. Li, L.W., Seltzer, M.M.&Greenberg, J.S. (1997) Social support and depressive symptoms: differential patterns in wife and daughter caregivers. Journals of Gerontology Series B Psychological Sciences and Social Sciences, 52, S200-211.
70. Livingston, G., Johnston, K., Katona, C. et al. (2005) Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia. American Journal of Psychiatry, 162, 1996-2021.
71. Luscombe, G., Brodaty, H. & Freeth, S. (1998) Younger people with dementia: diagnostic issues, effects on carers and use of services. International Journal of Geriatric Psychiatry, 13, 323-30.
72. Maas, M.L., Reed, D., Park, M. et al. (2004) Outcomes of family involvement in care intervention for caregivers of individuals with dementia. Nursing Research, 53, 76-86.
73. Mahoney, D.F.&Shippee-Rice, R. (1994) Training family caregivers of older adults: a program model for community nurses. Journal of Community Health Nursing, 11, 71-8.
74. Marriott, A., Donaldson, C., Tarrier, N. & Burns, A. (2000) Effectiveness of cognitive-behavioural family intervention in reducing the burden of care in carers of patients with Alzheimer's disease. British Journal of Psychiatry, 176, 557-62.
75. Max, W., Webber, P. & Fox, P. (1995) Alzheimer's disease. The unpaid burden of caring. Journal of Aging and Health, 7, 179-99.
76. McCann, J.J., Hebert, L.E., Bienias, J.L. et al. (2004) Predictors of beginning and ending caregiving during a 3-year period in a biracial community population of older adults. American Journal of Public Health, 94, 1800-6.
77. McNally, S., Ben-Shlomo, Y. & Newman, S. (1999) The effects of respite care on informal carers' well-being: a systematic review. Disability and Rehabilitation, 21, 1-14.
78. Mendez, M. F. & Cummings, J. L. (2003) Dementia. A Clinical Approach, 3rd edn. Butterworth Heinemann, Philadelphia PA.
79. Mittelman, M.S., Ferris, S.H., Shulman, E. et al. (1995) A comprehensive support program: effect on depression in spouse-caregivers of AD patients. Gerontologist, 35(6), 792-802.
80. Mittelman, M.S., Ferris, S.H., Shulman, E. et al. (1996) A family intervention to delay nursing home placement of patients with Alzheimer disease. a randomized controlled trial. Journal of the American Medical Association, 276(21), 1725-31.
81. Mittelman, M.S., Ferris, S.H., Steinberg, G. et al. (1993) An intervention that delays institutionalization of Alzheimer's disease patients: treatment of spouse-caregivers. Gerontologist, 33(6), 730-40.
82. Mittelman, M.S., Roth, D.L., Coon, D.W. & Haley, W.E. (2004) Sustained benefit of supportive intervention for depressive symptoms in caregivers of patients with Alzheimer's disease. American Journal of Psychiatry, 161, 850-6.
83. Mohide, E.A., Pringle, D.M., Streiner, D.L. et al. (1990) A randomized trial of family caregiver support in the home management of dementia. Journal of the American Geriatrics Society, 38, 446-54.
84. Montgomery, R. & Borgatta, E. (1989) The effects of alternative support strategies on family caregiving. Gerontologist, 29, 457-64.
85. Ostwald, S.K., Hepburn, K.W., Caron, W. et al. (1999) Reducing caregiver burden: a randomized psychoeducational intervention for caregivers of persons with dementia. Gerontologist, 39, 299-309.
86. Philp, I., McKee, K.J., Meldrum, P. et al. (1995) Community care for demented and non-demented elderly people: a comparison study of financial burden, service use, and unmet needs in family supporters. British Medical Journal, 310, 1503-6.
87. Pinquart, M. & Sorensen, S. (2004) Associations of caregiver stressors and uplifts with subjective well-being and depressive mood: a meta-analytic comparison. Aging and Mental Health, 8, 438-49.
88. Pusey, H.&Richards, D. (2001) Asystematic reviewof the effectiveness of psychosocial interventions for carers of people with dementia. Aging and Mental Health, 5, 107-19.
89. Rabins, P.V. (1998) The caregiver's role in Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 3, 25-8.
90. Riordan, J. & Bennett, A. (1998) An evaluation of an augmented domiciliary service to older people with dementia and their carers. Aging and Mental Health, 2, 137-43.
91. Ryan, A.A. & Scullion, H.F. (2000) Family and staff perceptions of the role of families in nursing homes. Journal of Advanced Nursing, 32, 626-34.
92. Schulz, R.&Beach, S.R. (1999) Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. Journal of the American Medical Association, 282, 2215-19.
93. Schulz, R., Burgio, L., Burns, R. et al. (2003) Resources for Enhancing Alzheimer's Caregiver Health (REACH): overview, site-specific outcomes, and future directions. Gerontologist, 43, 514-20.
94. Schumock, G.T. (1998) Economic considerations in the treatment and management of Alzheimer's disease. American Journal of Health System Pharmacy, 55, 1.
95. Shaw,W.S., Patterson, T.L., Semple, S.J. et al. (1997) Longitudinal analysis of multiple indicators of health decline among spousal caregivers. Annals of Behavioral Medicine, 19, 101-9.
96. Shaw,W.S., Patterson, T.L., Ziegler, M.G. et al. (1999) Accelerated risk of hypertensive blood pressure recordings among Alzheimer caregivers. Journal of Psychosomatic Research, 46, 215-27.
97. Smith, G.E., Kokmen, E. & O'Brien, P.C. (2000) Risk factors for nursing home placement in a population-based dementia cohort. Journal of the American Geriatrics Society, 48, 519-25.
