Clinical ReviewFamily Caregiving of Persons With Dementia: Prevalence, Health Effects, and Support Strategies
Section snippets
Dementia Caregiving
Dementia caregiving is the most frequently studied type of caregiving represented in the literature.5 Most older adults with dementia receive assistance from their spouse, but when the spouse is no longer alive or is unavailable to provide assistance, adult children usually step in to help. Adult daughters and daughters-in-law are more likely than sons and sons-in-law to provide routine assistance with household chores and personal care over long periods of time, and they also spend more hours
Health Effects of Caregiving
Although family caregivers perform an important service for society and their relatives, they do so at considerable cost to their own well-being. There is strong consensus that caring for an elderly individual with disability is burdensome and stressful to many family members and contributes to psychiatric morbidity in the form of higher prevalence and incidence of depressive and anxiety disorders.8, 17, 18, 19 Most studies indicate that female caregivers report higher levels of depressive and
Intervention Research
The accumulating evidence on the personal, social, and health impacts of caregiving has generated intervention studies aimed at decreasing the burden and stress of caregiving. The dominant theoretical model guiding the design of caregiver interventions is the stress/health model illustrated in the left column of Figure 1. According to this model, the primary stressors being placed on the caregiver include the level of patient cognitive impairment, the frequency of patient problem behaviors
Existing Guidelines for Practitioners
Caregivers play a critical role in the diagnosis and treatment of patients with dementia. Because caregivers have around-the-clock access to patient behavior and the knowledgebase to identify significant changes in patient functioning, they serve as a critical source of information for the clinical assessment of the patient.48 Also, treatments and behavioral interventions for the patient are typically implemented by the caregiver, who has day-to-day contact with the patient. The centrality of
Future Directions
Caregiving presents difficult, sometimes intractable problems, and although we have learned a great deal about how to describe and characterize the challenges of caregiving, assess its impact on family members, and identify promising intervention approaches, much more needs to be done. For example, with the exception of a few recent studies, we know relatively little about transitions into and out of the caregiving role. Understanding pre- or early caregiving stages may enable us to develop
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This work was supported by grants from the National Institute on Aging (K01 MH065547, R01 AG15321, U01-AG13313), National Institute of Mental Health (R01 MH46015, P30 MH52247),and National Institute for Nursing Research (R01 NR08272), and grant P50 HL65111-65112 (Pittsburgh Mind-Body Center) from the National Heart, Lung, and Blood Institute.