scholarly journals Cognitive-Behavioral Dementia Caregiving Styles: Associations With Care Stress and Well-Being

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 816-816
Author(s):  
Amanda Leggett ◽  
Cathleen Connell ◽  
Laura Gitlin ◽  
Helen Kales
Keyword(s):  
Family Caregiving ◽  
Well Being ◽  
Health Impact ◽  
Process Models ◽  
Behavioral Approach ◽  
Cognitive Behavioral ◽  
Dementia Severity ◽  
Significant Public Health ◽  
Poor Outcomes ◽  
Distress Scale

Abstract While Stress Process Models of family caregiving have been examined extensively, little focus has been placed on caregiver’s actual management of care. We consider whether caregiving style classified previously through k-modes machine learning models and based on cognitive-behavioral approaches to care impact caregivers’ experiences of care-related stress and well-being. The three previously identified styles include: Adapters- strong dementia understanding and adaptability, encouraging behavioral approach; Managers- poor dementia understanding and adaptability, critical behavioral approach; and Avoiders- moderate dementia understanding and adaptability, passive behavioral approach. Participants included 100 primary family caregivers for PWDs who were on average 64 years old, 74% female, and 18% non-White. Utilizing linear regressions, each caregiving style was considered a key predictor (reference: Adapters) of the Zarit Burden Interview (ZBI), Caregiver Assessment of Function and Upset (CAFU) upset score, Neuropsychiatric Inventory (NPI-C) distress scale, and Positive and Negative Affect scale (PANAS) controlling for dementia severity, care duration, co-residency, and demographics. Relative to Adapters, Managers had more CAFU upset (β=0.4, p<.001), more NPI-C distress (β=0.4, p<.001), and greater burden (ZBI) (β=0.3, p<.001). Avoiders showed significantly greater CAFU upset than Adapters (β=0.2, p<.05). Positive affect was not associated with caregiving style. Caregiving styles associated with less understanding and adaptability and a more critical behavioral approach showed worse caregiving outcomes accounting for dementia severity. Results can inform a nuanced approach to tailoring and targeting interventions based on caregiver styles with the goal of reaching caregivers at risk for poor outcomes and ultimately leading to significant public health impact.

scholarly journals Family Caregiving During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Scott R Beach ◽  
Richard Schulz ◽  
Heidi Donovan ◽  
Ann-Marie Rosland
Keyword(s):  
Sleep Disturbance ◽  
Family Caregivers ◽  
Social Participation ◽  
Family Caregiving ◽  
Risk Index ◽  
Well Being ◽  
Adverse Outcomes ◽  
Process Models ◽  
Health Crisis ◽  
Anxiety Depression

Abstract Background and Objectives The coronavirus disease 2019 (COVID-19) pandemic has negatively impacted persons with existing chronic health conditions. The pandemic also has the potential to exacerbate stresses of family caregiving. We compare family caregivers with non-caregivers on physical, psychosocial, and financial well-being outcomes during the pandemic and determine family caregivers most at risk for adverse outcomes. Research Design and Methods We conducted a cross-sectional online survey of 576 family caregivers and 2,933 non-caregivers from April-May 2020 in Pittsburgh, PA region with a national supplement. Outcome measures included concurrent anxiety, depression, fatigue, sleep disturbance, social participation; and financial well-being); and perceived changes due to COVID-19 (loneliness, financial well-being, food security). We also measured socio-demographic; caregiving contextual variables; and COVID-related caregiver stressors (COVID Caregiver Risk Index). Results Controlling for socio-demographics, family caregivers reported higher anxiety; depression; fatigue; sleep disturbance; lower social participation; lower financial well-being; increased food insecurity (all p < .01) and increased financial worries (p=.01). Caregivers who reported more COVID-related caregiver stressors and disruptions reported more adverse outcomes (all p < .01). In addition, caregivers who were female, younger, lower income, providing both personal / medical care, and providing care for cognitive / behavioral / emotional problems reported more adverse outcomes. Discussion and Implications Challenges of caregiving are exacerbated by the COVID-19 pandemic. Family caregivers reported increased duties, burdens, and resulting adverse health, psychosocial, and financial outcomes. Results were generally consistent with caregiver stress-health process models. Family caregivers should receive increased support during this serious public health crisis.

