The burden of caring for a family member with Alzheimer's disease is well recognized and much has been written about the effects on family members in the literature. The study by Lieberman and Fisher looked at how putting the patient in a nursing home affected the health of the caregivers (Lieberman and Fisher, 2001). Past studies have shown that there is an improvement in the health and well-being of caregivers once the burden of caring for the Alzheimer's patient is relieved by placing them in a nursing home. Many factors influence the decision to place an Alzheimer's patient in a nursing home, such as amount of family help available, health of the caregiver (often an elderly spouse), affect on second-generation marriages, and available community help. This study looked at the effects of institutionalization on several family members as well as the primary caregiver. It explored how the family caregiving setting, demographic characteristics of the patient and caregiver, and severity of the patient's functional deficit qualified the relationship between institutionalization and changes in family members' health and well-being.
Families for the study were recruited from eight university-based Alzheimer's centers in California. Criteria for acceptance in the study were a diagnosis of probable or possible Alzheimer's disease; at least one adult offspring living in California; and the patient living in the community, either with a spouse or the offspring. Two-hundred and thirty five families qualified for the study, including 89 spouses, 184 offspring, and 136 in-laws; 87.7 percent were Caucasian and 12.1 percent were ethnic minorities. The patients were divided into two groups: those institutionalized within six months of diagnosis, and those not institutionalized for two years following diagnosis. Patients and spouses were contacted first, then the offspring most involved in patient care, then an in-law not married to the...