Sage Journals: Discover world-class research

Abstract

Empathic perspective-taking may support mental health in caregivers of people living with dementia (PLWD). A photo captioning intervention can promote perspective-taking by guiding caregivers to capture the inner voice of the PLWD. Caregivers’ approaches to captioning may be an important mechanism of intervention efficacy. Using a mixed-methods design including subgroup parallel sampling and descriptive content-analysis of 310 captions from an intervention trial, we identified patterns in caregivers’ photo captioning. Captions from caregivers who experienced increases in perspective-taking (1) maintained first-person, PLWD focused language, (2) highlighted engagement and intention, and (3) illustrated resilient living. Captions from caregivers who experienced little-to-no increases in perspective-taking (1) offered inconsistent, incomplete phrasing, (2) provided generic, detached descriptions, and (3) adopted a negative, critical tone. Captions from both subgroups (1) connected PLWDs’ emotions to events and (2) recorded PLWDs’ wonders, wants, and wishes. Results support the development and refinement of perspective-taking interventions to maximize caregiver benefits.

Keywords

perspective taking Alzheimer's disease family caregiving behavioral intervention

Get full access to this article

View all access options for this article.

References

Batson

C. D.

Early

Salvarani

(1997). Perspective taking: Imagining how another feels versus imaging how you would feel. Personality and Social Psychology Bulletin, 23(7), 751–758. https://doi.org/10.1177/0146167297237008

Bientzle

Eggeling

Kanzleiter

Thieme

Kimmerle

(2021). The impact of narrative writing on empathy, perspective-taking, and attitude: Two randomized controlled experiments on violations of Covid-19 protection regulations. PloS One, 16(7), Article e0254501. https://doi.org/10.1371/journal.pone.0254501

Bloom

Osso

McCarthy

Falzarano

(2023). Motivations and role captivity among informal caregivers to community-dwelling persons with dementia. Innovation in Aging, 7(Suppl 1), 745. https://doi.org/10.1093/geroni/igad104.2411

Creswell

J. W.

Clark

V. L. P.

(2017). Designing and conducting mixed methods research. Sage publications.

Davis

M. H.

(1983). Measuring individual differences in empathy: Evidence for a multidimensional approach. Journal of Personality and Social Psychology, 44(1), 113–126. https://doi.org/10.1037/0022-3514.44.1.113

Decety

Jackson

P. L.

(2006). A social-neuroscience perspective on empathy. Current Directions in Psychological Science, 15(2), 54–58. https://doi.org/10.1111/j.0963-7214.2006.00406.x

Galinsky

A. D.

Moskowitz

G. B.

(2000). Perspective-taking: Decreasing stereotype expression, stereotype accessibility, and in-group favoritism. Journal of Personality and Social Psychology, 78(4), 708–724. https://doi.org/10.1037//0022-3514.78.4.708

Gaugler

J. E.

(2022). Unpaid dementia caregiving: A policy and public health imperative. Public Policy & Aging Report, 32(2), 51–57. https://doi.org/10.1093/ppar/prac002

Gehlbach

(2023). How we understand others: A theory of how social perspective taking unfolds. Review of General Psychology, 27(3), 282–302. https://doi.org/10.1177/10892680231152595

10.

Gitlin

L. N.

Corcoran

Martindale-Adams

Malone

Stevens

Winter

(2000). Identifying mechanisms of action: Why and how does intervention work. In: Handbook on dementia caregiving: Evidence-based interventions for family caregivers (pp. 225–248). Springer Publishing Company.

11.

Han

Kim

T. H.

Hong

(2021). A factorial randomized controlled trial to examine separate and combined effects of a simulation-based empathy enhancement program and a lecture-based education program on family caregivers of people with dementia. Aging & Mental Health, 25(10), 1930–1940. https://doi.org/10.1080/13607863.2020.1768214

12.

Huo

Yoneda

Wei

Abbott

Monin

J. K.

(2025). Empathy and psychological outcomes in informal caregivers of community-dwelling older adults: A systematic review and meta-analysis. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 80(6), gbaf018. https://doi.org/10.1093/geronb/gbaf018

13.

Jütten

L. H.

Mark

R. E.

Sitskoorn

M. M.

(2019). Empathy in informal dementia caregivers and its relationship with depression, anxiety, and burden. International Journal of Clinical and Health Psychology: IJCHP, 19(1), 12–21. https://doi.org/10.1016/j.ijchp.2018.07.004

14.

Kitwood

(1997). Dementia Reconsidered the person comes. first Open University Press. Maidenhead.

15.

Kripal

S. J.

Reiter-Palmon

(2024). The role of empathy in problem construction and creative problem solving. Learning and Individual Differences, 114(4), Article 102501. https://doi.org/10.1016/j.lindif.2024.102501

16.

