Treating Anxiety and Depression in Family Caregivers of People with Dementia with CBT Interventions

TREATING ANXIETY AND
DEPRESSION IN FAMILY
CAREGIVERS OF PEOPLE
WITH DIAGNOSIS OF
DEMENTIA WITH
COGNITIVE-
BEHAVIOURAL THERAPY
INTERVENTIONS CBT

ABSTRACT
The research was focused on the experience of family caregivers suffering from anxiety and
depression while providing care to their close ones suffering with dementia. It does not lay much
emphasis on treating the patients suffering from dementia but the anxiety and depression of
family caregivers who provide care to those patients. For this, the research was done to solve
these issues and to analyse the effectiveness of CBT in treating the anxiety and depression of
such family care givers. So, the major focus of the research was to improve the symptoms of
those family care caregivers and provide them with certain strategies which help them to manage
the symptoms. Literature review was done by going through already published research papers,
articles etc. Appropriate methods were chosen which helped in doing the research more easily
and accurately. Data was analysed through thematic analysis to obtain suitable interpretations
which can contribute in achieving the objectives of the research.

TABLE OF CONTENTS
ABSTRACT....................................................................................................................................2
INTRODUCTION...........................................................................................................................4
Literature Review............................................................................................................................5
Theme 1: Evaluate impact of anxiety and depression family caregivers of people with
treatment of dementia..................................................................................................................5
Theme 2: Explore the challenges in determining anxiety and depression in family caregiver of
people with diagnosis of dementia..............................................................................................6
Theme 3: Evaluate the base for CBT on family caregivers of dementia.....................................7
Theme 4: To evaluate significance of CBT in the treatment of choice in specific aspects of
anxiety and depression family caregivers experience.................................................................8
Rationale and justification...........................................................................................................9
Research Aims and Objectives....................................................................................................9
Research Questions....................................................................................................................10
RESEARCH METHODOLOGY..................................................................................................10
Data and information sources....................................................................................................11
Inclusion and Exclusion criteria................................................................................................11
Study Quality.............................................................................................................................12
Critical appraisal tools...............................................................................................................12
ETHICAL CONSIDERATIONS...............................................................................................13
DATA ANALYSIS.......................................................................................................................13
Results and Findings......................................................................................................................16
Coding........................................................................................................................................16
Discussion..................................................................................................................................17
Implications for practice............................................................................................................17
Strengths and Limitations of the critical review........................................................................17
Dissemination of review............................................................................................................18
CONCLUSION..............................................................................................................................18
REFERENCES..............................................................................................................................20

