Based on the stress and coping model of Lazarus and Folkman, the aim of this comparative study was to determine whether the caregiving experience of the caregivers of an institutionalized demented relative is different from the one of the caregivers whose relative does not suffer from dementia. Five dimensions of the caregiving experience were considered: stressors, cognitive appraisal of the stressors, social support, coping strategies and well-being. The sample consisted of primary caregivers of a demented and a nondemented relative. Results revealed that the caregivers of a demented relative were exposed to more stressors than the caregivers of a nondemented relative. Functional impairment as well as depressive behaviors were appraised as more disturbing. According to MANCOVA analysis, formal and informal social support seems to play a protective role in the psychological distress of the caregivers of a demented relative. There was no difference between the two groups with regard to their coping strategies. Overall, the caregivers of a demented relative seemed to experience some dimensions of caregiving in a different way compared with their counterparts, and the nature of dementia in itself helps to explain this difference.
Get full access to this article
View all access options for this article.
References
1.
Abel, E. K. (1990). Informal care for the disabled elderly. A critique of recent literature. Research on Aging, 12, 139-157.
2.
Almberg, B. , Grafström, M., & Winblad, B. (1997). Caring for a demented elderly person—burden and burnout among caregiving relatives.Journal of Advanced Nursing, 25, 109-116.
3.
Aneshensel, C. S. , Pearlin, L. I., Mullan, J. T., Zarit, S. H., & Whitlach, C. J. (1995). Profiles in caregiving: The unexpected career. New York: Academic Press.
4.
Barber, C. E. (1993). Spousal care of Alzheimer’s disease patients in nursing home versus in-home settings: Patient impairments and caregiver impacts. Clinical Gerontologist, 12, 3-30.
5.
Biegel, D. E. , Sales, E., & Schulz, R. (1991). Family caregiving in chronic illness. Newbury Park, CA: Sage.
6.
Billing, A.G. , & Moos, R. H. (1981). The role of coping responses and social resources in attenuating the stress of life events. Journal of Behavioral Medicine, 4, 139-157.
7.
Bonder, B. R. , Miller, B., & Linsk, M. (1991). Who should do what? Staff and family responsibilities for persons with Alzheimer’s disease in nursing homes. Clinical Gerontologist, 10, 80-84.
8.
Bowers, B. (1988). Family perception of care in a nursing home. The Gerontologist, 28, 361-369.
9.
Bradburn, N. M. (1969). The structure of psychological well-being. Chicago: Adline de Gruyter.
10.
Buck, D. , Gregson, B. A., Bamford, C. H., McNamee, P., Farrow, G. N., Bond, J., & Wright, K. (1997). Psychological distress among informal supporters of frail older people at home and in institutions. International Journal of Geriatric Psychiatry, 12, 737-744.
11.
Canadian Study of Health and Aging (CSHA) Working Group . (1994). Patterns of caring for people with dementia in Canada. Canadian Journal on Aging/La Revue Canadienne du Vieillissement, 13, 470-487.
12.
Carruth, A. K. (1996). Motivating factors, exchange patterns, and reciprocity among caregivers of parents with and without dementia. Research in Nursing & Health, 19, 409-419.
13.
Chenier, M. C. (1997). Review and analysis of caregiver burden and nursing home placement. Geriatric Nursing, 18, 121-126.
14.
Cohen, S. , & Wills, T. (1985). Stress, social support and the buffering hypothesis. Psychological Bulletin, 98, 310-357.
15.
Duncan, M. T. , & Morgan, D. L. (1994). Sharing the caring: Family caregivers’ views of their relationships with nursing home staff. The Gerontologist, 34, 235-244.
16.
Folkman, S. , & Lazarus, R. S. (1988). Manual for the ways of coping questionnaire. Palo Alto, CA: Consulting Psychologists Press.
17.
Folstein, M. , Folstein, S., & McHugh, P. (1975). Mini-Mental State: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189-198.
18.
Gendron, M. , & Lévesque, L. (1993). Evaluating the functional autonomy of persons with Alzheimer’s disease: A tool for observing four activities of daily living. The American Journal of Alzheimer’s Care and Related Disorders and Research, 8, 24-35.
