scholarly journals The Half Life of Stress: Caregiver Stress Increases Next-Day Severity of Behavioral Symptoms of Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 253-254
Author(s):  
Carolyn Pickering ◽  
Frank Puga ◽  
Danny Wang ◽  
Maria Yefimova
Keyword(s):  
Well Being ◽  
Care Recipient ◽  
Behavioral Symptoms ◽  
Relationship Type ◽  
Severity Rating ◽  
Threshold Theory ◽  
Stress Threshold ◽  
Progressively Lowered Stress Threshold ◽  
Time Lagged ◽  
Person With Dementia

Abstract The progressively lowered stress threshold theory posits that behavioral symptoms of dementia (BSD) are reactions to environmental and care related stressors. In line with this theory, this study tests whether the stress experienced the caregiver impacts BSD expression. Caregivers to persons with dementia recruited online completed daily diary surveys for 21 days reporting on daily contextual and environmental factors of caregiving life. Using multi-level modeling of diaries (n=911) nested within participants (N=51), two daily caregiver stressors (conflict with someone other than the person with dementia, stress about own personal health) were examined as predictors of BSD. The outcome of BSD was measured as severity (a rating on a Likert scale of 1-5 that was then person-centered to represent deviations from average severity). Covariates in the model included relationship type, caregiver age, as well as stressors to the care recipient known to increase BSD. On days when a caregiver had a conflict with others the severity of the care recipient’s BSD increased by 1.44 points from average (p<.001, CI 1.05-1.75). In a time-lagged model, we observe that a caregiver having a conflict yesterday impacts today’s BSD severity by an increase of 0.43 points from average (p = 0.027, CI 0.05-0.81). Caregivers’ stress about their own health did not have a significant impact on the same day or next day BSD severity rating. These findings demonstrate that the well-being of the caregiver has measurable immediate impacts on the well-being of the person living with dementia, and suggests not all stress is equal.

Outcomes of a Two-Component Intervention on Behavioral Symptoms in Persons With Dementia and Symptom Response in Their Caregivers

2016 ◽  
Vol 37 (5) ◽  
pp. 570-594 ◽  
Author(s):  
Karen M. Robinson ◽  
Timothy N. Crawford ◽  
Kathleen C. Buckwalter ◽  
David A. Casey
Keyword(s):  
New York ◽  
Disease Process ◽  
Care Recipient ◽  
Behavioral Symptoms ◽  
New York University ◽  
Family Meeting ◽  
Progressively Lowered Stress Threshold ◽  
Quasi Experimental ◽  
Symptom Response

Purpose: This study evaluated the longitudinal influence of an individualized evidence-based psychoeducational intervention for caregivers on frequency of behavioral symptoms in persons with dementia (PWD) and caregiver reaction to these symptoms. The intervention included information about the disease process using Progressively Lowered Stress Threshold (PLST) content and a family meeting based on Mittelman’s New York University Intervention. Method: A quasi-experimental study design was implemented. The Revised Memory and Behavior Problems Checklist was administered to N = 127 caregiver/care recipient dyads at baseline, 6, 12, and 18 months follow-up. All caregivers were enrolled in the intervention at baseline and followed over 18 months. Linear mixed models were developed to evaluate effects on frequency of behavioral symptoms in PWD and caregiver response. Results: The most frequently occurring behavior was memory problems, although depressive behaviors produced the most negative caregiver responses. Between baseline and 6-month follow-up, there was a significant decrease in frequency of behavioral symptoms. Overall, there was a significant decrease in caregiver’s reaction to behavioral symptoms from baseline to 18-month follow-up.

scholarly journals Memory and communication support strategies in dementia: Effect of a training program for informal caregivers

2012 ◽  
Vol 24 (12) ◽  
pp. 1927-1942 ◽  
Author(s):  
Jacki Liddle ◽  
Erin R. Smith-Conway ◽  
Rosemary Baker ◽  
Anthony J. Angwin ◽  
Cindy Gallois ◽  
...  
Keyword(s):  
Training Program ◽  
Controlled Trial ◽  
Informal Caregivers ◽  
Training Group ◽  
Well Being ◽  
Care Recipient ◽  
Control Group ◽  
People With Dementia ◽  
Person With Dementia ◽  
The Impact

