Physical Disability Contributes to Caregiver Stress in Dementia Caregivers

Edith Cowan University, Joondalup, Western Australia, Australia
The Journals of Gerontology Series A Biological Sciences and Medical Sciences (Impact Factor: 5.42). 04/2005; 60(3):345-9. DOI: 10.1093/gerona/60.3.345
Source: PubMed


Previous findings of studies on the impact of physical illness on caregiver health have been inconsistent. The authors wanted to determine whether physical disability, as determined by the SF-12 survey that provides information on both physical and mental health problems, contributes to caregiver stress.
The authors interviewed 91 primary caregivers (aged 38-85 years) of persons with dementia who had been referred by their family physicians for the first time for formal support services or memory evaluation. Caregivers completed the SF-12 version of the Medical Outcomes Study Short Form Health Survey that generates Mental Component Summary (MCS) and Physical Component Summary (PCS) scores and reported on caregiver stress and concurrent medical conditions and medications.
Most caregivers reported stress (76.9%), having medical conditions (72.4%), or taking medications (67%). The MCS but not the PCS scores were significantly lower than community norms, indicating an excess of disability due to mental health problems. Nevertheless, 40.7% had PCS scores indicating some degree of physical disability. Using multiple logistic regression analysis, PCS scores but not the presence of medical problems were independently associated with caregiver stress.
Chronic disability as assessed by SF-12 PCS scores is independently associated with caregiver stress. These data suggest that caregivers of persons with dementia should be assessed for disabling physical conditions and mental health problems. In addition, reducing the impact of physical disability could ameliorate caregiver stress.

Download full-text


Available from: David G Bruce, Sep 25, 2014
  • Source
    • "During the last decades, the Scientific Community has been interested in investigating the impact that the assistance of chronic patients produces over the family caregiver [8]. Connected to this, numerous studies that have been developed pointed out that taking care of a disabled person is a stressful process which increases the risk of physical and mental problems and tends to reduce the caregivers' social life. "
    [Show abstract] [Hide abstract]
    ABSTRACT: As worldwide population ages, an increase of inhabitants who suffer neurodegenerative diseases can be observed. Considering that the task of caregiving is generally carried out by a family member, he becomes an easy target for diseases, especially for being subjected to a stressing process. This study intends to analyze whether the older caregivers’ health suffers affections if compared with the health conditions of those who do not take care of family members. The present investigation defends the fact that the person who develops the activity of caregiving has high probabilities of developing diseases. An observational, analytical, cross sectional study was made. One hundred and twenty four (124) older adults divided in two groups were cross-examined: 62 interviewees were caregivers of chronic patients and 62 were not. The total amount of candidates was given two questionnaires: one analyzed socio-demographic data and the other one health disturbances. The results showed that 48% of the sample experienced unfavorable changes in their health, and that the condition of being a caregiver somehow predicted the changes (OR 15.) As for the kind of disturbance, it can be said that 85% of the caregivers went through psychical disturbances; however, there were no significant differences found between the selfperception of the caregivers and non-caregivers health conditions. The findings confirm the established hypothesis and coincide with other investigations: the caregiver suffers unfavorable health effects despite the fact that sometimes he is not aware of those negative consequences experienced. Therefore, family caregivers are referred to as “hidden patients.” Health services should promote psycho-educational intervention programs and diagnose for proper pharmacological treatment of depression and anxiety usually with SSRIs according to co-morbid conditions of the patient.
    Full-text · Article · Aug 2014
  • Source
    • "The instrument supports the calculation of Quality Adjusted Life Years (QALY). The SF-12 has been applied to people with dementia recently [53] and to caregivers [54]. The SF-12 appears to identify under-reported mental health problems in dementia caregivers [54]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: A recent Dutch mono-centre randomised controlled trial has shown that occupational therapy improves daily functioning in dementia. The aim of this present study is to compare the effects of the Dutch community occupational therapy programme with a community occupational therapy consultation on daily functioning in older people with mild or moderate dementia and their primary caregivers in a German multi-centre context. A multi-centre single blind randomised controlled trial design is being used in seven health care centres (neurological, psychiatric and for older people) in urban regions. Patients are 1:1 randomised to treatment or control group. Assessors are blind to group assignment and perform measurements on both groups at baseline, directly after intervention at 6 weeks and at 16, 26 and 52 weeks follow-up. A sample of 140 community dwelling older people (aged >65 years) with mild or moderate dementia and their primary caregivers is planned. The experimental intervention consists of an evidence-based community occupational therapy programme including 10 sessions occupational therapy at home. The control intervention consists of one community occupational therapy consultation based on information material of the Alzheimer Society. Providers of both interventions are occupational therapists experienced in treatment of cognitively impaired older people and trained in both programmes. 'Community' indicates that occupational therapy intervention occurs in the person's own home. The primary outcome is patients' daily functioning assessed with the performance scale of the Interview for Deterioration in Daily Living Activities in Dementia and video tapes of daily activities rated by external raters blind to group assignment using the Perceive, Recall, Plan and Perform System of Task Analysis. Secondary outcomes are patients' and caregivers' quality of life, mood and satisfaction with treatment; the caregiver's sense of competence, caregiver's diary (medication, resource utilisation, time of informal care); and the incidence of long-term institutionalisation. Process evaluation is performed by questionnaires and focus group discussion. The transfer from the Dutch mono-centre design to the pragmatic multi-site trial in a German context implicates several changes in design issues including differences in recruitment time, training of interventionists and active control group treatment.The study is registered under DRKS00000053 at the German register of clinical trials, which is connected to the International Clinical Trials Registry Platform.
    Full-text · Article · Oct 2009 · BMC Geriatrics
  • [Show abstract] [Hide abstract]
    ABSTRACT: Gesundheitsförderung und Prävention im Sinne eines komplementären planvollen Vorgehens zur Stärkung von gesundheitsbezogenen Ressourcen einerseits und einer Reduktion von Risiken andererseits sind klassische Kernbereiche von Public Health. Wird der Auftrag von Public Health darin gesehen, den bestmöglichen Gesundheitszustand für die größtmögliche Anzahl von Individuen zu erreichen bzw. zu erhalten, kommen nur Strategien und Maßnahmen in Betracht, die soziodemografische und Merkmale der Sozialstruktur berücksichtigen. Denn bekanntlich hängen soziale und gesundheitliche Ungleichheit eng miteinander zusammen. Für die Gruppe älterer Menschen gilt es, sowohl horizontale als auch vertikale Dimensionen sozialer Ungleichheit einzubeziehen (vgl. für einen kurzen Abriss zu Public Health auch in Bezug auf den Altersstrukturwandel: Kolominsky- Rabas 2006).
    No preview · Article · Jan 2011
Show more