Comparison of the burdens of family caregivers and foreign paid caregivers of the individuals with dementia

2012 ◽  
Vol 24 (12) ◽  
pp. 1953-1961 ◽  
Author(s):  
Wei-Chen Lin ◽  
Chia-Fen Tsai ◽  
Shuu-Jiun Wang ◽  
Jeng-Ping Hwang ◽  
Jong-Ling Fuh
Keyword(s):  
Family Caregivers ◽  
Caregiver Burden ◽  
Behavioral Problems ◽  
Neuropsychiatric Symptoms ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Clinical Dementia Rating ◽  
Adequate Treatment ◽  
Severity Of Dementia ◽  
Paid Caregivers

ABSTRACTBackground: The caregiver burden on foreign paid caregivers (FPCs) is currently not well understood. This study identified predictors and differences in caregiver burden between FPCs and family caregivers who provided care for patients with dementia.Methods: We recruited 489 patients with dementia (diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition) and used the Neuropsychiatric Inventory (NPI) and Clinical Dementia Rating (CDR) Scale to assess their neuropsychiatric behavioral problems and severity of dementia. All caregivers [FPCs (n = 42) and family caregivers with (n = 42) and without (n = 447) FPCs] completed three questionnaires: the Zarit Burden Interview (ZBI), the Center for Epidemiological Studies–Depression Scale (CES-D), and caregivers’ knowledge of dementia (KD). To understand caregiver burden, we analyzed the correlations between ZBI and other variables and investigated the differences between family caregivers and FPCs.Results: NPI and CDR scores were higher among patients assisted by FPCs than among those whose families did not employ FPCs. Burdens were greater among family caregivers assisted by FPCs than among FPCs and family caregivers who were not assisted by FPCs. Family caregivers had greater knowledge of dementia than did FPCs. For family caregivers, CES-D scores (Spearman's r = 0.650; p < 0.01) and patients’ NPI scores (Spearman's r = 0.471; p < 0.01) were correlated with caregiver burden. For FPCs, only CES-D scores (Spearman's r = 0.511; p < 0.01) were correlated with caregiver burden. A linear regression model showed that CES-D scores contributed most to caregiver burden in all groups [β = 0.560 (family caregivers without FPCs), 0.546 (family caregivers with FPCs), and 0.583 (FPCs); p < 0.005].Conclusion: Both family caregivers and FPCs need emotional support. Adequate treatment to reduce the neuropsychiatric symptoms of patients with dementia might reduce the burden on family caregivers.

scholarly journals Iterating a framework for the prevention of caregiver depression in dementia: a multi-method approach

2017 ◽  
Vol 30 (8) ◽  
pp. 1119-1130 ◽  
Author(s):  
Jiangbo Ying ◽  
Philip Yap ◽  
Mihir Gandhi ◽  
Tau Ming Liew
Keyword(s):  
Family Caregivers ◽  
Behavioral Problems ◽  
Recent Literature ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Extensive Literature ◽  
Caregiver Depression ◽  
Wide Range ◽  
Multi Method Approach ◽  
Method Approach

ABSTRACTBackground:Dementia caregiving is often stressful and depression in family caregivers is not uncommon. As caregiver depression can have significant effects, there is a need for preventive efforts which are consistent with the extensive literature. We sought to consolidate the wide range of evidence (using a multi-method approach) into a simple framework that can guide the prevention of caregiver depression.Methods:Using multiple logistic regression, we derived the predictors of caregiver depression from an empirical dataset containing key information and depression scores (based on the Center-for-Epidemiological-Studies-Depression-Scale) of 394 family caregivers. We then chose an underpinning theory as the foundation of the framework, and conducted an umbrella systematic review to find possible links between the derived predictors and the theory. Last, we compared the iterated framework with known interventions for caregiver depression in recent literature to assess whether the framework could map meaningfully with the known interventions.Results:Significant predictors of caregiver depression included primary caregiver (odds ratio, OR = 1.53), severe dementia (OR = 1.40), and behavioral problems (OR = 3.23), lower education (OR = 1.77), and spousal caregivers (OR = 1.98). The integrated framework derived focuses on four strategic areas: physical-care demands of persons with dementia (PWD), behavioral problems of PWD, caregiving competency, and loss and grief of caregivers. This framework is supported by known interventions for caregiver depression in recent literature.Conclusions:By consolidating a broad range of evidence, we iterated a framework to aid the understanding and prevention of caregiver depression in dementia. The framework offers an approach to prevention which is simple, systematic, and reflective of the extensive literature.

