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Behavioural Problems and Distress among Caregivers of People with Dementia

Published online by Cambridge University Press:  14 November 2008

Neena L. Chappell
Affiliation:
Centre on Aging, Department of Sociology, University of Victoria, P.O. Box 1700, MS 6369, Victoria, B.C., Canada V8W 2Y2.
Margaret Penning
Affiliation:
Centre on Aging, Department of Sociology, University of Victoria, P.O. Box 1700, MS 6369, Victoria, B.C., Canada V8W 2Y2.

Abstract

This paper seeks to identify specific problem behaviours related to the distress experienced by informal caregivers of dementia victims. Analyses are conducted using a random sample of caregivers rather than a restricted clinical sample. Distress is measured in terms of both depression and caregiver burden. The findings reveal that specific behaviours on the part of the care receiver are strong correlates of the distress experienced by caregivers. In particular, aimlessness, aggressive behaviours, forgetfulness, and restlessness are correlated with heightened feelings of burden. Apathy or a lack of interest in daily activities is strongly correlated with both feelings of burden and depression. The identification of specific problem behaviours suggests where efforts should be placed in order to alleviate the distress experienced by informal caregivers.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1996

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References

American Psychiatric Association. 1987. Diagnostic and Statistical Manual of Mental Disorders (Third ed. — revised). American Psychiatric Association, Washington, D.C.Google Scholar
Bass, D. M., McClendon, M.J., Deimling, G. T. and Mukherjee, S. 1994. The influence of a diagnosed mental impairment on family caregiver strain. Journal of Gerontology: Social Sciences, 49, S146–S155.CrossRefGoogle ScholarPubMed
Baumgarten, M. 1989. The health of persons giving care to the demented elderly: a critical review of the literature. Journal of Clinical Epidemiology, 42, 11371148.CrossRefGoogle Scholar
Baumgarten, M., Becker, R. and Gauthier, S. 1990. Validity and reliability of the Dementia Behaviour Disturbance Scale. Journal of the American Geriatric Society, 38, 221226.CrossRefGoogle ScholarPubMed
Biegel, D. E., Sales, E. and Schulz, R. 1991. Family Caregiving in Chronic Illness. Sage, Newbury Park.Google Scholar
Canadian Study of Health and Aging. 1994. Canadian Study of Health and Aging: study methods and prevalence of dementia. Canadian Medical Association Journal, 150, 899913.Google Scholar
Chiriboga, D. A., Weiler, P. G. and Nielsen, K. 1990. The stress of caregivers. In Biegel, D. E. and Blum, A. (Eds.), Aging and Caregiving: Theory, Research, and Policy. Sage, Newbury Park, CA.Google Scholar
Deimling, G. T. and Bass, D. M. 1986. Symptoms of mental impairment among elderly adults and their effects on family caregivers. Journal of Gerontology, 41, 6, 778784.CrossRefGoogle ScholarPubMed
Eagles, J. M., Craig, A. and Rawlinson, F. 1987. The psychological well-being of supporters of the demented elderly. British Journal of Psychiatry, 150, 293298.CrossRefGoogle ScholarPubMed
Fillenbaum, G. G. 1988. Multidimensional Functional Assessment of Older Adults: The Duke Older Americans Resources and Services Procedures. Lawrence Erlbaum Associates, Hillsdale, W.J.Google Scholar
Gallagher, D., Rose, J., River, P., Lovett, S. and Thompson, L. W. 1989. Prevalence of depression in family caregivers. Gerontologist, 29, 449456.CrossRefGoogle ScholarPubMed
George, L. K. and Gwyther, L. P. 1986. Caregiver well-being: a multidimensional examination of family caregivers of demented adults. The Gerontologist, 26, 253259.CrossRefGoogle ScholarPubMed
