Do caregiver management strategies influence patient behaviour in dementia?

Abstract

Caregiver management strategies would appear to be associated with behavioural problems in dementia, and are important in predicting patient behaviour and caregiver burden. Intervention programmes should aim at teaching caregivers adequate management strategies.

Influence of personality on caregiver's burden, depression and distress related to the BPSD

“…Various studies have mentioned that caregivers with high levels of neuroticism use maladaptative strategies in dealing with patients' behaviours (Vugt et al, 2003;Chappell and Dujela, 2009). They primarily approach the patient with impatience, irritation or anger, and try to manage behavioural problems by confronting or ignoring the patient (Vugt et al, 2004). Some caregivers tend to respond with irritability, criticism and confrontation to patients' recurrent forgetfulness, mistakes in performing daily tasks, lack of initiative in engaging in activities, and low expression of affection towards the presence of relatives and friends.…”

“…Some caregivers tend to respond with irritability, criticism and confrontation to patients' recurrent forgetfulness, mistakes in performing daily tasks, lack of initiative in engaging in activities, and low expression of affection towards the presence of relatives and friends. Consequently, they frequently cause a mirror-response of aggressiveness, agitation, or on the contrary of disquiet and dismay in the patient (Zarit, 1996;Vugt et al, 2004). In clinical practice, one usually finds caregivers with difficulties in understanding and tolerating ideas expressed in delirium or in the hallucinations of their patients.…”

“…Int J Geriatr Psychiatry (2011) more hyperactivity symptoms over time, as a direct response to the caregiver's attitudes such as impatience or irritation (Vugt et al, 2004). It has been proposed that the factors associated with the caregiver have greater impact on depression and burden than those relating to the patient (Zanetti et al, 1998;Campbell et al, 2008).…”

“…The objective and subjective burden of care and psychiatric morbidity, namely depression, are associated with specific characteristics of the caregiver (Sink et al, 2006) and influence some factors of the own caregiver, as the caregiver's coping strategies to deal with the symptoms and meaning of the illness (Vugt et al, 2004). However, it has been suggested that interventions to improve coping strategies only offer moderate success (Brodaty et al, 2003) and there is a call for a more individualized approach with an increase in knowledge of the differences and variability in caregivers (Mittelman et al, 2004;Carratero et al, 2007).…”

Challenge Demcare: management of challenging behaviour in dementia at home and in care homes – development, evaluation and implementation of an online individualised intervention for care homes; and a cohort study of specialist community mental health care for families

“…Most people are distressed by behaviours such as screaming, repetitive questions, violence or behaviour of great intensity. Nevertheless, in many cases, individual characteristics of family carers 51,52 or care staff are often as important as severity of behaviour in determining whether or not, or to what degree, the behaviour is perceived as challenging. These factors include limited understanding of the changes associated with dementia; lack of support; limited skills; pejorative attitudes to people with dementia or older people; and mood disorders in caregivers.…”