ABSTRACTBackground: People with dementia have a range of needs that are met by informal caregivers. A DVD-based training program was developed using research-based strategies for memory and communication in dementia. The effectiveness of the training on the caregiver experience and the well-being of the person with dementia was evaluated.Methods: A pre-test/post-test controlled trial was undertaken with caregiver–care-recipient dyads living in the community. Measures of the carers’ knowledge of memory and communication strategies, burden, positive perceptions of caregiving, and perceptions of problem behaviors were taken pre- and three months post-intervention. The depression and well-being of the person with dementia were also evaluated. Satisfaction with the training and feedback were measured.Results: Twenty-nine dyads (13 training group, 16 control group) participated. Bonferroni's correction was made to adjust for multiple comparisons, setting α at 0.00385. A significant improvement was found in caregivers’ knowledge for the training group compared to the control group (p = 0.0011). The training group caregivers reported a reduction in the frequency of care recipient disruptive behaviors (p = 0.028) and increased perceptions of positive aspects of caregiving (p = 0.039), both at a level approaching significance. The training group care recipients had increased frequency of verbally communicated depressive behaviors at a level approaching significance (p = 0.0126). The frequency of observed depressive behaviors was not significantly different between groups.Conclusions: This approach to training for caregivers of people with dementia appears promising for its impact on knowledge and the caregiving experience. Further research could monitor the impact of the training on broader measures of depression and well-being, with a larger sample.

scholarly journals Partner Effects on Depressed Mood in Caregiving Dyads Are Most Pronounced in Cancer Caregiving, Partner Caregiving

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 352-352
Author(s):  
Nadia Al Nassar ◽  
Kristin Litzelman
Keyword(s):  
Depressed Mood ◽  
Adult Child ◽  
Well Being ◽  
Health Condition ◽  
Care Recipient ◽  
Dissemination And Implementation ◽  
Relationship Type ◽  
Care Recipients ◽  
Point Increase ◽  
Nuanced Understanding

Abstract Theory and empirical evidence indicate that the well-being of caregivers and their care recipients is interrelated, although conflicting evidence has emerged across different caregiving populations. To establish a more nuanced understanding of this phenomenon, we used data from the National Health and Aging Trends Survey and the National Survey on Caregivers (2015 and 2017, n=759 dyads with complete longitudinal data) to construct actor-partner interdependence models assessing how spillover of depression varies by care recipient health condition (cancer, dementia, stroke, diabetes, or other conditions) and relationship type (spouse/partner, child, or other). Across condition types, the largest magnitude partner effects were observed in dyads with cancer, in which a one-point increase in caregiver depressed mood was associated with a 0.23-point increase in subsequent care recipient depressed mood (p=0.02) and a one-point increase in care recipient depressed mood was associated with a 0.33-point increase in subsequent caregiver depressed mood (p<0.01). Moderation by cancer status was statistically significant (pinteraction=0.03). Among spouse/partner caregivers, caregivers’ depressed mood was associated with subsequent depressed mood in the care recipient (p<0.05) but there was no evidence of spillover from the care recipient to the caregiver. Conversely, in both adult child caregivers and other caregivers, there was evidence for spillover from the care recipient to the caregiver (p<0.05) but not the reverse. The findings show that the interrelationship in the well-being of caregivers and care recipients varies by key caregiving characteristics, with implications for the development, dissemination, and implementation of interventions targeting caregiver, care recipient, and dyadic well-being.

Reasons why family members become carers and the outcome for the person with dementia: results from the CARD study

2011 ◽  
Vol 23 (9) ◽  
pp. 1442-1450 ◽  
Author(s):  
Andrew Camden ◽  
Gill Livingston ◽  
Claudia Cooper
Keyword(s):  
Care Home ◽  
Negative Relationship ◽  
Well Being ◽  
Preliminary Evidence ◽  
Care Recipient ◽  
Family Carers ◽  
Abusive Behavior ◽  
Scale Scores ◽  
Person With Dementia ◽  
Conflict Tactics