scholarly journals The Influence of Dementia Caregiving Styles on Caregiver Distress and the Person With Dementia’s Quality of Life

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 360-361
Author(s):  
Amanda Leggett ◽  
Cathleen Connell ◽  
Laura Gitlin ◽  
Helen Kales
Keyword(s):  
Quality Of Life ◽  
Process Model ◽  
Management Practices ◽  
Health Impact ◽  
Behavioral Strategies ◽  
Behavioral Management ◽  
Dementia Caregivers ◽  
Poor Outcomes ◽  
Distress Scale

Abstract Building vertically upon the Stress Process Model, dementia caregivers’ cognitive-behavioral management styles are an understudied area with implications for dyadic care outcomes and tailoring of care interventions. We consider whether membership in five previously classified caregiving styles (Externalizers, Individualists, Learners, Adapters, Nurturers- which vary in their adaptability, dementia understanding, and behavioral management practices) impacts caregivers’ experiences of care-related stress and the quality of life of the person with dementia (PWD). Participants included 100 primary family caregivers for PWDs who were 74% female, 18% non-White, and on average 64 years old. Utilizing linear regressions, each caregiving style was considered as a key predictor (reference: Externalizers- poor understanding, non-adaptable approach, and punitive behavioral strategies) of the Caregiver Assessment of Function and Upset (CAFU) upset score, Neuropsychiatric Inventory (NPI-C) distress scale, Zarit Burden Interview (ZBI), and PWD quality of life (QOL-AD) scale controlling for demographics, care duration, co-residency, and dementia severity. Relative to Externalizers, Nurturers (understanding, adaptability, positive engagements) had less CAFU upset (β=-0.4, p<.01), less NPI-C distress (β=-0.3, p<.05), and greater QOL-AD for the PWD (β=0.4, p<.01). Learners (recognize need to change care approach, attempting adaptability, trial-and-error behavioral care) also showed significantly lower NPI-C distress than Externalizers (β=-0.5, p<.01). Thus caregiving styles with more dementia understanding, adaptability and positive behavioral strategies showed less distress and better PWD QOL. Corresponding with recent dementia care summits calling for identification of caregivers at greatest risk for poor outcomes, targeting and tailoring interventions based on caregiving styles may lead to great public health impact.

scholarly journals Caregiving for Persons Living With Dementia in the New Normal: Family Caregiver’s Perspective

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1036-1036
Author(s):  
Priyanka Shrestha ◽  
Donna Fick ◽  
Marie Boltz ◽  
Susan Loeb ◽  
Andrew High
Keyword(s):  
Family Caregivers ◽  
Family Caregiving ◽  
Qualitative Methodology ◽  
Well Being ◽  
Intensive Care Admission ◽  
Increased Risk ◽  
The Family ◽  
Poor Outcomes ◽  
Person With Dementia ◽  
The Impact

Abstract Persons living with dementia (PLWD) are at increased risk for COVID-19 and associated poor outcomes, including: incident delirium, hospitalization, severe symptoms, intensive care admission, and even death. PLWD are likely to rely on family caregivers to maintain their health and well-being in the community. Under normal circumstances, caregiving can be stressful and complex, and the COVID-19 pandemic has the potential to change and exacerbate the stresses of family caregiving. As a part of a larger study using descriptive qualitative methodology to explore the family caregiver understanding and experiences related to delirium in caring for a person with dementia, 14 participants (age x̄ =67, SD= 13.8) were asked about the impact of COVID-19 on their caregiving for PLWD. Thematic analysis of the transcribed interviews using Dedoose generated four overarching themes associated with the family caregiver’s perspective of changes in caregiving during the COVID-19 pandemic: 1) Cautious of COVID-19 exposure, 2) We can’t go in, 3) Feeling of isolation for both the PLWD and caregiver, and 4) Six-feet distance. The current study highlights the importance of understanding the needs of PLWD during a pandemic based upon the perspective of their family caregivers and will inform the development of ways to safely incorporate family caregivers in the interdisciplinary care team. Caregivers are integral to the care of PLWD across settings of care and should be partners even during a pandemic. Solutions for care include integrating technology for individualized approaches. Finally, future areas for research will be discussed.

