The Role of Family and Supporter Accommodation in Late-Life Anxiety

Abstract

Objectives: Family accommodation (e.g. providing excessive reassurance, facilitating avoidance) is widespread and exacerbates anxiety in children and young adults, however has not been examined in older adults. There are reasons to expect that family accommodation may also exacerbate anxiety in later life. However, it is important to consider that age-related changes in physical or cognitive abilities may necessitate the need for functional assistance from others during assessment. This study aimed to examine the phenomenology and clinical correlates of family accommodation in older adults. Methods: Participants were 32 community-dwelling older adults, aged 60–88 (M = 69.78, SD = 8.62; 31% with a probable anxiety disorder) and their supporters. Dyads reported on supporter accommodation, mental health and functional ability and completed a behavioral stress task designed to elicit behavioral accommodation (intrusiveness, reassurance, and avoidance). Results: 80% of supporters of older adults with anxiety engaged in accommodation. Accommodation was associated with greater anxiety severity, but not functional ability. Conclusions: Family accommodation is common from supporters of older adults with anxiety, and linked to increased anxiety. Assessment and modification of these environmental reinforcers may be important targets for treatment. Clinical Implications: Accommodation is an important environmental factor maintaining late-life anxiety, and should be reduced.