ABSTRACTBackground: Using a representative secondary care survey for the first time, we explored family carers’ reasons for providing care. We hypothesized that carers with a positive rather than negative motivation for caring would be less abusive towards the care recipient and more likely to be caring for someone still living at home a year later.Methods: We interviewed 220 consecutively referred dementia family/friend carers from UK Community Mental Health Teams. We asked non-spousal carers why they were the main carer. Our main outcomes were the revised Modified Conflict Tactics Scale scores, measuring abusive behavior by the carer, and admission of the person with dementia to a care home.Results: Nineteen (17.1%) said they were the main carer due to the high quality of their relationship with the care recipient, their willingness to take on or their suitability for the carer role. A further 22 (19.8%) said they were the main carer due to other potential carers’ negative relationship with the care recipient, unwillingness or lack of suitability for the role. Carers who gave the latter explanation tended to be more anxious at baseline (F = 3.0, p = 0.055), reported higher abusive behavior towards the care recipient a year later after controlling for sociodemographic variables (t = 2.0, p = 0.05), and their care recipient was more likely to be admitted to a care home in the following year (hazards ratio 9.9, p = 0.040).Conclusions: We found preliminary evidence that carers’ reasons for providing care predict the well-being of the care recipient. Future studies involving dementia family carers should consider asking why the main carer assumed this role.

Progress in BPSD research: analyzing individual BPSD might hold the key to better support caregivers

2016 ◽  
Vol 28 (11) ◽  
pp. 1759-1760 ◽  
Author(s):  
Nicola T. Lautenschlager
Keyword(s):  
Psychological Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Well Being ◽  
Care Recipient ◽  
Effective Interventions ◽  
Person With Dementia ◽  
The Relationship ◽  
Behavioral And Psychological Symptoms

Behavioral and Psychological Symptoms of Dementia (BPSD) or neuropsychiatric symptoms occur in more or less every person with dementia at some stage during the illness. They often have a significant impact on caregiver well-being and vice versa – caregivers response to BPSD can impact on the well-being of the care recipient with dementia (Feast et al., 2016A). The relationship between caregiver and care-recipient factors when it comes to BPSD is complex and more detailed research is needed to be able to progress to more effective interventions and support.

scholarly journals 407 - The Baycrest Quick-Response Caregiver Tool: The Role for a New Tool for Caregivers of Persons with Dementia

2020 ◽  
Vol 32 (S1) ◽  
pp. 123-123
Author(s):  
Ken Schwartz ◽  
Robert Madan ◽  
Anna Berall ◽  
Marsha Natadira ◽  
Anna Santiago
Keyword(s):  
Family Caregivers ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Well Being ◽  
Moderate Degree ◽  
Quick Response ◽  
Care Providers ◽  
High Level ◽  
Person With Dementia ◽  
The Impact

Background:Responsive behaviours in dementia are associated with poor outcomes for the person with dementia (PWD) and caregiver burnout. Family caregivers need a variety of tools to manage responsive behaviours. The Baycrest Quick-Response Caregiver Tool was developed to provide caregivers with a tool that can be used in real time. In this study, the feasibility, impact, and effectiveness of this new tool were studied in family caregivers and health care providers (HCP) using quantitative and qualitative measures.Methods:Family caregivers were recruited and were asked to complete a pre-survey before being sent the link to the educational tool. One month after the telephone survey, caregivers were sent an online post-survey to gather their feedback on the tool and the impact of the tool on caregiver well -being. Healthcare providers were also recruited and reviewed the tool through an online feedback survey. The feasibility, impact, and effectiveness of the tool were assessed using quantitative and qualitative measures.Results:Caregivers had a moderate degree of and reported a high level of competence - these scores were maintained throughout the study. Caregivers reported that tool positively impacted their compassion towards the person with dementia (PWD), and that their interactions with improved. 100% of HCP who completed the feedback survey would recommend the tool to other HCP and to caregivers of PWD. The caregivers and HCP provided specific suggestions for improvement.Conclusions:The Baycrest Quick-Response Caregiver Tool was found to be feasible and helpful. It provides caregivers and HCP with an additional approach for responsive behaviours.

scholarly journals ‘Getting back to normality seems as big of a step as going into lockdown’: the impact of the COVID-19 pandemic on people with early to middle stage dementia

2021 ◽  
Author(s):  
Catherine V Talbot ◽  
Pam Briggs
Keyword(s):  
Well Being ◽  
Cognitive Stimulation ◽  
Social Worlds ◽  
Middle Stage ◽  
People With Dementia ◽  
The Social ◽  
Function Loss ◽  
The Government ◽  
Person With Dementia ◽  
The Impact

