Vugt ME, Stevens F, Aalten P, et al. Do caregiver management strategies influence patient behaviour in dementia

Department of Psychiatry and Neuropsychology, University of Maastricht, The Netherlands.
International Journal of Geriatric Psychiatry (Impact Factor: 2.87). 01/2004; 19(1):85-92. DOI: 10.1002/gps.1044
Source: PubMed


Little is known about the effectiveness of caregiver management strategies on the functioning of the demented patient. However, identification of specific caregiver strategies may provide useful information on the management and manifestation of behavioural problems in dementia.
Ninety-nine patients with dementia and their informal caregivers were followed up for one year. Interviews were used to assess differences in caregiver management strategies. Behavioural disturbances in the patient were measured with the Neuropsychiatric Inventory (NPI). Repeated measures analysis were carried out to investigate the relationship between caregiver management strategies and patient behaviour.
Three caregiver management strategies were identified, based on whether caregivers accepted, or not, the caregiving situation and dementia related problems. Caregivers characterized by non-acceptance were typified as 'Non-adapters'; caregivers characterized by acceptance were further subdivided into two groups typified as 'Nurturers' and 'Supporters'. Caregiver characteristics such as sex, education and personality were important determinants of management strategies. MANOVA showed that non-adapters reported significantly more hyperactivity symptoms in patients and felt less competent than did supporters.
Caregiver management strategies would appear to be associated with behavioural problems in dementia, and are important in predicting patient behaviour and caregiver burden. Intervention programmes should aim at teaching caregivers adequate management strategies.

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    • "life of both the caregiver and care-recipient, as dealing with the burden might be reflected through cultural and social norms (De Vugt et al., 2005). It seems that the impact of caregiving on the caregivers depends on how they maintain a balance between caregiving activities and personal tasks. "
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    • "REVIEW ARTICLE stressful and burdensome caregiving process (Donaldson and Burns, 1999; Vitaliano et al., 2003; de Vugt et al., 2004). Therefore, they could be referred to—as Brodaty and Donkin (2009) put it— " the invisible second patient. "
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