scholarly journals Neuropsychiatric symptoms and severity of dementia

2013 ◽  
Vol 7 (2) ◽  
pp. 171-175
Author(s):  
Gustavo Henrique de Oliveira Caldas ◽  
Sueli Luciano Pires ◽  
Milton Luiz Gorzoni
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Motor Behavior ◽  
Neuropsychiatric Symptoms ◽  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Clinical Dementia Rating ◽  
Cross Sectional ◽  
Specific Stage ◽  
Severity Of Dementia

ABSTRACT Neuropsychiatric symptoms (NPS) cause distress, disabilitiy and reduced quality of life for both the patient and their families Objective: To evaluate the prevalence of NPS as a specific stage of dementia status. Methods: A cross-sectional study in patients attending an outpatient clinic for dementia was performed. We applied the Neuropsychiatric Inventory and Clinical Dementia Rating (CDR) scale. Statistical analysis was carried out with SPSS 17 software. Results: The 124 subjects (mean age of 80.4±7.0 years), 88 women (70.9%) had average duration of dementia of 7.1±3.2 years, most common dementias of Alzheimer's disease (35.5%) and mixed (31.5%) and most prevalent NPS of apathy (75%) and irritability (66.9%). Correlation between apathy and a CDR 1 had a PR (prevalence ratio) = 0.289 and p<0.001 while between apathy and CDR 4-5 (PR=8.333, p<0.005). A similar result was found between aberrant motor behavior (AMB) and CDR 1 (PR=0.352, p<0.003) and between AMB and CDR4-5 (PR=2.929, p<0.006). Conclusion: Alzheimer's disease and mixed dementia were predominant, while apathy and AMB were detected in association with the progressive stages of dementia.

scholarly journals Neuropsychiatric symptoms as the main determinant of caregiver burden in Alzheimer's disease

2011 ◽  
Vol 5 (3) ◽  
pp. 203-208 ◽  
Author(s):  
Renata Kochhann ◽  
Ericksen Borba ◽  
Maria Otília Cerveira ◽  
Diego Onyszko ◽  
Alyne de Jesus ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Caregiver Burden ◽  
Functional Capacity ◽  
Neuropsychiatric Symptoms ◽  
Primary Caregivers ◽  
Sociodemographic Characteristics ◽  
Small Male ◽  
Main Determinant ◽  
Severity Of Dementia

Abstract Caregiver burden is common in Alzheimer's disease (AD), decreasing the quality of life among caregivers and patients. Projections of aging and aging-related diseases such as AD in developing countries justify additional data about this issue because people living in these countries have shown similarly high levels of caregiver strain as in the developed world. Objective: The aim of this study was to analyze the association of AD caregivers' burden with patients' neuropsychiatric symptoms (NPS), cognitive status, severity of dementia, functional capacity, caregiver sociodemographic characteristics, and the characteristics of care provided by caregivers. Methods: A cross-sectional study was conducted in a sample of 39 consecutive AD patients and their primary caregivers. NPS were evaluated using the Neuropsychiatric Inventory (NPI). Severity of dementia was assessed with the Clinical Dementia Rating (CDR) scale. Functional capacity was assessed using the Katz and Lawton scales. The burden level was rated using the Burden Interview (BI). Sociodemographic characteristics of caregivers and the characteristics of care provided by them were evaluated. The Mann-Whitney U-test, Kruskal-Wallis test and Spearman's rho coefficient were performed. Results: The BI had a moderate correlation with NPI intensity (rho=0.563), p<001. Female caregivers reported a greater level of burden (p=0.031) than male caregivers. The other variables were not significantly associated to caregiver burden. Conclusion: NPS were the main determinant of burden in primary caregivers of AD patients. This result underscores the need for prevention and treatment of these symptoms. Sex also had an effect on caregiver burden, but the small male sample in this study precludes the generalization of this finding.

Effects of Inappropriate Sexual Behaviors and Neuropsychiatric Symptoms of Patients With Alzheimer Disease and Caregivers’ Depression on Caregiver Burden

2019 ◽  
Vol 33 (5) ◽  
pp. 243-249 ◽  
Author(s):  
Faik Ilik ◽  
Hüseyin Büyükgöl ◽  
Fatih Kayhan ◽  
Devrimsel Harika Ertem ◽  
Timur Ekiz
Keyword(s):  
Alzheimer Disease ◽  
Caregiver Burden ◽  
Sexual Behaviors ◽  
Rating Scale ◽  
Neuropsychiatric Symptoms ◽  
Clinical Dementia Rating ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Prevalence Of Depression ◽  
State Examination

