scholarly journals Daily Cortisol Total Output Mediated Sleep and Affect Among Dementia Family Caregivers

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 180-180
Author(s):  
Daniel Fleming ◽  
Elizabeth Fauth ◽  
Yin Liu
Keyword(s):  
Family Caregivers ◽  
Quality Care ◽  
High Stress ◽  
Area Under The Curve ◽  
Total Output ◽  
Night Time ◽  
Wake Time ◽  
Adult Day Services ◽  
Time In Bed ◽  
Day Services

Abstract Cortisol is a primary stress hormone associated with sleep. We examined daily cortisol as the potential mechanism linking prior night’s sleep and daily mood among 173 dementia family caregivers (M (SD) age = 61.97 (10.66)) who used adult day services (ADS) at least two days a week. Caregivers self-reported sleep characteristics (bed and wake time, sleep quality, care receiver’s night-time problems) and affect (anxiety, depressive symptoms) across eight consecutive ADS/non-ADS days. Salivary cortisol was collected five times each day. Multilevel mediation analysis suggested that daily cortisol total output (assessed as “area under the curve”) mediated prior nights’ total time in bed and daily anxiety, but only on high-stress (non-ADS) days. Mediation was non-significant on low-stress (ADS) days, and at the between-person level. ADS use is respite from a chronically stressful role. Reducing exposure to stress via respite may protect against harmful processes related to sleep, cortisol reactivity, and daily anxiety.

scholarly journals Care Transitions and Adult Day Services Moderate the Longitudinal Links between Stress Biomarkers and Family Caregivers' Functional Health

Gerontology ◽  
2017 ◽  
Vol 63 (6) ◽  
pp. 538-549 ◽  
Author(s):  
Yin Liu ◽  
David M. Almeida ◽  
Michael J. Rovine ◽  
Steven H. Zarit
Keyword(s):  
Family Caregivers ◽  
Functional Limitation ◽  
Care Transitions ◽  
Functional Health ◽  
Total Output ◽  
Stress Biomarkers ◽  
Adult Day Services ◽  
Day Services ◽  
Over Time ◽  
Daily Total

Background: Stress biomarkers have been linked to health and well-being. There are, however, few studies on how dysregulation in the hypothalamic-pituitary-adrenal axis and sympathetic nervous system actually affects functional health of family caregivers of persons with dementia. Further, it is not clear whether and how factors affecting caregiving stressor exposures such as care transitions and adult day services (ADS) use may affect such association. Objective: First, to examine the association of daily stress biomarkers and functional health over time among family caregivers of persons with dementia. Second, to examine effects of care transitions and ADS use on the association between baseline stress biomarkers and functional health over time. Methods: At baseline, caregivers provided 5 saliva samples each day during an 8-day diary study, where all caregivers were having a varying number of ADS days per week. There were 2 longitudinal follow-ups at 6 and 12 months on ADS use, care transitions, and caregivers' functional health. The average daily total output across days was computed at baseline for salivary cortisol, the sulfated form of dehydroepiandrosterone (DHEA-s), and salivary alpha amylase (sAA), which were used as predictors of caregivers' longitudinal functional limitation trajectories. Care transitions and total number of ADS days per week at baseline were considered as moderators of the associations between stress biomarkers and health over time. Results: The associations between functional limitation trajectories and daily total outputs of cortisol and sAA were modified by ADS use and care transitions. Among caregivers who experienced a transition, and who used less than average ADS days per week, lower daily cortisol total output and lower daily sAA total output were associated with increasing functional limitations. Caregivers who experienced a transition but used greater than average ADS days per week did not show such patterns of association. No significant effect was found for DHEA-s. Conclusion: The study contributes to an important but largely unanswered question regarding implications of stress biomarkers on functional health. Assessments of the association between stress biomarkers and health among family caregivers of persons with dementia need to consider changes in stressor exposures over time, such as care transitions and ADS use.

scholarly journals Daily Sleep, Well-Being, and Adult Day Services Use Among Dementia Care Dyads

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 816-816
Author(s):  
Yin Liu ◽  
Amanda Leggett ◽  
Kyungmin Kim ◽  
Courtney Polenick ◽  
Susan McCurry ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Problems ◽  
Well Being ◽  
Dementia Care ◽  
Daytime Functioning ◽  
Wake Time ◽  
Adult Day Services ◽  
Time In Bed ◽  
Day Services ◽  
Nighttime Sleep

