On Saturday mornings, Cyndi Mariner puts on her Nikes, grabs a hat, and heads for Shoreline Park in Mountain View, Calif. Joining a handful of other people caring for elderly parents, she walks for an hour along San Francisco Bay. The walkers watch the kayaks and sailboats on the water, notice the hummingbirds buzzing across the trail. And they talk about things like how not to scream when your loved one with dementia has asked you the same question five times in a row.
The program that brings them together, called Meet and Move, began just a few weeks ago, but "I've already noticed a significant boost in my spirits," said Ms. Mariner, 55.
Four years ago, she moved in with her ailing mother, now 84 and in need of a great deal of help. "I was getting tired, mentally and physically," she said. Besides walking with other caregivers twice a week, Ms. Mariner religiously monitors the pedometer that the program provided; often she adds a 20-minute amble after work, or parks her car at the far end of the supermarket lot, aiming to record 10,000 steps a day. She has come to recognize, she said, that "I have to take better care of myself in order to take care of Mom."
Sometimes the best ideas are the simplest. El Camino Hospital in Mountain View and the Palo Alto Medical Foundation wanted to help family caregivers take a break, get some exercise and connect with others.
"By focusing on caregivers, we could improve the health and well-being of seniors and at the same time deal with the tremendous caregiver burden and burnout we see in our daily practices," said Dr. Sangeeta Kopardekar, chairwoman of geriatrics and palliative care at El Camino.
Traditional support groups serve that purpose, too, and have been shown to reduce caregiver stress and depression. But not everyone wants to sit in a circle of chairs and share. Some might find exercise, also a potent way to relieve stress and improve health, more palatable.
We are learning more about caregiver burden and its potentially pernicious effects. "Caregiver stress increases the likelihood of depression, other mental health symptoms and illness," said Steven Zarit, a Penn State geriatric psychologist who has led research on the topic for years. Predictable breaks from caregiving, he and his team have shown, are "very important emotionally, but also at a physiological level."
A study by Mr. Zarit and his colleagues, recently published in the American Journal of Geriatric Psychiatry, is among the first to demonstrate that a helpful intervention can affect not only caregivers' moods but their stress hormone levels.
The researchers asked 151 caregivers who lived with relatives who had received a diagnosis of dementia — one of the highest-stress situations — to collect their saliva five times a day for eight days. Later analysis showed that caregivers' levels of DHEA-S, a hormone that protects against the harmful effects of other stress hormones, were significantly higher on days after their relatives attended an adult day program.
In nightly phone interviews, the caregivers also scored higher on scales measuring positive mood on those days, reporting greater cheerfulness, calm and closeness to others.
Might other kinds of interventions — like regularly walking with other caregivers — have similar physiological effects? It's hard to say, and the Meet and Move program isn't designed to find out. But early participants — 32 have enrolled to date, most women, most caring for a spouse or parent — seem enthusiastic.
"Sometimes you just need to talk about it," said Margaret Hsieh, 72, who shares the care of a demanding 98-year-old mother. "It was a godsend to get to know other people in a similar situation. And it gets us out."
To help keep participants active and connected, Meet and Move provided water bottles and pedometers to those who signed up and asked them to log their physical activity and social interactions. A facilitator stays in touch by email, sometimes forwarding articles of interest. Every four weeks, those who send in their logs receive a $25 Visa or MasterCard gift card.
In parts of the country with less-enviable weather, of course, people starting such efforts would have to do some of their walking in malls, or other climate-controlled places with less sunshine and fewer hummingbirds.
I could also envision a more targeted reward for participating: an hour of home care. Meet and Move or similar programs could negotiate volume discounts with agencies, then provide caregivers with that rare thing, an hour off the clock.
Though Ms. Mariner, I should add, sounded quite pleased about her gift card. She works nearly full time, in addition to taking care of her mother, and she knew just how she planned to use it. "I'm going to get a massage," she said.
Paula Span is the author of "When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions."
