Psychoeducation in dementia: Results of a survey of all psychiatric institutions in Germany, Austria and Switzerland

Authors


*Christine Rummel-Kluge, MD, Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Möhlstrasse 26, 81675 München, Germany. Email: christine.rummel@lrz.tum.de

PSYCHOEDUCATION FOR CAREGIVERS in dementia can reduce human suffering and delay the time of institutionalization of the patients.1 To assess how often such psychoeducation is provided, we conducted a two-part postal survey, which addressed all psychiatric departments in Germany, Austria and Switzerland from December 2003 to July 2004. In German-speaking countries dementia is associated with psychiatric institutions, not with neurological institutions as in most other countries. Part I was sent to the heads of the psychiatric departments (n = 622) to determine whether psychoeducation had taken place there in 2003 and who the specific contact person was. Part II (23 multiple-choice/open-ended questions) was then sent to that contact person to assess the details of their psychoeducation in dementia. Further details about questionnaires and survey are published elsewhere.2 Responses were analyzed using descriptive statistics.

The response rate for Part I was 54% (337/622); only eight (2%) of the responding institutions reported offering psychoeducation in dementia, seven returned Part II of the questionnaire (response rate, 88%). According to the responses, 6–15 caregivers (grown up daughters/sons or spouses) met once a month in open groups of 75–120 min each, moderated by psychologists and psychiatrists. The main informational topics were communication skills, impact of family/friends, coping strategies, symptoms, course of the illness and sociotherapeutic offerings; principal emotional topics were isolation, burnout, guilt and shame. The groups had one to two moderators (psychiatrists, psychologists, social workers, or nursing staff), who used prepared informational material (flipcharts, handouts, transparencies).

Six respondents reported the numbers of patients with dementia (mean 300 ± 318) treated in their institution (mean number of hospital beds 446 ± 229) in 2003 and the numbers of caregivers who participated in psychoeducation that year (mean, 46 ± 35): a mean of 20% (range, 7–52%) of the caregivers (assuming one caregiver per patient) had taken part in psychoeducation for dementia in the year 2003.

The present results show that psychoeducation for caregivers in dementia is very rarely offered, only in 2% of the responding institutions. But when psychoeducation in dementia was offered, 20% of the caregivers participated; this percentage is even higher compared to psychoeducation in schizophrenia (13%)2, showing that caregivers of patients with dementia are highly interested in such interventions. Furthermore, the rarity of psychoeducation in dementia is surprising because such interventions have been shown to reduce suffering of both caregivers and patients, to delay the time of institutionalization of the patients and to reduce health-care costs.1,3 Great efforts need to be made in the future to offer such interventions more frequently.

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