Objective: We investigated the effects of inappropriate sexual behaviors (ISBs) and neuropsychiatric symptoms (NPSs) of patients with Alzheimer disease (AD), and of caregivers’ depression, on the caregiver burden. Method: One hundred forty three patients with AD and their caregivers were included in the study. Sixty-five patients without AD who needed care due to their disability and their caregivers were enrolled for the comparison. Depression in caregivers was diagnosed using The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (SCID-I). The Mini-Mental State Examination (MMSE) and Clinical Dementia Rating Scale were used to evaluate the severity of AD. The Neuropsychiatric Inventory (NPI) was used to assess the NPSs of patients. Caregiver burden was evaluated using the Zarit Burden Interview (ZBI). Results: Inappropriate sexual behaviors were found in 13 (9.1%) of the AD group. Inappropriate sexual behaviors were more common in moderate or severe AD ( P = .009, χ2 = 9.396). The prevalence of depression (n = 38, 26.6%) was higher in caregivers of AD group with ISBs ( P = .000, χ2 = 24.69). The ZBI scores of caregivers of patients with AD were higher than the comparison group. In addition, the ZBI scores of caregivers of patients with AD were significantly higher in the AD group with ISB, a high total score of NPI, and a low score of MMSE. The caregivers of AD group with depression had higher ZBI scores ( P < .05). Conclusions: The severity of AD, the presence of NPSs in patients, and major depression in caregivers were risk factors for an increased caregiver burden.

scholarly journals Caregiver Burden of Family Caregivers of Patients With Dementia in a Shanghai Community

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 751-751
Author(s):  
Juan Li ◽  
Zhijian Liu ◽  
You Yin
Keyword(s):  
Social Support ◽  
Cognitive Function ◽  
Family Caregivers ◽  
Community Service ◽  
Service Utilization ◽  
Caregiver Burden ◽  
Neuropsychiatric Symptoms ◽  
Demographic Information ◽  
Factors Associated ◽  
Family Caregiver Burden

Abstract This study explored the level of and factors related to Chinese dementia family caregiver burden. We recruited 109 dyads of patients with dementia and their family caregivers from communities in Shanghai, China. Caregiver burden was assessed by Caregiver Burden Inventory. We used multivariate linear regression model to investigate factors associated with caregiver burden, including patients’ socio-demographic information, cognitive function, ADL, neuropsychiatric symptoms, caregivers’ depression, coping strategy, social support and community service utilization. The level of caregiver burden was moderate (65.92±16.74). The patients’ cognitive function and social support were negatively associated with caregiver burden (β=﹣0.850, p＜0.01, β=﹣1.787, p=0.044, respectively). Caregivers’ depression and community service utilization were positively associated with caregiver burden (β=2.109, p＜0.01,β=1.215, p＜0.01, respectively). These findings suggest enhancing social support and reducing depression of caregivers may have the potential of decreasing caregiver burden.

scholarly journals Predictors of Caregiver Burden in Aged Caregivers of Demented Older Patients

2020 ◽  
Author(s):  
Chia-Fen Tsai ◽  
Wei-Shen Hwang ◽  
Jun-Jun Lee ◽  
Wen-Fu Wang ◽  
Ling-Chun Huang ◽  
...  
Keyword(s):  
Caregiver Burden ◽  
Oldest Old ◽  
Neuropsychiatric Symptoms ◽  
Short Version ◽  
Monthly Income ◽  
Male Predominance ◽  
Dementia Registry ◽  
The Mean ◽  
Older Caregivers ◽  
Severity Of Dementia

Abstract BackgroundDementia in the oldest-old is projected to increase exponentially as is the burden of their caregivers who may experience unique challenges and suffering. Thus, we aim to investigate which factors are associated with older caregivers’ burden in caring demented outpatients in a multicenter cohort.MethodsPatients and their caregivers, both aged ≧65 years, in the National Dementia Registry Study in Taiwan (T-NDRS) were included in this study. Caregiver burden was measured with the short version of the Zarit Burden Interview (ZBI). The correlations between the ZBI scores and characteristics of caregivers and patients, including severity of dementia, physical comorbidities, instrumental activities of daily living (IADL), neuropsychiatric symptoms assessed by the Neuropsychiatric Inventory (NPI), and family monthly income, were analyzed.ResultsWe recruited 328 aged informal caregiver-patient dyads. The mean age of caregivers was 73.7± 7.0 years, with female predominance (66.8%), and the mean age of patients was 78.8±6.9 years, with male predominance (61.0%). Multivariable linear regression showed that IADLs (β=0.83, p<0.001) and NPI subscores of apathy (β=3.83, p<0.001)and irritability (β=4.25, p<0.001) were positively associated with ZBI scores. The highest family monthly income (β= -10.92, p=0.001) and caregiver age (β= -0.41, p=0.001) were negatively correlated with ZBI scores.ConclusionsOlder caregivers of older demented patients experience a higher care burden when patients had greater impaired functional autonomy and the presence of NPI symptoms of apathy and irritability. Our findings provide the direction to identify risky older caregivers, and we should pay more attention to and provide support for these exhausted caregivers.