Lamm

Batson

C. D.

Decety

(2007). The neural substrate of human empathy: Effects of perspective-taking and cognitive appraisal. Journal of Cognitive Neuroscience, 19(1), 42–58. https://doi.org/10.1162/jocn.2007.19.1.42

17.

Lin

S.-Y.

Lewis

F. M.

(2015). Dementia friendly, dementia capable, and dementia positive: Concepts to prepare for the future. The Gerontologist, 55(2), 237–244. https://doi.org/10.1093/geront/gnu122

18.

Lovell

Newman

Wetherell

M. A.

(2023). Seeing it my way: A perspective taking intervention alleviates psychological distress in caregivers of autistic children. Research in Developmental Disabilities, 133(5), Article 104396. https://doi.org/10.1016/j.ridd.2022.104396

19.

Mroz

E. L.

Ali

Piechota

Matta-Singh

T. D.

Abboud

Sharma

Monin

J. K.

Fried

T. R.

(2024). Personal health planning in adult-child former caregivers of parents living with dementia. American Journal of Health Promotion: AJHP, 38(3), 402–411. https://doi.org/10.1177/08901171231204670

20.

Onwuegbuzie

A. J.

Leech

N. L.

(2007). Sampling designs in qualitative research: Making the sampling process more public. Qualitative Report, 12(2), 238–254.

21.

Rilling

J. K.

Lee

McIsaac

Factor

Gallagher

Kim

J. H.

Zhang

Zhou

McDade

T. W.

Hepburn

Perkins

M. M.

(2024). Evaluation of a photo captioning cognitive empathy intervention for dementia caregivers. Clinical Gerontologist, 47(5), 1–14. https://doi.org/10.1080/07317115.2024.2317972

22.

Sabatini

Turner

S. G.

Stephan

B. C.

(2025). Correlates of self-perceptions of aging in dementia caregivers: Findings from the German aging survey. Aging & Mental Health, 29(7), 1–13. https://doi.org/10.1080/13607863.2025.2464705

23.

Sandelowski

(2000). Whatever happened to qualitative description? Research in Nursing & Health, 23(4), 334–340. https://doi.org/10.1002/1098-240x(200008)23:4<334::aid-nur9>3.0.co;2-g

24.

Shim

Barroso

Davis

L. L.

(2012). A comparative qualitative analysis of stories of spousal caregivers of people with dementia: Negative, ambivalent, and positive experiences. International Journal of Nursing Studies, 49(2), 220–229. https://doi.org/10.1016/j.ijnurstu.2011.09.003

25.

Sörensen

Conwell

(2011). Issues in dementia caregiving: Effects on mental and physical health, intervention strategies, and research needs. The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry, 19(6), 491–496. https://doi.org/10.1097/JGP.0b013e31821c0e6e

26.

Suri

(2011). Purposeful sampling in qualitative research synthesis. Qualitative Research Journal, 11(2), 63–75. https://doi.org/10.3316/qrj1102063

27.

Thompson

N. M.

Van Reekum

C. M.

Chakrabarti

(2022). Cognitive and affective empathy relate differentially to emotion regulation. Affective Science, 3(1), 118–134. https://doi.org/10.1007/s42761-021-00062-w

28.

Tong

Sainsbury

Craig

(2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care: Journal of the International Society for Quality in Health Care, 19(6), 349–357. https://doi.org/10.1093/intqhc/mzm042

29.

Vaismoradi

Turunen

Bondas

(2013). Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nursing & Health Sciences, 15(3), 398–405. https://doi.org/10.1111/nhs.12048

30.

Waligora

K. J.

Bahouth

M. N.

Han

H.-R.

(2019). The self-care needs and behaviors of dementia informal caregivers: A systematic review. The Gerontologist, 59(5), e565–e583. https://doi.org/10.1093/geront/gny076

31.

Wijma

E. M.

Veerbeek

M. A.

Prins

Pot

A. M.

Willemse

B. M.

(2018). A virtual reality intervention to improve the understanding and empathy for people with dementia in informal caregivers: Results of a pilot study. Aging & Mental Health, 22(9), 1121–1129. https://doi.org/10.1080/13607863.2017.1348470

32.

Zarit

S. H.

Reever

K. E.

Bach-Peterson

(1980). Relatives of the impaired elderly: Correlates of feelings of burden. The Gerontologist, 20(6), 649–655. https://doi.org/10.1093/geront/20.6.649

“One More Picture:” A Mixed-Methods Examination of Caption Content in a Photo Captioning Cognitive Empathy Intervention for Dementia-Caregivers

Abstract

Keywords

Get full access to this article

References