Wives, husbands, and daughters of dementia patients: predictors of caregivers' mental and physical health.

The purpose of this study was to investigate differences in and predictors of mental and physical health among wife, husband, and daughter caregivers of dementia patients using a stress and coping framework. The sample of 151 caregivers consisted of 55 wives, 43 husbands, and 53 daughters and was recruited from multiple community-based sources. Variables addressed were caregiver age, social position, years spent in caregiving, dementia severity, burden, worry, physical health, and mental health. Analysis of variance demonstrated gender-specific, kinship group differences in burden (F = 8.09, p = .000), worry (F = 6.287, p = .002), and age (F = 55.27, p = .000). Post hoc comparisons indicated that wives reported worrying most, while husbands were oldest and reported the least burden. Health predictors differed by group, with wives' mental health being predicted by severity of dementia, age, and worry (R2 = .16), husbands' mental health was predicted by burden and worry (R2 = .18); and worry was the only significant predictor of daughters' mental health (R2 = .33). Wives' physical health was predicted by years of caregiving and age (R2 = .10); husbands' physical health was predicted by age and worry (R2 = .24); and daughters' physical health was predicted by years spent in caregiving and burden (R2 = .27). Findings suggest that a stress and coping framework is a better predictive model for daughters' mental and physical health than for health of wives and husbands. Findings further indicate that different health-related nursing interventions may be required for different caregiver groups.

Interventions for caregivers of persons with dementia: educational support groups and Alzheimer's association support groups.

This study compared three groups of dementia caregivers: educational support group (ESG) participants, Alzheimer's Association support group (AASG) participants, and a contrast group (CNG) of nonparticipants. ESG members reported lowest levels of care-receiver impairment. AASG members more frequently were wives, reported highest levels of care-receiver impairment, and expressed highest levels of concerns for themselves. CNG members reported lowest levels of concern for both themselves and their care receiver. As a means of further understanding why caregivers might have selected the ESG or the AASG, underlying group leader, group member, and group process characteristics were examined.

Dementia care-receiver needs and their impact on caregivers.

This study examines home-based persons with dementia, their needs associated with activities of daily living (ADL), cognitive impairment, and disruptive behaviors, and the relationship of these needs to caregiver distress and burden. Findings suggest that selected disruptive behaviors were most distressing to caregivers, and that when disruptive behaviors occurred more frequently, caregivers were significantly more distressed with these behaviors and reported higher levels of burden. The frequency of cognitive impairment behaviors and level of ADL impairment were not significantly related to caregiver burden, but caregiver distress with these needs was significantly related to caregiver burden.

Finding meaning: an alternative paradigm for Alzheimer's disease family caregivers.

Theoretical formulations of stress and coping, family systems, crisis intervention, and loss and grief have inadequately explained how persons might grow and find meaning through their caregiving experiences. An existential theoretical framework guided the data interpretation in a qualitative study of 94 dementia family caregivers. Results suggest that an existential framework provides an alternative paradigm for understanding the caregiving experience.