INTRODUCTION
Anxiety and Depression has become one of the major issues across the world because
there are lots of people in young age who are suffering from such mental illness, so it has
become big discussion point for everyone. Depression and anxiety are not only the reason of
personal issues but also there are some work-related stress and depression that have in people
due to undue pressure. these are long-term mental health illness which is more dangerous to
themselves rather than others. Estimated 80 to 90% of people are experiencing mental distress
and they die by suicide. 1 in 4 people experience mental health issues each year means around
792 million people are affected by this mental illness across the world. In fact, it is considered
the second largest source of burden disease in England, UK. The mental illnesses are more
common, impactful and long lasting rather than other health issues (Allen and et.al., 2017). So,
there are various healthcare, personal centred care etc. service companies are available for such
people with mental illness to treat them promptly. This report will provide understanding about
experience of caregivers while treating anxiety and depression in family. In this context,
literature review will be used to highlight overall issues and solution for treating mental illness
i.e. anxiety and depression.
Literature Review
Theme 1: Evaluate impact of anxiety and depression family caregivers of people with treatment
of dementia
According to Barnes and Markham, (2018), family caregivers are family, friends or
neighbours who offers support related to people with mental or physical disability at home for
care delivery as well as assist in the daily routine activities. However, they do not get any
payment or do not have any formal training to offer such services to the patient with mental
disorder. A recent study stated that around 26.6% of all British adults have become family
caregivers currently. At 2012 report by the Dementia’s Association stated that estimated 15
million of those family caregivers are offering their care services to the people with mental
disability. By 2009, around 61.6 million caregivers were offering ‘unpaid’ care to such people.
Such caregivers are relatives who gives emotional, financial, nursing, social, homemaking and
other services to ill and disable person on daily basis. Most of the family caregivers spends their
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more time to support with the care needs of a loved one. Other Farrand and et.al., (2020) have
quoted in their published research articles about family caregivers people with dementia. That
such people are known as second patients because being a family caregiver, they have high rates
of burden and psychological mobility due to this they become socially isolated, financial
hardship and physical ill health. Currently, there are around 30 million people with dementia
across the world and this figure always become double per 20 years. As know people with
dementia needs high level of care, which is often provided by family caregivers. In the absence
of caregivers, people with dementia would spend poorer quality of life and needs institutional
care more effectively. Dementia caregivers are at on high risk of various health issues including
cardiovascular problem, lower immunity, poorer immune response to vaccine, high level of
chronic conditions i.e. diabetes, arthritis, ulcers etc., poorer self-rated health, alcohol and
cigarette consumption and poor sleep pattern. Hopkinson and et.al., (2019) illustrated in their
books about effect of dementia on family caregivers that they face various obstacles as they keep
balance between caregiving and other demands i.e. child rearing, career and relationship. So,
they become at high risk of burden depression, stress and other variety of health complications.
Dementia leads lots of burden over caregivers because they have to recall patient about their
identity again and again and often they think that someone is going to harm them. Such thoughts
arise risks for the caregivers because they are not only taking care of their physical and mental
health but also, they have to give full attention on their daily routine life. Such consequences
make them feel too stressful and anxiety. Apart from this, caregivers often lacking behind of
social contact and support that experience makes them feel socially isolated. They always tend to
scarify their leisure’s and hobbies, restrict time with family and friends as well as give up
employment. These all situation brings fewer negative psychological symptoms in family
caregivers.
However, some Jackson and Browne, (2017) have criticized above sated fact in their
published research articles that family caregivers gets positive prospects as well because they
enable to treat patient with dementia more promptly and enables to offer them all type services
I.e. financial, social, caring and others to the people. authors said that each person wants that
they get family support if they are suffering from any mental health issue wherein family
caregivers are the best option for them because they do not have to invest money on formal
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training or other nursing services. Apart from this, family caregivers enable to spend maximum
period to the patient with dementia as compared other caregivers.
Theme 2: Explore the challenges in determining anxiety and depression in family caregiver of
people with diagnosis of dementia
Illustrated by Kaddour, (2017), the average prevalence of mental disorder across the
world is around 13.4% and 30-50% of psychiatric patients. However, family caregivers play vital
role in reducing hospital admission for example they able to manage and control the psychiatric
patients (PPs)and their disease. So, family caregivers of PPs suffers from great pressure
mentally, physically and socially in the context of control and care of the sick member of the
family. In fact, patients and their families are continuously affected by the changes that arises
from the disease and it’s treatment. Such changes gradually decrease level of performance and
the ability of family caregivers, leads ineffective relationship among family members, emergence
of economic and financial issues, changes in role and reduce social interaction of family and
brings emergence of symptoms i.e. anger, feeling guilty etc. Overall, it brings mental burden of
care for a psychiatric patient while decreasing the quality of life of family caregivers which can
endanger their mental and physical health, ultimately leads poorer care or can lead violent
behaviour with the patient. So, if family caregivers are left without social support then they can
also be considered as hidden patients. Noone and et.al., (2019) stated in books that family
caregivers have main goal to offer high quality care services to the people with dementia so that
they become act like normal. Most of the time it happens when family caregivers do not get time
for themselves that makes them feel alone and creates pressure on them as well because being
family caregivers have responsibility to give proper support in term of financial, physical,
mental, social and care to the people with dementia. In that state, family caregivers unable to
determine that they are suffering from anxiety and depression.
Theme 3: Evaluate the base for CBT on family caregivers of dementia
As per the view of Sadek, Hoe and Orrell, (2018), Cognitive behavioural therapy (CBT)
is a talking therapy that supports individual to fix up their issues by modifying the way they
think and act. It is one of the most commonly used therapy that is used to treat anxiety and
depression. This therapy can be useful for the other physical and mental health issues. It is
gradual process that helps individuals to take appropriate action with presence of mind. For
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