Relationships Among Caregiver Factors and Quality of Life in Care Recipients with Irreversible Dementia

Abstract

Using Lawton's (1983) model of quality of life (QoL) in older adults as a guiding framework, the central purpose of this ongoing longitudinal, prospective study is to examine predictors of QoL outcomes in persons with irreversible dementia as they move through the disease stages. From an initial sample of 96 caregiver/care recipient pairs, 73 (N = 146) pairs remain at the 18-month data collection point. Changes in care recipient outcomes from baseline to the 18-month assessment include significant declines in mental status, productive behaviors, and functional ability, with a statistically significant improvement in depression. Controlling for 12-month mental ability, caregiver factors at 12 months predicting care recipient QoL outcomes at 18 months include psychologic well being predicted by the quality of the relationship with the caregiver and activity participation. Depression was predicted by activity participation as well. Care recipient functional ability was predicted by activity participation and caregiver role stress (disruption to routines and social functioning). Two of the three aspects of care recipient productive behaviors were predicted by caregiver factors, with quality of the relationship predicting problem solving and caregiver role stress (negative attitudes toward care recipient) and total social contacts predicting care recipient social behaviors in the expected direction. Lawton's QoL model was supported by this analysis, with a total explained variance of 32% for three (psychologic well being, productive behaviors, functional ability) of the five (physical impairment and perceived personal control not included) components of care recipient QoL outcomes.

Factors Associated with Caregivers’ Underestimation of Quality of Life in Patients with Alzheimer’s Disease

“…These results are also in concordance with the results of recent studies [13,14]. Indeed, such discrepancies in evaluation have been noted in most QoL studies that have recorded both the patient’s evaluation and that of the caregiver [9,10,16,28,29].…”

“…Nonetheless, a tendency towards underestimation of the patient’s QoL by the caregiver on more subjective outcomes has also been reported [11,12]. Recent studies reporting a difference in evaluation of QoL-AD between patients and their caregivers have suggested that these discrepancies could be due to depression in the caregiver, and the extent of their caregiving burden [13,14,15,16]. …”

Assessing quality of life in Taiwanese patients with Alzheimer's disease

“…Although we cannot rule out the possibility that patients with severe dementia lack disease insight, our study supports the results of previous studies conducted in Western countries. These studies also showed the caregiver rating was related to caregiver's level of perceived burden and depression (Karlawish et al, 2001;Burgener and Twigg, 2002;Sands et al, 2004). These findings might be a culturally common phenomena.…”

“…Previous studies have shown that the caregiver report differs from the patient report, and these discrepancies might be associated with the caregivers' burden and depression (Burgener and Twigg, 2002;Sands et al, 2004). Since the QOL assessment is subjective, the caregiver report obviously cannot replace the patient report.…”

Effects of Dementia Knowledge, Self-Efficacy and Depression on Dementia Preventive Behavior in Elderly Couples: Dyadic Data Analysis

“…www.kan.or.kr 치매지식, 자기효능감 및 우울이 노인부부의 치매예방행위에 미치는 영향: 커플관계자료 분석방법적용 삶의 질을 저하시키고 (Lee, Lee, Yang, & Jun, 2008;Park & Kim, 2009), 가족에게는 부양 부담을 증가시킨다 (Burgener & Twigg, 2002;Lee, 2011).…”