The development and testing of a multidimensional instrument to assess the reactions of family members caring for elderly persons with physical impairments, Alzheimer's disease, and cancer is reported. Forty items were administered to a sample of 377 caregivers of persons with physical impairments and Alzheimer's disease. Five dimensions of caregivers' reactions were identified through exploratory factor analysis. Using confirmatory factor analysis on an independent sample (N = 377), these dimensions were tested for factorial invariance across spouse and nonspouse caregivers and between caregivers of persons with cancer and those caring for persons with Alzheimer's disease. The subscales also had a high level of factorial invariance across a three-wave panel study (N = 185). The subscales appeared consistent with first order tests of construct validity.

This study describes family caregiver perceptions of the experience of loss and grief as it occurs prior to and following the death of a relative with dementia. A content analysis was conducted of responses to open-ended questions by a sample of 82 primary caregivers participating in a longitudinal study who had experienced the death of their relative with dementia. Six themes were identified: loss of person and relationship, loss of hope, predeath grief, expectancy of death, post-death relief, and caregiving reflections. Implications for clinical practice and research are presented.

In this paper three categories of variables were identified to predict spouses' reactions to caregiving roles: patient characteristics, the caregiving environment, and characteristics of the caregiver. Measures of these variables were administered to 159 spouse caregivers. Four domains of caregivers' responses were identified: negative emotional reactions, feelings of responsibility for the patient, feelings of abandonment by family, and impact of caregiving on daily schedules. These domains were influenced most by patient negative behaviors, physical health, and age, and by caregiver age, employment, and emotional status. Amount of assistance, affective support, and hours of care also were predictive of spouse responses.

Previous research has not taken into account the influence of attitudinal variables on the use of community services by dementia caregivers. The Community Service Attitude Inventory (CSAI) was developed to provide a measurement tool to further understanding of community service use by family caregivers. Testing of the CSAI revealed five distinct components of family attitudes toward use of community services.

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