Abstract Sleep is critical for health and well-being among both persons with dementia (PwD) and their family caregivers (CG). This study described sleep characteristics for dementia family care dyads, then examined the associations with sleep quality, daytime functioning, and mood in the context of Adult Day Services (ADS) use. Caregivers (n = 173) reported daily bedtime, wake time, and sleep quality for themselves and the persons with dementia across 8 consecutive days (N = 1,359), where PwD attended ADS at least 2 days of the week. They also reported their own fatigue and affect and PwD’s daytime and nighttime sleep and behavior problems on each day. Findings from multilevel models suggested that bedtime was earlier and total time in bed was shorter before an ADS day for the dyad, and also on an ADS day for PwD; wake time was earlier for the dyad on and following an ADS day. Using ADS related to better prior night sleep quality for PwD; it also weakened the association between nighttime sleep problems and higher daytime negative affect for CG. Yesterday’s ADS use buffered the negative impact of shorter total time in bed on CG daytime fatigue; it also buffered the association between nighttime sleep problems and lowered CG daytime positive affect. Regular ADS use may protect against the adverse impact of sleep disturbances on daytime functioning and well-being for dementia care dyads.

scholarly journals Use of Adult Day Services: Improving the Lives of Family Caregivers

2020 ◽  
Vol 21 (8) ◽  
pp. 20
Author(s):  
Theresa A. Kessler ◽  
Lynette Rayman
Keyword(s):  
Family Caregivers ◽  
Adult Day Services ◽  
Day Services

scholarly journals Temporal Patterns of Daily Behavioral and Psychological Symptoms of Dementia Throughout the Day

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 53-54
Author(s):  
Caitlin Connelly ◽  
Kyungmin Kim ◽  
Yin Liu ◽  
Steven Zarit
Keyword(s):  
Family Caregivers ◽  
Stress Responses ◽  
Stress Reactivity ◽  
Psychological Symptoms ◽  
Temporal Patterns ◽  
Adaptive Intervention ◽  
Adult Day Services ◽  
Lower Reactivity ◽  
Day Services ◽  
Behavioral And Psychological Symptoms

Abstract Behavioral and psychological symptoms of dementia (BPSD) are taxing for both the person with dementia (PWD) and their family caregivers. Yet, little is known about how BPSD fluctuates throughout the day (i.e., morning, daytime, evening, and night; e.g., sundowning) and how caregivers perceive BPSD at different times of the day. Using 8-day daily diary data from 173 family caregivers whose relatives were using Adult Day Services (ADS), this study investigated temporal patterns of BPSD and caregivers’ stress responses to BPSD throughout the day. Overall, the number of BPSD was highest in the evening, and caregivers’ stress reactivity to BPSD increased throughout the phases of the day (i.e., most stressful at night). However, caregivers showed lower reactivity to BPSD in the mornings and at night on days when the PWD used ADS. Our findings about fluctuations of (caregiver reactions to) BPSD throughout the day suggest target windows for just-in-time adaptive intervention.

scholarly journals Caring for a Family Member Living With Dementia When Adult Day Services Close

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 111-111
Author(s):  
Katherine Marx ◽  
Lauren Parker ◽  
Joseph Gaugler ◽  
Holly Dabelko-Schoeny ◽  
Laura Gitlin
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Family Member ◽  
Family Caregivers ◽  
Community Services ◽  
Time Range ◽  
Adult Day Services ◽  
Day Services ◽  
At Home

Abstract Adult Day Service (ADS) centers play an important role in community services that help families keep a person living with dementia (PLWD) at home. We interviewed 33 family caregivers about their experience during the COVID-19 Pandemic and the shutdown of the ADS centers where the PLWD attends. All 33 (100%) reported that the ADS center was shut for a period of time (range: 2 weeks – remain closed). Caregivers reported a decline in their physical health (33%,n=11) and mental health (52%,n=17) and an increase in feelings of loneliness (48%,n=16). For the PLWD, the caregivers noted, a decline in physical (48%,n=16) and mental (55%,n=18) health and an increase in behaviors (39%,n=13). The shutdown of most ADS centers across the country due to the COVID-19 pandemic has had implications not only for the ADS sites but for the families that entrust them with the care for a family member.

scholarly journals ADULT DAY SERVICES IN A RURAL REGION: CHALLENGES AND OPPORTUNITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S154-S155
Author(s):  
Sandra S Butler ◽  
Jennifer Crittenden ◽  
Dyan Walsh ◽  
Lenard Kaye
Keyword(s):  
Older Adults ◽  
Family Caregivers ◽  
Service Providers ◽  
Positive Impact ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Adult Day Services ◽  
Challenges And Opportunities ◽  
Day Services ◽  
Intergenerational Programming

