Daily Stressors and Adult Day Service Use by Family Caregivers: Effects on Depressive Symptoms, Positive Mood, and Dehydroepiandrosterone-Sulfate

Abstract

Objectives This study examines effects of daily use of adult day services (ADS) programs by caregivers of individuals with dementia (IWD) on a salivary biomarker of stress reactivity, dehydroepiandrosterone-sulfate (DHEA-S), and whether these effects on DHEA-S are associated with daily variability in positive mood and depressive symptoms. Design We used a daily diary design of 8 consecutive days with alternation of intervention (ADS) and non-intervention days to evaluate within- and between-person effects of the intervention. Setting Caregivers were interviewed daily by telephone at home. Participants 151 family caregivers of IWD who were using ADS. Measurements Saliva samples were collected from caregivers 5 times a day for 8 consecutive days and were assayed for DHEA-S. Daily telephone interviews assessed daily stressors and mood. Results DHEA-S levels were significantly higher on days following ADS use. Daily DHEA-S levels covaried significantly with daily positive mood, but not depressive symptoms. Conclusions These results demonstrate an association of ADS use by family caregivers and higher DHEA-S levels on the next day. Prior research has found that higher DHEA-S levels are protective against the physiological damaging effects of stressor exposure and may reduce risks of illness. Regular use of ADS may help reduce depletion of DHEA-S and allow the body to mount a protective and restorative response to the physiological demands of caregiving. To our knowledge, this is the first study to examine DHEA-S levels across the day in connection with an intervention that affected daily exposure to stressors.

There’s No Place Like Home

“…This study also found that being able to send a spouse or parent to an adult day service program reduced family caregivers' daily stress levels by about 40% [3]. "Adult day services create a win-win situation for everyone involved," said Elia Femia, a codirector of the research and coauthor of the article.…”

“…According to the Penn State study, the improvement in behavior and mood achieved by adult day service program is similar to, or greater than, the improvement provided by available medications for persons with dementia, without the adverse effects [3].…”

“…A study by a research team at Penn State University [3] There found that people with Alzheimer disease and other types of dementia showed improvements in behavior, mood, and sleep when they participated in an adult day service program, and their family caregivers experienced decreased daily stress. According to this study, the activities and social interaction provided by adult day service programs are an effective nonpharmacological way of treating people with dementia:…”

“…"Adult day services create a win-win situation for everyone involved," said Elia Femia, a codirector of the research and coauthor of the article. "The person with dementia benefits by participating in engaging activities, while the family caregiver gets a helpful break" [3]. Family caregivers sometimes report that it is difficult to get their relative ready in the morning to go to an adult day service program.…”

“…Family caregivers sometimes report that it is difficult to get their relative ready in the morning to go to an adult day service program. However, this study found that morning routines were not, on average, more challenging for caregivers on mornings when their relative went to an adult day service program [3]. A complete list of currently licensed adult day service programs in North Carolina is available on the North Carolina Division of Aging and Adult Services Web site [4].…”