2004 Zenith Fellows Award

The direct impact of Alzheimer’s disease is an individual’s loss of memory and other thinking skills, but the disease influences the emotional and psychological well-being of the person with the disease, the well-being of his or her spouse, and the quality of their relationship. Although counseling has often been used as an intervention for couples affected by Alzheimer’s, each person’s needs have usually been addressed separately without sufficient appreciation of the importance of the couple’s ongoing relationship. Counseling each person separately may make it difficult to understand the contribution of the ill person to the relationship and may disregard complex relationship roles beyond that of “caregiver” and “patient”.

Mary S. Mittelman and her colleagues will assess the effectiveness of a couples counseling program among people recently diagnosed with Alzheimer’s or in early stages of the disease and their spouses. Couples will be randomly assigned to counseling or to a three-month waiting period before counseling begins. This strategy will enable the investigators to compare the outcomes of therapy, no therapy, and delayed intervention.

Therapy will focus on helping each individual express feelings, needs and issues that have emerged since a diagnosis was made. The researchers have hypothesized that counseling will help spouses maintain the quality of their relationship and the support that they give each other. The counseling may also lead to better use of formal support services and a reduction in depression, anxiety or related mental health disorders that can affect people with the disease or their spouses. The outcomes of this study may lead to long-term investigations, which would be necessary to establish couples counseling as a standard practice in Alzheimer treatment and care.