Behavioral Approach–Avoidance and Distress Scale

1988 ◽  
Author(s):  
Nancy C. Hubert ◽  
Susan M. Jay ◽  
Myra Saltoun ◽  
Marci Hayes
Keyword(s):  
Behavioral Approach ◽  
Approach Avoidance ◽  
Distress Scale

scholarly journals Mental health policy issues and development in Lithuania

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I R Rubikas
Keyword(s):  
Mental Health ◽  
Alcohol Consumption ◽  
Mental Health Policy ◽  
Well Being ◽  
Health Impact ◽  
Health Policies ◽  
Social And Emotional ◽  
Suicide Rates ◽  
Mental Health Policies ◽  
The Eu

Abstract Background Lithuanian has experienced rapid and relatively successful transition to capitalism and transatlantic-Western values and practices in recent decades. Suicide and legal alcohol consumption rates remain the highest in the EU and OECD, and Lithuania's Positive emotions index score has been consistently amongst the 10 lowest in the world in recent years. Emigration rate is the highest in the EU and OECD, social inequality is amongst the highest in the same groups. Despite a relatively strong economy these changes are not automatically transferred to better social and emotional well-being. Methods This unconventional situation calls for strong and unconventional policy responses in the area of mental health, amongst others. Health impact assessment using theory-based approach and desk research. Results Recent attempts include strategic reorientation towards social and emotional well-being, stronger focus on prevention and promotion and primary care, intensifying efforts to reduce suicide rates, and implementation of strong regulatory measures to reduce alcohol use. Suicide rates have been declining since 2013 but remain high. Effort is made to implement best practices in media reporting, recognition and providing appropriate help for those in suicide crisis, expanding prevention efforts. Conclusions Finally, WHOs “best buys” in alcohol control were implemented since 2017, including steep increases in excise taxes, ban on alcohol advertisement, increase of allowed age, reducing alcohol trading hours and others. This resulted in the steepest decline of legal alcohol consumption in decades. The chosen policy route may be called iterative policy-making, whereby improvements are made along the way, which allows for quicker policy decisions and results. Key messages Mental health policies need to be based on the socio-political context of the specific country. Smaller countries such as Lithuania might benefit form flexible approaches to mental health policies.

Biomarkers of Stress in Music Interventions: A Systematic Review

2021 ◽  
Author(s):  
Melanie Mitsui Wong ◽  
Talha Tahir ◽  
Michael Mitsui Wong ◽  
Annilee Baron ◽  
Rachael Finnerty
Keyword(s):  
Psychological Stress ◽  
Acute Stress ◽  
Well Being ◽  
Health Concern ◽  
Music Intervention ◽  
P Values ◽  
Stress Biomarkers ◽  
Study Protocols ◽  
Significant Public Health ◽  
Meta Analyses

Abstract Psychological stress is a significant public health concern as it is associated with various comorbidities and long-term health implications. Music interventions are emerging therapies for alleviating psychological stress and improving one’s physical and mental well-being. We conducted a systematic literature review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement guidelines for reporting to identify all neuroendocrine biomarkers used to evaluate psychological stress in randomized control trials involving music interventions. We identified 18 unique biomarkers of stress from 14 full-text randomized controlled trials studies. Only one of the 14 music studies included a music therapy intervention. The most frequently used biomarkers across the studies were plasma cortisol, salivary cortisol, and salivary α-amylase. Of the 14 studies, 12 included in this review assessed at least one of these three biomarkers. Of these 12 studies, five papers reported p-values for changes in both stress biomarkers and psychological stress outcome measures. Four of the five studies found significant p-values for the reduction of both stress biomarkers and psychological stress in music intervention groups. The variety of stress biomarkers used and the variance in study protocols makes it difficult to assess the magnitude of effect of music interventions on psychological stress. However, our findings suggest that music interventions have the potential for reducing both stress biomarker levels and psychological stress in acute stress situations.

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