Abstract Adult day services (ADS) programs provide stimulation and socialization for older adults with cognitive and physical disabilities, and much needed respite for family caregivers. Like many services for older adults, ADS programs are far less available in rural regions of the country than in more urban settings. This paper reports on a needs assessment for an ADS program in a small city, which serves as a health and human services hub for a large rural area; a particular focus of the study was to assess the feasibility and interest in intergenerational programming. Family caregivers were surveyed (n = 84) about their use and knowledge of and interest in ADS. Less than one in five respondents were using or had ever used ADS. Cost (20%) and ignorance of such programs (20%) were primary reasons for not using ADS; reduction of stress was the most frequently cited reason for using ADS (73%). Ten in-person interviews were conducted with ADS program directors and service providers who refer clients to ADS. Funding issues emerged as the key challenge given lack of private insurance coverage and poor reimbursement levels from public insurance programs. Challenges around transportation, stigma, and marketing of services also surfaced in the interviews. Nonetheless, all ten informants spoke of the positive impact of ADS for both consumers and their caregivers, and generally endorsed intergenerational activities, though with caveats. Implications will be discussed, including the need for greater financial support for this valuable aspect of our long-term supports and services system.

Day-to-day and longer-term longitudinal associations between physical activity, sedentary behavior, and sleep in children

SLEEP ◽  
2020 ◽  
Author(s):  
Devan Antczak ◽  
Taren Sanders ◽  
Borja del Pozo Cruz ◽  
Philip Parker ◽  
Chris Lonsdale
Keyword(s):  
Physical Activity ◽  
Primary Schools ◽  
Fixed Effects ◽  
Vigorous Physical Activity ◽  
Sleep Onset ◽  
Sleep Efficiency ◽  
Night Time ◽  
Wake Time ◽  
Time In Bed ◽  
Longitudinal Associations

Abstract Study Objectives To determine the day-to-day and longer-term longitudinal associations between daytime physical activity and night-time sleep. Methods We used data from a 2-year longitudinal study which included three time points (i.e. baseline, year 1, and year 2). Participants were recruited from primary schools and included 1059 children (50% girls) with a mean age of 8.81-years-old (SD = 0.72) at baseline. Sleep variables included sleep duration, sleep efficiency, time in bed, sleep onset, and wake time. Physical activity variables included light, moderate, moderate-to-vigorous, and vigorous physical activity as well as sedentary time. We objectively assessed physical activity and sleep behaviors using the GENEActiv wrist-worn accelerometer over an 8-day period at each timepoint for a potential 21 190 observed days. Results We used fixed-effects multilevel models and parallel latent growth curve modeling to examine day-to-day and longer-term associations, respectively. Day-to-day, physical activity, and sleep variables were significantly, positively, and bidirectionally associated, except for sleep efficiency, which showed little association with physical activity. Longer-term, we found little association between physical activity and sleep variables. Conclusions Overall, our findings indicate that there is a day-to-day association between the amount of time spent being physically active and improved sleep. The lack of a longer-term association indicates that a focus on children’s daily behavior may be most appropriate to help children improve sleep and increase physical activity.

scholarly journals Implications of the COVID-19 Pandemic on Adult Day Services

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 110-111
Author(s):  
Katherine Marx ◽  
Laura Gitlin ◽  
Tina Sadarangani
Keyword(s):  
Family Caregivers ◽  
Long Term Care ◽  
The United States ◽  
Care Provision ◽  
Term Care ◽  
Adult Day Services ◽  
The People ◽  
Day Services ◽  
Residential Long Term Care

Abstract Adult day service (ADS) centers serve an important role in care provision for people living with dementia (PLWD). These programs provide socialization, activities, and access to many therapies for PLWD. Additionally, they offer respite to family caregivers so they can work, run errands, and recharge. In March 2020, like much of the nation, ADS sites across the nation were shut down. This left many PLWD and their caregivers without access to the services they depended on to manage day to day care. It also left many sites without a revenue source to pay employees and maintain buildings. Almost a year later, many states have still not reopened ADS and sites that have reopened have done so with a lower census, increased costs, and the lingering fear of a second closure. Much focus has been on the care of older adults in nursing homes or other residential long-term care settings but the challenges of ADS and the people they serve has been mostly ignored. The purpose of this symposium is to highlight the implications of the COVID-19 pandemic on ADS centers. Holly Dabelko-Schoeny will present data gathered from ADS Centers across Ohio. Lauren Parker, will then present data from ADS sites across the United States that examines the effect of COVID-19 on closures and programming during the closures. Katherine Marx will present the effect of ADS closures on family caregivers of persons living with dementia. Finally, Joseph Gaugler will explore this from a policy perspective and provide recommendations moving forward.

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