19.
George, L. K. , & Bearon, L. B. (1980). Quality of life in older persons. New York: Human Sciences Press.
20.
Gouvernement du Québec. (1996). Enquête santé Québec: Enquête sociale et de santé de 1992-1993. Québec, Canada: Ministère de la Santé et des Services Sociaux.
21.
Grafström, M. , Fratiglioni, L., Sandman, P. O., & Winblad, B. (1992). Health and social consequences for relatives of demented and non-demented elderly. A population-based study. Journal of Clinical Epidemiology, 45, 861-870.
22.
Greene, V. L. , & Monahan, D. J. (1982). The impact of visitation on patient well-being in nursing homes. The Gerontologist, 22, 418-423.
23.
Haccoun, R. R. (1987). Une nouvelle technique de vérification de l’équivalence de mesures psychologiques traduites. Revue Québécoise de Psychologie, 8, 30-39.
24.
Harris, M. M. , & Bladen, A. (1994). Wording effects in the measurement of role conflict and role ambiguity: A multitrait-multimethod analysis. Journal of Management, 20, 887-901.
25.
Harrison, D. A. , & McLaughlin, M. E. (1993). Cognitive processes in self-report responses: Tests of item context effects in work attitude measure. Journal of Applied Psychology, 78,129-140.
26.
Hébert, R. , Bravo, G., & Girouard, D. (1993). Fidélité de la traduction française de trois instruments d’évaluation des aidants naturels de malades déments. Canadian Journal on Aging/La Revue Canadienne du Vieillissement, 12, 324-337.
27.
Hertzberg, A. , & Ekman, S.-L. (1996). How the relatives of elderly patients in institutional care perceive the staff. Scandinavian Journal of Caring Sciences, 10, 205-211.
28.
Huitema, B. E. (1980). The analysis of covariance and alternatives. New York: John Wiley.
29.
Ilfeld, F. W. (1976). Further validation of Psychiatric Symptom Index in a normal population. Psychological Report, 39, 1215-1228.
30.
Kammer, C. H. (1994). Stress and coping of family members responsible for nursing home placement. Research in Nursing & Health, 17, 89-98.
31.
King, S. , Collins, C., Given, B., & Vredevoogd, J. (1991). Institutionalization of an elderly family member: Reactions of spouse and non-spouse caregivers. Archives of Psychiatric Nursing, 5, 323-330.
32.
Latourelle, D. , & Lévesque, L. (1985). Intervenir auprès du malade chronique hospitalisé et de sa famille. Canadian Journal of Community Mental Health/Revue Canadienne de Santé Mentale Communautaire, 4, 89-104.
33.
Lawton, M. P. , Moss, M., Kleban, M. H., Glickman, A., & Rovine, M. (1991). A two-factor model of caregiving appraisal and psychological well-being. Journal of Gerontology, 46, 181-189.
34.
Lazarus, R. S. , & Folkman, S. (1984). Stress, appraisal and coping. New York: Springer.
35.
Lévesque, L. , Cossette, S., & Laurin, L. (1995). A multidimensional examination of the psychological and social well-being of caregivers of a demented relative. Research on Aging, 17, 332-360.
36.
Maas, M. L. , Buckwalter, K. C., Kelley, L. S., & Stolley, J. M. (1991). Family members’perceptions. How they view care of Alzheimer’s patients in a nursing home. Journal of Long-Term Care Administration, 19, 21-25.
37.
Moos, R. H. , Cronkite, R. C., & Finney, J. W. (1990). Health and daily living form: Manual (2nd ed.). Palo Alto, CA: Center of Health Care Evaluation, Stanford University.
38.
Naleppa, M. J. (1996). Families and the institutionalized elderly: A review. Journal of Gerontological Social Work, 27, 87-111.
39.
Nightingale, F. (1860). Notes on nursing: What it is and what it is not. London: Harrison.
40.
Oberst, M. , Thomas, S., Grass, K., & Ward, S. (1989). Caregiving demands and appraisal of stress among family caregivers. Cancer Nursing, 12, 209-215.
41.
Pearlin, L. I. , Mullan, J. T., Semple, S. J., & Skaff, M. M. (1990). Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30, 583-594.