Gilhooly, M. L. M. 1984. The impact of caregiving on caregivers: factors associated with the psychological well-being of people supporting a dementia relative in the community. British Journal of Medical Psychology, 57, 3544.CrossRefGoogle ScholarPubMed
Gilleard, C.J., Belford, H., Gilleard, E., Whittick, J. E. and Gledhill, K. 1984. Emotional distress amongst the supporters of the elderly mentally infirm. British Journal of Psychiatry, 145, 172177.CrossRefGoogle ScholarPubMed
Grafstrom, M., Fratiglioni, L., Sandman, P. O. and Winblad, B. 1992. Health and social consequences for relatives of demented and non-demented elderly: a population-based study. Journal of Clinical Epidemiology, 45, 861870.CrossRefGoogle ScholarPubMed
Greene, J. G., Smith, R., Gardiner, M. and Timbury, G. C. 1982. Measuring behavioural disturbance of elderly demented patients in the community and its effects on relatives: a factor analytic study. Age and Ageing, 11, 121126.CrossRefGoogle ScholarPubMed
Haley, W. E., Levine, E. G., Brown, S. L. and Bartolucci, A. A. 1987 a. Stress, appraisal, coping, and social support as predictors of adaptational outcome among dementia caregivers. Psychology and Aging, 2, 323330.CrossRefGoogle ScholarPubMed
Haley, W. E., Levine, E. G., Brown, S. L., Berry, J. W. and Hughes, G. H., 1987 b. Psychological, social, and health consequences of caring for a relative with senile dementia. Journal of the American Geriatrics Society, 35, 405411.CrossRefGoogle ScholarPubMed
Hamel, M., Gold, D. P., Andres, D., Reis, M., Dastoor, D., Grauer, H. and Bergman, H. 1990. Predictors and consequences of aggressive behaviour of community-based dementia patients. The Gerontologist, 30, 206211.CrossRefGoogle ScholarPubMed
Harper, S. and Lund, D. 1990. Wives, husbands, and daughters caring for institutionalized and noninstitutionalized dementia patients: toward a model of caregiver burden. International Journal of Aging and Human Development, 30, 4, 241261.CrossRefGoogle Scholar
Kiecolt-Glaser, J. K., Glaser, R., Shuttleworth, E. C. et al. 1987. Chronic stress and immunity in family caregivers of Alzheimer's disease victims. Psychosom Med, 49, 523535.CrossRefGoogle ScholarPubMed
Kinney, J. M. and Stephens, M. P. 1989. Hassles and uplifts of giving care to a family member with dementia. Psychology and Aging, 4, 402408.CrossRefGoogle ScholarPubMed
Levine, N. B., Dastoor, D. P. and Gendron, C. E. 1983. Coping with dementia: a pilot study. Journal of the American Geriatrics Society, 31, 1218.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. 1984. Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-aDRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939944.CrossRefGoogle ScholarPubMed
Montgomery, R. J. V., Kosloski, K. and Borgatta, E. 1990. Service use and the caregiving experience: does Alzheimer's disease make a difference? In Biegel, D. E. and Blum, A. (Eds.), Aging and Caregiving: Theory, Research, and Policy. Sage, Newbury Park, CA.Google Scholar
Morris, L. W., Morris, Robin G. and Britton, Peter G. 1988. The relationship between marital intimacy, perceived strain and depression in spouse caregivers of dementia sufferers. British Journal of Medical Psychology, 61, 231236.CrossRefGoogle ScholarPubMed
Novak, M. and Guest, C. 1987. Application of a multidimensional caregiver burden inventory. The Gerontologist, 29, 6, 798803.CrossRefGoogle Scholar
O'Connor, D. W., Pollitt, P. A., Roth, M., Brook, C. P. B. and Reiss, B. B. 1990. Problems reported by relatives in a community study of dementia. British Journal of Psychiatry, 156, 835841.CrossRefGoogle Scholar
Pagel, M. D., Becker, J. and Coppel, D. B. 1985. Loss of control, self-blame, and depression: an investigation of spouse caregivers of Alzheimer's disease patients. Journal of Abnormal Psychology, 94, 169182.CrossRefGoogle ScholarPubMed
