Mental strategy helps dementia care partners' wellbeing
Responding to dementia symptoms can be a stressful daily activity, especially for spousal partners. Living with a partner with early-stage dementia means that spouses are often the first in line to witness changes in their partners and to provide daily support and assistance.
But care oftentimes is lacking for the caregivers themselves: Studies have shown that spousal care partners have a greater risk of death, functional disability and cognitive decline compared to other family care partners. And even when help arrives, it's often too late to be effective.
A new study from the Yale School of Public Health may have found an answer. The research suggests that a promising early intervention targeted at spousal care partners not only increases their quality of life but also may positively impact their partners living with dementia.
The intervention—known as the Wish Outcome Obstacle Plan (WOOP) strategy—has been used in health contexts from back pain to relationship dysfunctions in a variety of populations and has been shown to be highly effective in over 20 years of research. Its steps include identifying a feasible wish, finding a desirable outcome, recognizing the internal and controllable obstacle, and coming up with a concrete plan to overcome the obstacle. The researchers wrote that WOOP differs from other therapeutic approaches because it involves vividly imagining not only the wish but also the outcome and identifying the internal, controllable obstacle that can be overcome with a simple "if, then" plan—components that make goals easier to achieve.
In their study, 45 couples were randomly assigned to either the WOOP intervention or a wait list group. They then coached the care partners with WOOP in a one-hour coaching session, asked them to practice WOOP daily for 2 weeks on their own with check-in phone calls, and assessed their progress through surveys and phone calls over three months. The emotional experiences and well-being of the partners with early-stage dementia were also assessed over the same time-period.
By the end of the trial, care partners who used WOOP reported feeling less stressed and having an increased quality of life compared to those in the wait list group. Those living with dementia also reported similar benefits, but those results were not statistically significant.
"Dementia caregiving interventions often get to care partners too late. We wanted to test whether a well-known, evidence-based intervention for improving emotion-regulation and coping in other health contexts could also help protect dementia care partners. We also wanted to find a solution that could eventually be easily incorporated into care delivery for families facing the dementia diagnosis," said Joan Monin, associate professor in the Department of Social and Behavioral Sciences and the study's lead author.
The results reinforce the need for spousal support when dealing with dementia very early in the disease progression, and further underscore the effectiveness of the WOOP strategy in multiple contexts, the study said.
In the United States alone, more than 6 million people are living with Alzheimer's, and this does not include all forms of dementia. By 2050 the number is projected to reach about 13 million. Incorporating easy to use interventions, such as WOOP, into health care delivery early in the disease progression, is a promising direction in the effort to protect the quality of life of families impacted by dementia.
The study was published in the Journals of Gerontology.
More information: Joan K Monin et al, A Controlled Pilot Study of the Wish Outcome Obstacle Plan Strategy for Spouses of Persons with Early-Stage Dementia, The Journals of Gerontology: Series B (2021). DOI: 10.1093/geronb/gbab115