42.
Perkinson, M. A. , Albert, S. M., Luborsky, M., Moss, M., & Glicksman, A. (1994). Exploring the validity of the Affect Balance Scale with a sample of family caregivers. Journal of Gerontology, 49, S264-S265.
43.
Rosenthal, C. J. , Sulman, J., & Marshall, V. W. (1992). Problems experienced by families of long-stay patients. Canadian Journal on Aging/La Revue Canadienne du Vieillissement, 11, 169-183.
44.
Ross, M. M. , Rosenthal, C. J., & Dawson, P. G. (1993). Spousal caregiving following institutionalization: The experience of elderly wives. Journal of Advanced Nursing, 18, 1531-1539.
45.
Ross, M. M. , Rosenthal, C. J., & Dawson, P. G. (1997a). Spousal caregiving in the institutional setting: Task performance. Canadian Journal on Aging/La Revue Canadienne du Vieillissement, 16, 51-69.
46.
Ross, M. M. , Rosenthal, C. J., & Dawson, P. G. (1997b). Patterns of caring following the institutionalization of elderly husbands. Canadian Journal of Nursing Research, 29, 79-98.
47.
Stephens, M.A.P. , Kinney, J. M., & Ogrocki, P. K. (1991a). Stressors and well-being among caregivers to older adults with dementia: The in-home versus nursing home experience. The Gerontologist, 31, 217-223.
48.
Stephens, M.A.P. , Kinney, J. M., & Ogrocki, P. K. (1991b). Sources of stress for family caregivers of institutionalized dementia patients. Journal of Applied Gerontology, 10, 328-342.
49.
Stewart, M. J. (1993). Integrating social support in nursing. Newbury Park, CA: Sage.
50.
Tabachnick, B. G. , & Fidell, L. S. (1996). Using multivariate statistics. New York: Harper Collins.
51.
Teri, L. , Truax, P., Logsdon, R., Uomoto, J., Zarit, S., & Vitalino, P. P. (1992). Assessment of behavioral problems in dementia: The revised memory and behavior problems checklist. Psychology and Aging, 4, 622-631.
52.
Tilden, V. P. , Nelson, C. A., May, B. A. (1990). The IPR Inventory: Development and psychometric characteristics. Nursing Research, 39, 337-343.
53.
Townsend, A. L. (1990). Nursing home care and the family caregivers’ stress. In M.A.P. Stephens (Ed.), Stress and coping in later-life families (pp. 267-280). New York: Hemisphere.
54.
Wuest, J. , Ericson, P. K., & Stern, P. N. (1994). Becoming strangers—The changing family caregiving relationship in Alzheimer disease. Journal of Advanced Nursing, 20, 437-443.
55.
Zarit, S. H. (1989). Issues and directions in family: Intervention research. In E. Light & B. D. Lebowitz (Eds.), Alzheimer’s disease treatment and family stress: Directions for research (pp. 458-486). Rockville, MD: National Institute of Mental Health.
56.
Zarit, S. H. , & Whitlatch, C. J. (1992). Institutional placement: Phases of the transition. The Gerontologist, 32, 665-672.
57.
Barusch, A. S. , & Spaid, W. M. (1996). Spouse caregivers and the caregiving experience: Does cognitive impairment make a difference?Journal of Gerontological Social Work, 25(3/4), 93-105.
58.
Duncan, M. T. , & Morgan, D. L. (1994). Sharing the caring: Family caregivers’ views of their relationships with nursing home staff. The Gerontologist, 34(2), 235-244.
59.
Denton, M. (1997). The linkages between informal and formal care of the elderly. Canadian Journal of Aging, 16, 30-50.
60.
Bowers, B. J. (1988). Family perceptions of care in a nursing home. The Gerontologist, 28, 361-368.
61.
Nolan, M. , Grant, G., & Keady, J. (1996). Understanding family care. Philadelphia, PA: Open University Press.
62.
Teri, L. , Truax, P., Logsdon, R., Uomoto, J., Zarit, S., & Vitalino, P. P. (1992). Assessment of behavioral problems in dementia: The revised memory and behavior problems checklist. Psychology and Aging, 4, 622-631.