scholarly journals Characteristics of behavioral symptoms in right-sided predominant semantic dementia and their impact on caregiver burden: a cross-sectional study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Shunsuke Sato ◽  
Mamoru Hashimoto ◽  
Kenji Yoshiyama ◽  
Hideki Kanemoto ◽  
Maki Hotta ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Frontotemporal Dementia ◽  
Caregiver Burden ◽  
Daily Living ◽  
Neuropsychiatric Symptoms ◽  
Semantic Dementia ◽  
Behavioral Symptoms ◽  
Clinical Factors ◽  
Clinical Dementia Rating ◽  
Cross Sectional

Abstract Background This study aimed to clarify the neuropsychiatric symptoms of right-sided predominant semantic dementia (SD-R) by comparing them with those of behavioral variant frontotemporal dementia (bvFTD), left-sided predominant SD (SD-L), and Alzheimer’s disease (AD). This study also aimed to identify clinical factors related to caregiver burden for bvFTD, SD-R, and SD-L. Methods The neuropsychiatric symptoms of 28 patients with bvFTD, 14 patients with SD-R, 24 patients with SD-L, and 43 patients with AD were evaluated using the Neuropsychiatric Inventory (NPI) and the Stereotypy Rating Inventory (SRI). Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Dementia severity was assessed using the Clinical Dementia Rating. Activities of daily living were assessed using the Lawton Instrument Activities of Daily Living (IADL) scale and the Physical Self-Maintenance Scale. We compared the NPI and SRI scores among the four groups using the Kruskal-Wallis test. In addition, clinical factors related to caregiver burden, represented by the Japanese version of the Zarit Burden Interview (J-ZBI), were analyzed using multiple regression analysis in the bvFTD, SD-R, and SD-L groups. Results The NPI total score and the NPI subscale scores of apathy and disinhibition were significantly higher in the bvFTD group than in the SD-L and AD groups. The SD-R group scores were closer to those of the bvFTD group than the SD-L group. The SRI total score and SRI subscale scores for eating and cooking and speaking were significantly higher in the bvFTD, SD-R, and SD-L groups than in the AD group. The NPI total score was significantly associated with the J-ZBI score in the bvFTD group. The NPI total score and Lawton IADL scale score were independently associated with the J-ZBI score in the SD-R group. Furthermore, the NPI total score and MMSE score were independently associated with the J-ZBI score in the SD-L group. Conclusions SD-R seemed to be a similar condition to bvFTD rather than SD-L regarding behavioral symptoms. Our results suggest that each frontotemporal dementia subgroup requires different approaches to reduce the caregiver burden.

Neuropsychiatric Symptoms, Caregiver Burden and Distress in Behavioral-Variant Frontotemporal Dementia and Alzheimer's Disease

2015 ◽  
Vol 40 (5-6) ◽  
pp. 268-275 ◽  
Author(s):  
Thais Bento Lima-Silva ◽  
Valéria Santoro Bahia ◽  
Viviane Amaral Carvalho ◽  
Henrique Cerqueira Guimarães ◽  
Paulo Caramelli ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Frontotemporal Dementia ◽  
Sex Education ◽  
Caregiver Burden ◽  
Psychiatric Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Clinical Dementia Rating ◽  
Behavioral Variant Frontotemporal Dementia ◽  
Significant Difference

Background/Aims: We aimed to compare caregiver burden and distress in behavioral-variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD) and to investigate which factors contribute to caregivers' burden and distress. Methods: Fifty patients and their caregivers were invited to participate. Among the patients, 20 had a diagnosis of bvFTD and 30 had AD. Caregivers and patients were statistically equivalent for age, sex, education and dementia severity according to Clinical Dementia Rating. The protocol included the Short Zarit Burden Inventory, the Neuropsychiatric Inventory (NPI), Disability Assessment for Dementia (DAD), the Cornell Scale for Depression in Dementia (CSDD), Addenbrooke's Cognitive Examination-Revised, the Executive Interview with 25 Items, Direct Assessment of Functional Status and the Geriatric Anxiety Inventory (GAI). Results: In the NPI, caregivers of bvFTD patients reported a higher presence and severity of neuropsychiatric symptoms and caregiver distress compared to caregivers of AD patients. There was no significant difference in the perceived burden. In bvFTD, DAD and GAI scores were significantly correlated with burden, whereas in AD, burden was correlated with CSDD and NPI scores. Psychiatric symptoms were associated with distress in both groups. Conclusions: Caregivers of bvFTD patients experienced higher levels of distress than caregivers of AD patients. Patients' functional limitations were associated with burden of caregivers of bvFTD patients, whereas neuropsychiatric symptoms were associated with caregiver strain in both groups.

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