An analysis of the caregiver's burden and the "breaking-point" when home care becomes inadequate

Abstract

The burden of caregivers of patients suffering from of Alzheimer type dementia (DAT) and vascular dementia (VD) was analysed at the critical time, the "breaking-point", when home care becomes insufficient and/or inadequate and the caregiver burden has probably reached its upper limit. Primary family caregivers of 39 DAT and 40 VD patients who were being considered for relocation into group-living units were studied. Total caregiving burden and different aspects of the burden: general strain, isolation, disappointment, and emotional involvement, were correlated with the patients' diagnoses, abilities, and symptoms. Closer kinship to the patient imposed a heavier burden. The caregiver's gender, social class, and previous institutionalization of the patient did not influence the caregiver burden. There was no significant correlation between the patients' ADL ability or cognition and the burden. A higher level of disappointment was found among the VD carers. Different symptomatology in patients of the two diagnostic groups was related to special aspects of the burden. Multiple regression analysis showed that the amount of caregiving time each week and impaired sense of own identity, misidentifications, clinical fluctuations, and nocturnal deterioration in the patients predicted the breaking-point.

Predictors of institutionalization in patients with dementia in Korea

“…Both patient and caregiver factors play a role in the decision to institutionalize a dementia patient. Predictive patient characteristics include age, gender, type of residence, impairment of activities of daily living (ADL), behavioural and psychological symptoms of dementia (BPSD) (O'Donnell et al, 1992;Haupt and Kurz, 1993), and cognitive impairment (Cohen et al, 1993;Annerstedt et al, 2000). Candidates for caregiver-related predictors include age, gender, relation to the patient, health status (Colerick and George, 1986;Levin et al, 1986;Cohen et al, 1993;Scott et al, 1997), family income (Ferris et al, 1987;Chiu et al, 1998), education (Chiu et al, 1998), and care burden (Jerrom et al, 1993;Martinson et al, 1995).…”

Caregiving for people with dementia in a rural context in South Africa

“…22 Women seemed to be more prone to relational deprivation, which is a restriction in one's social life and feelings of social isolation. 3,23 It has been noted that women tend to use more emotion-focused coping strategies whilst men utilise more problem-focused methods. A combination of mixed coping methods yielded more efficacious results.…”

Complaints of informal caregivers providing home care for dementia patients: The Pixel study

“…Being forced to change working hours in order to look after a parent is a source of problems specific to daughters of dementia patients. The female caregivers are themselves vulnerable as far as their health is concerned (Adler et al, 1996;Annerstedt et al, 2000;Burns, 2000), and exposed to depression (Pruchno and Resch, 1989;Boss et al, 1990;Mittelman et al, 1995;Livingston et al, 1996;Kaplan and Boss, 1999;Clyburn et al, 2000) as is the case in this study. Support for caregivers should therefore be directed both at the concept of quality of life (Yates et al, 1999), and at ensuring that the caregiver is in good health (Boss et al, 1990;Zarit et al, 1999).…”