Men and women who care for a spouse with dementia often rely primarily on the nuclear family for emotional and instrumental needs, and they may have trouble asking for help from services in the community or may be unfamiliar with those services. A nonprofit, community-based rehabilitation agency in Toronto has used network therapy to help caregivers of patients with dementia enlist the assistance they need from their informal social network and from formal services in the community.

A nine-month pilot study of network therapy recruited seven caregivers—five men and two women— with an average age of 66.5 years who could identify a minimum of four people in their social network and who expressed some dissatisfaction with the support they received. A master's-level social worker or psychologist worked individually with each caregiver to determine how to mobilize members of the network.

Outcomes for individual participants included increased size of their informal and formal support network, increased assistance from members of the informal network, and increased use of formal support services. Study participants reported using some community services, such as medical specialists, transportation, meal services, and homemaking services, for the first time. In addition, their overall satisfaction with formal and informal social support increased. (Carole A. Cohen, M.D., Sunnybrook Health Science Center, 2075 Bayview Avenue, North York, Ontario, Canada M4N 3M5)