Care is given over, but not the stress

Deciding to place an elderly relative in a nursing home is often an agonizing decision -- and one, it appears, that can leave people with long-lasting depression and anxiety.

A new study in the Journal of the American Medical Assn. followed 1,222 caregiver-patient pairs in which the patient was being cared for at home at the start of the study. During the four-year study, 180 caregivers turned over the care of their loved one to an institution. But there was no sense of relief for those people.

The researchers, from the University of Pittsburgh School of Medicine, found that symptoms of depression and anxiety remained as high as before the loved one left the home.

An earlier study had shown that caregivers are often relieved when a loved one dies. But that sense of closure doesn’t typically occur when the loved one moves to an institution.

Caregivers “continue to feel distressed because of the suffering and decline of their loved one, as well as having to face new challenges such as frequent trips to the long-term care facility, reduced control over the care provided to their relative, and taking on responsibilities such as coordinating and monitoring care,” says Richard Schulz, professor of psychiatry and director of the Center for Social and Urban Research at the University of Pittsburgh School of Medicine.

The study found that caregivers who were married to the patient had the most difficult transitions. African American and Latino caregivers were less likely to place their relative in a facility compared with whites, the study found. Caregivers who reported a greater burden were more likely to place a loved one in a facility; people who felt that their care-giving jobs were useful and important were less likely to place their relative elsewhere.