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Electrodes, attached to Yvette Ortiz’s forehead and hooked up to a computerized biofeedback monitoring system, measure muscle tension in her face. As she performs breathing exercises and becomes more relaxed, the system’s Freeze-Framer picture (left), which starts out in black and white, begins to fill with color. A screen that is completely colored means Ortiz has achieved a healthy, relaxed state.
School of Nursing
Stressbusters
Researchers work to boost immune function of people who care for Alzheimer’s patients
By Natalie Gutierrez
At 35, Yvette Ortiz was at the prime of her life. Yet she felt just the opposite — tired, achy, irritable and depressed. Something wasn’t right within the walls of her veins.
Last year, after the death of her mother, Ortiz became the primary caregiver for her 82-year-old grandmother, who has Alzheimer’s disease. Torn between her undying love for her grandmother and the difficulty of caring for an ill loved one, Ortiz’s frustration soon turned into a deep depression.
Just when she was at the end of her rope, Ortiz learned about a program specifically aimed to help caregivers for people with Alzheimer’s disease. The "Relaxation Therapy and Stress Management for Caregivers" study, funded by the National Institutes of Health, is directed by Sharon Lewis, R.N., Ph.D. The purpose of the study is to determine the effectiveness of relaxation therapy to improve the quality of life, enhance the immune function and promote the relaxation responses of caregivers for individuals with Alzheimer’s disease. Dr. Lewis is professor of acute nursing care and the Castella Distinguished Professor at the Health Science Center. She also is a clinical nurse scientist at the Geriatric Research, Education and Clinical Center at the South Texas Veterans Health Care System.
In Bexar County, an estimated 39,000 people have Alzheimer’s disease or related disorders. According to the National Family Caregivers Association (NFCA), the number of persons in the United States who provide care for an elderly, disabled or chronically ill friend or relative doubled in the year 2000.
Dr. Lewis says that number will continue to grow. "Caregivers provide an amazing service for their loved ones. However, they do it at a high emotional and physical cost to themselves," Dr. Lewis said.
The field of psychoneuroimmunology plays a large role in the framework of Dr. Lewis’ study. Psychoneuroimmunology focuses on the study of the interactions between the brain and the immune system. "Our moods and feelings determine the kinds of chemicals secreted by our brains," Dr. Lewis said. "Under stressful situations, more epinephrine, norepinephrine and cortisol are released. These chemicals can inhibit the immune system."
Ortiz is one of nearly 60 caregivers ranging in age from 35 to 87 who participate in the study. Their mental and physical parameters are monitored. Dr. Lewis’ staff use state-of-the-art biofeedback equipment to measure subjects’ heart rates, muscle tension, skin temperatures and sweat gland activity. Caregivers’ blood samples are drawn to determine various immune functions. One test in particular investigates the ability of the caregivers’ lymphocytes (a type of white blood cell also called a "natural killer" cell) to destroy cancer cells.
"In patients whose stress levels were unusually high, we found their natural killer cells weak and unable to kill the cancer cells, meaning a compromised immune system," Dr. Lewis said.
After the testing period, patients are instructed on breathing techniques, muscle relaxation, and other techniques to decrease stress and anxiety. Patients return for testing every fourth week for four months. Their progress is evaluated on an ongoing basis.
Dr. Lewis hopes to expand the program to include educational support groups for caregivers of individuals with chronic neurological conditions such as Parkinson’s disease, stroke, multiple sclerosis and dementia. Since many caregivers are not able to leave their homes to attend support groups or therapy sessions, Dr. Lewis plans to create a home-based intervention program using the Web and telephone communication.
Ortiz says the program not only helped her learn to control her emotions and to ease her anxiety, she says it helped her gain a whole new perspective about Alzheimer’s disease and her grandmother.
"The program came at a time when I felt I had no place to turn," Ortiz said. "It saved my life."
Although she completed the program, Ortiz continues her own self-therapy and wellness program at home. The strength of her white blood cells has increased from 12 percent to 26 percent, and she says she can feel it in her veins. With a deeper understanding of Alzheimer’s disease and a healthy mind and body, Ortiz says she is confident that her well-being will continue to flourish.
"I’ve always had a close relationship with my grandmother, but now I feel an even stronger bond," Ortiz said. "I know she [grandmother] sees the positive changes in me and is happy that I’m healthier for the both of us."