Effects of formal supports on stress outcomes in family caregivers of Alzheimer's patients

Abstract

The aim of this study was to examine whether formal support and coping would mediate the effects of primary stressors and caregiver characteristics on three stress outcomes: yielding of role, anxiety, and physical health. Secondary analysis of longitudinal data from a convenience sample of 452 spouse and adult child caregivers of Alzheimer's patients was used for model testing. Path analysis suggested that decreased physical health of the caregiver was best explained by caregiver overload. Caregiver anxiety was explained by lower levels of care receiver dependency, higher levels of caregiver overload, and higher levels of caregiver anxiety measured 1 year earlier. Yielding of the caregiver role was explained by the direct effect of higher levels of care receiver problem behaviors as well as more use of formal supports. Spouse relationship had a negative effect and care receiver dependency had a positive effect on yielding of the role through the mediating influence of formal support. Neither coping nor formal support mediated primary stressors and caregiver characteristics in the directions hypothesized.

A systematic review of the prevalence and covariates of anxiety in caregivers of people with dementia

“…Anxiety scores have also been correlated in studies previously discussed, with: more hassles relating to CR morbidity in caregivers of institutionalized CRs (Stephens et al, 1991); higher depression levels and poorer physical health in Italian female co-resident CGs recruited from a dementia out-patient clinic (Sansoni et al, 2004); and poor physical health in CGs of people living at home and in institutional care, recruited through the ADA, local newspaper advertisements and caregiver group newsletters (Winslow, 1997). No relationship was found between anxiety scores and heart rate reactivity to stressful situations in CGs aged 50+ recruited from the local ADA, caregiver resource and counseling centers (Knight and McCallum, 1998).…”

“…Another level-4 study (Winslow, 1997) reported data from CGs recruited through the ADA, local newspaper advertisements and newsletters for caregiver groups, some of whom cared for a CR in fulltime care. Anxiety at one year was predicted by greater CR dependency, caregiver subjective burden, and baseline anxiety.…”

Differential features of burden between spouse and adult-child caregivers of patients with Alzheimer's disease: An exploratory comparative design

“…As regards the use of external resources, adult-child caregivers receive more help from other people (Lawton et al, 1991), show a greater tendency to make use of community resources (Winslow, 1997;Robinson et al, 2005;Sanders et al, 2008), and are more likely to place the patient in institutional care (Montgomery and Kosloski, 1994;Winslow, 1997;Zhu et al, 2008).…”

Systematic review of respite care in the frail elderly

“…29, These are summarised in tabular format in Appendices 4-7, classified according to study design (26 RCT/quasiexperimental papers; 29, 14 longitudinal beforeand-after papers; [57][58][59][60][61][62][63][64][65][66][67][68][69][70] 19 longitudinal papers; [71][72][73][74][75][76][77][78][79][80][81][82][83][84][85][86][87][88][89] and 45 cross-sectional observational papers ). In some cases more than one paper refers to the same study and so the number of studies at each level of evidence was seven RCTs, 12 quasiexperimental studies, 13 longitudinal before-andafter studies, 13 observational longitudinal studies and 40 observational cross-sectional studies.…”

“…74,77,[84][85][86]88 The methods and results of these studies were heterogeneous and it is difficult, therefore, to draw any firm conclusions because of the lack of definitions and the variation in study contexts. One further study 87 reported on institutionalisation but did not have data linking respite and institutionalisation.…”