Pearlin, L. I., Mullan, J. T., Semple, S.J. and Skaff, M. M. 1990. Caregiving and the stress process: an overview of concepts and their measures. The Gerontologist, 30, 8393.CrossRefGoogle ScholarPubMed
Poulshock, S. W. and Deimling, G. T. 1984. Families caring for elders in residence: issues in the measurement of burden. Journal of Gerontology, 39, 2, 230239.CrossRefGoogle ScholarPubMed
Pruchno, R. A. and Resch, N. L. 1989. Aberrant behaviours and Alzheimer's disease: mental health effects on spouse caregivers. Journal of Gerontology: Social Sciences, 44, S177–S182.CrossRefGoogle ScholarPubMed
Rabins, P. V., Mace, N. L. and Lucas, M.J. 1982. The impact of dementia on the family. Journal of the American Medical Association, 248, 333335.CrossRefGoogle ScholarPubMed
Radloff, L. S. 1977. The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385401.CrossRefGoogle Scholar
Schulz, R., Williamson, G. M., Morycz, R. and Biegel, D. E. 1993. Changes in depression among men and women caring for an Alzheimer's patient. In Zarit, S. H., Pearlin, L. I., and Schaie, K. Warner (Eds.), Caregiving Systems: Formal and Informal Helpers. Lawrence Erlbaum, Hillsdale, NJ, 119–40.Google Scholar
Scott, J. P., Roberto, K. A. and Hutton, J. T. 1986. Families of Alzheimer's victims: family support to caregivers. Journal of the American Geriatrics Society, 34, 348354.CrossRefGoogle ScholarPubMed
Shapiro, E. 1990. Impact of Alzheimer's on personal care homes and home care in the next decade. Address to the Alzheimer's Society, May 1990.Google Scholar
Stommel, M. C., Given, C. and Given, B. 1990. Depression as an overriding variable explaining caregiver burdens. Journal of Aging and Health, 2, 81102.CrossRefGoogle Scholar
Teng, E. L. and Chui, H. C. 1987. The Modified Mini-Mental State (3MS) Examination. Journal of Clinical Psychiatry, 48, 314318.Google ScholarPubMed
Teng, E. L., Chui, H. C. and Gong, A. 1990. Comparisons between the Mini-Mental State Exam (MMSE) and its modified version — the 3MS test. In Hasegawa, K. and Homma, A. (Eds.), Psychogeriatrics: biomedical and social advances. Selected proceedings of the Fourth Congress of the International Psychogeriatric Association, September 5–8, Tokyo: Excerpta Medica, 189192.Google Scholar
Tennstedt, S., Cafferata, G. L. and Sullivan, L. 1992. Depression among caregivers of impaired elders. Journal of Aging and Health, 4, 1, 5876.CrossRefGoogle ScholarPubMed
Tombaugh, T. N., McIntyre, N.J. 1992. The Mini-Mental State Examination: a comprehensive review. Journal of the American Geriatrics Society, 40, 9, 922935.CrossRefGoogle ScholarPubMed
Wilder, D. E., Teresi, J. A. and Bennett, R. G. 1983. Family burden and dementia. In Mayeux, R. and Rosen, W. G. (Eds.), The Dementias. Raven Press, New York.Google Scholar
World Health Organization. 1987. Tenth revision of the International Classification of Diseases, 1987 draft of chapter V, categories F00–F99, mental behavioural and developmental disorders. In Clinical Descriptions and Diagnostic Guidelines. MNH/MEP/87.1 Rev. 1. WHO, Geneva.Google Scholar
Yu, L. C. and Kaltreider, D. L. 1987. Stressed nurses: dealing with incontinent patients. Journal of Gerontological Nursing, 13, 1, 2730.CrossRefGoogle ScholarPubMed
Zarit, S. H. and Zarit, J. M. 1983. The Burden Interview. Ethel Percy Andrus Gerontology Centre, Los Angeles, CA.Google Scholar
Zarit, S. H., Reever, K. E. and Bach-Peterson, J. 1980. Relatives of impaired elderly: correlates of feelings of burden. The Geronlologist, 20, 649655.CrossRefGoogle ScholarPubMed
Zarit, S. H., Anthony, C.R. and Boutselis, M. 1987. Interventions with caregivers of dementia patients: comparison of two approaches. Psychology and Aging, 2, 225232.CrossRefGoogle Scholar