Abstract People with dementia can experience shrinkage of their social worlds, leading to a loss of independence, control and reduced well-being. We used ‘the shrinking world’ theory to examine how the COVID 19 pandemic has impacted the lives of people with early to middle stage dementia and what longer-term impacts may result. Interviews were conducted with 19 people with dementia and a thematic analysis generated five themes: the forgotten person with dementia, confusion over government guidance, deterioration of cognitive function, loss of meaning and social isolation, safety of the lockdown bubble. The findings suggest that the pandemic has accelerated the ‘shrinking world’ effect and created tension in how people with dementia perceive the outside world. Participants felt safe and secure in lockdown but also missed the social interaction, cognitive stimulation and meaningful activities that took place outdoors. As time in lockdown continued, these individuals experienced a loss of confidence and were anxious about their ability to re-engage in the everyday practises that allow them to participate in society. We recommend ways in which the government, communities and organisations might counteract some of the harms posed by this shrinking world.

scholarly journals A qualitative study of the shared experience of humour between people living with dementia and their partners

Dementia ◽  
2018 ◽  
Vol 19 (6) ◽  
pp. 1794-1810
Author(s):  
Helen Hickman ◽  
Chris Clarke ◽  
Emma Wolverson
Keyword(s):  
Interpretative Phenomenological Analysis ◽  
Emotional Experience ◽  
Well Being ◽  
Future Research ◽  
Structured Interviews ◽  
Relationship Strength ◽  
Social And Emotional ◽  
People With Dementia ◽  
Care Partners ◽  
Person With Dementia

Humour is a complex social and emotional experience which could constitute a positive resource for people endeavouring to live well with dementia. However, little is currently known about the shared use and value of humour in dyads where one person has dementia. The purpose of this study was therefore to explore how people with dementia and their care-partners experience, use and draw meaning from humour in relation to their shared experiences of dementia and their ongoing relationships. Ten participant dyads (the person with dementia and their spousal partner) took part in joint semi-structured interviews. Interpretative Phenomenological Analysis revealed eight subthemes that were subsumed under three super-ordinate themes: ‘Humour Has Always Been There (and Always Will Be)’; ‘Withstanding Dementia’ and ‘Renewing the Value of Humour in Dementia’. Overall, the findings suggest that humour, in different forms, can represent a salient and enduring relationship strength that helps dyads maintain well-being and couplehood by providing a buffer against stressors associated with dementia. The findings highlight the potential value of integrating a dyadic perspective with strengths-based approaches in future research into how people live well with dementia.

scholarly journals Mental Health in Affectionate, Antagonistic, and Ambivalent Relationships During the COVID-19 Pandemic: A Latent Profile Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Jasmina Mehulić ◽  
Željka Kamenov
Keyword(s):  
Mental Health ◽  
Intimate Relationships ◽  
Latent Profile Analysis ◽  
Profile Analysis ◽  
Health Indicators ◽  
Well Being ◽  
Relationship Functioning ◽  
Relationship Type ◽  
Relationship Types ◽  
Latent Profile

The ongoing coronavirus disease-2019 (COVID-19) pandemic presents an acute stressor affecting mental health. In these stressful times, intimate relationships functioning could serve as a protective or a risk factor to the well-being of partners. Adult Croatian citizens engaged in intimate relationships (N = 727) reported their relationship characteristics and assessed symptoms of depression, anxiety, and stress during the state lockdown in May 2020. Three relationship profiles based on variations in key relationship characteristics were identified using latent profile analysis. Profiles represented distinct relationship types described as affectionate, ambivalent, and antagonistic relationships. These relationship types differed in their levels of love and perception of humility, responsiveness, and behavior of the partner. Relationship type was associated with mental health symptoms such as depression, anxiety, and stress during the COVID-19 pandemic and state lockdown. Being in an affectionate relationship was associated with the lowest levels of depression, anxiety, and stress, while in an antagonistic relationship these are in the highest levels. Ambivalent relationships were characterized by moderate levels on all measured mental health indicators with no difference in anxiety compared with affectionate relationships. The results emphasized the link between relationship functioning and successful coping with mental health hazards such as the fear of disease or restrictive measures put in place to contain the COVID-19 pandemic.

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