Chronic disease in the elderly and its impact on the family: A review of the literature

Medical literature from 1986 through 1992 was reviewed in order to investigate the impact of specific chronic diseases in the elderly on the physical and psychological health of members of the patient's family. The results of 65 research reports and 9 reviews are discussed. It is not possible to draw definite conclusions regarding cause and effect with respect to the impact of specific chronic diseases upon the health of family members since most research carried out on this topic has been cross-sectional, with no appropriate control groups. Most research reports did not satisfy agreed- upon quality criteria. The majority of research reports dealt with the impact of Alzheimer's disease in elderly patients upon the health of spouses and children. Much less research has been conducted into the influence of other frequently occurring chronic diseases in the elderly. However, it can be concluded that both the psychological and physical health of spouses and children of chronically diseased elderly people seem to be negatively affected. The detrimental impact of caregiving is especially clear in female spouses of elderly male patients. The most important factor affecting the health of the family members is the quality of the marital relationship and, in particular, the amount of social support the patient is able to give to the spouse. Disease-specific characteristics such as communicative disabilities in cases of senile dementia and cerebrovascular disease, impending death in terminal cancer, or the opportunity for behavioral changes that will influence the risk of recurrence in myocardial infarction, help to explain differences in the intensity of the impact that different chronic diseases have on family members.