98. Sorensen, S., Pinquart, M. & Duberstein, P. (2002) How effective are interventions with caregivers? An updated meta-analysis. Gerontologist, 42, 356-372.
99. Specht, J.P., Kelley, L.S., Manion, P. et al. (2000) Who's the boss? Family/staff partnership in care of persons with dementia. Nursing Administration Quarterly, 24, 64-77.
100. Stephens, M.A. & Zarit, S.H. (1989) Family caregiving to dependent older adults: stress, appraisal, and coping. Psychology and Aging, 4, 387-88.
101. Stolley, J.M., Reed, D. & Buckwalter, K.C. (2002) Caregiving appraisal and interventions based on the progressively lowered stress threshold model. American Journal of Alzheimer's Disease and Other Dementias, 17, 110-20.
102. Stone, R., Cafferata, G.L. & Sangl, J. (1987) Caregivers of the frail elderly: a national profile. Gerontologist, 27, 616-26.
103. Teri, L. (1999) Training families to provide care: effects on people with dementia. International Journal of Geriatric Psychiatry, 14, 110-16.
104. Teri, L., Gibbons, L.E., McCurry, S.M. et al. (2003) Exercise plus behavioral management in patients with Alzheimer disease: a randomized controlled trial. Journal of the American Medical Association,, 290, 2015-22.
105. Teri, L., Logsdon, R.G., Uomoto, J. & McCurry, S.M. (1997) Behavioral treatment of depression in dementia patients: a controlled clinical trial. Journals of Gerontology Series B Psychological Sciences and Social Sciences, 52, 159-66.
106. Thomas, P., Chantoin-Merlet, S., Hazif-Thomas, C. et al. (2002) Complaints of informal caregivers providing home care for dementia patients: the Pixel study. International Journal of Geriatric Psychiatry, 17, 1034-47.
107. Thompson, E.H., Jr., Futterman, A.M., Gallagher-Thompson, D. et al. (1993) Social support and caregiving burden in family caregivers of frail elders. Journal of Gerontology, 48, S245-254.
108. Toseland, R.W., Rossiter, C.M. & Labrecque, M.S. (1989) The effectiveness of peer-led and professionally led groups to support family caregivers. Gerontologist, 29, 465-71.
109. Vedhara, K., Cox, N.K., Wilcock, G.K. et al. (1999) Chronic stress in elderly carers of dementia patients and antibody response to influenza vaccination. Lancet, 353, 627-31.
110. Vernooij-Dassen, M., Felling, A. & Persoon, J. (1997) Predictors of change and continuity in home care for dementia patients. International Journal of Geriatric Psychiatry, 12, 671-7.
111. Vernooij-Dassen, M., Huygen, F., Felling, A. & Persoon, J. (1995) Home care for dementia patients. Journal of the American Geriatrics Society, 43, 456-7.
112. Vernooij-Dassen, M., Lamers, C., Bor, J. et al. (2000) Prognostic factors of effectiveness of a support program for caregivers of dementia patients. International Journal of Aging and Human Development, 51, 259-74.
113. Vernooij-Dassen, M. & Olde Rikkert, M.G. (2004) Personal disease management in dementia care. International Journal of Geriatric Psychiatry, 19(8), 715-17.
114. Vitaliano, P.P., Zhang, J. & Scanlan, J.M. (2003) Is caregiving hazardous to one's physical health? A meta-analysis. Psychological Bulletin, 129, 946-72.
115. Whitlatch, C. & Noelker, L. (1996) Caregiving and Caring. Encyclopaedia Gerontologica, 1, 253-68.
116. Whitlatch, C.J., Zarit, S.H. & Von Eye, A. (1991) Efficacy of interventions with caregivers: a reanalysis. Gerontologist, 31, 9-14.
117. Woods, R.T.,Wills,W., Higginson, I.J. et al. (2003) Support in the community for people with dementia and their carers: a comparative outcome study of specialist mental health service interventions. International Journal of Geriatric Psychiatry, 18, 298-307.
118. Yaffe, K., Fox, P., Newcomer, R. et al. (2002) Patient and caregiver characteristics and nursing home placement in patients with dementia. Jama, 287, 2090-7.
119. Yates, M.E., Tennstedt, S. & Chang, B.H. (1999) Contributors to and mediators of psychological well-being for informal caregivers. Journals of Gerontology Series B Psychological Sciences and Social Sciences, 54, 12-22.
120. Yee, J. L. & Schulz, R. (2000) Gender differences in psychiatric morbidity among family caregivers: a review and analysis. Gerontologist, 40, 147-64.
121. Zarit, S.H. (2005) Interventions for family caregivers: do they work and why? Available from www2.uni-jena.de/svw/devpsy/news/2003/download/zarit.pdf.
122. Zarit, S.H., Anthony, C.R.&Boutselis, M. (1987) Interventions with care givers of dementia patients: comparison of two approaches. Psychology and Aging, 2, 225-232.
123. Zarit, S.H., Femia, E.E., Watson, J. et al. (2004) Memory Club: a group intervention for people with early-stage dementia and their care partners. Gerontologist, 44, 262-9.
124. Zarit, S.H., Gaugler, J.E. & Jarrott, S.E. (1999) Useful services for families: research findings and directions. International Journal of Geriatric Psychiatry, 14, 165-77.
125. Zarit, S.H.&Leitsch, S.A. (2001) Developing and evaluating community based intervention programs for Alzheimer's patients and their caregivers. Aging and Mental Health, 5 (Suppl. 1), 584-9.
126. Zarit, S.H., Stephens, M.A., Townsend, A.&Greene, R. (1998) Stress reduction for family caregivers: effects of adult day care use. Journals of Gerontology Series B Psychological Sciences and Social Sciences, 53, S267-278.