carer strain in dementia

Alzheimer's dementia is one of the most commost mental health disorders associated with aging. In its earlier stages sufferers live independently but gradually rely increasingly on loved ones or formal carers for support as the illness progresses. Its treatment involves both medical and social care. This study assesses the impact of outpatients' care and cholinesterase inhibitors in patients being treated for Alzheimer's dementia. The needs and quality of life of patients attending an outpatients dementia care service were assessed using the Camberwell Assessment of Need for the Elderly (CANE) and Quality of Life in Alzheimer's Disease: Patient and Caregiver report...

BACKGROUND: Family carers are the most important source of dementia care, especially among ethnic minority populations, who are less likely to access health or social services. The evidence base on the carer experience in these communities is profoundly limited. AIMS: To explore the caregiving attitudes, experiences and needs of family carers of people with dementia from the three largest ethnic groups in the UK. METHOD: A qualitative study, using a grounded theory approach...

BACKGROUND: Too little is currently known about the prevalence of and risk factors for depression and carer strain among informal carers of community-dwelling elderly mentally ill. This study seeks to assess the prevalence of depression, using the Geriatric Depression Scale-15 (GDS-15), the degree of carer burden/strain, and their risk factors among the primary informal carers of patients referred to our community-based old age psychiatry service. METHODS: A cross-sectional study design was used, with the subjects comprising 100 primary informal carers of patients who live at home and were referred to our service...

OBJECTIVE: To identify carer and patient characteristics associated with various aspects of burden of care. METHOD: The burden on 196 carers, each caring for one patient with dementia, was rated by means of the Relative Stress Scale (RSS). Patients were assessed with the Mini Mental State Examination (MMSE), the Disability Assessment for Dementia (DAD) and the Neuropsychiatric Inventory (NPI). RESULTS: Factor analysis of the RSS resulted in three subgroups: 'emotional distress', 'social distress' and 'negative feelings'...

BACKGROUND: A carer-held record (CHR) was developed to enable carers to contribute to care plans for their relatives with dementia, alongside other professionals. The aim of this study was to establish whether CHRs provide any measurable benefits for carers, in the areas of health, stress, knowledge of dementia and locus of control. METHODS: This was a controlled parallel-group trial involving 84 carer/patient pairs, drawn from all new referrals to two community mental health teams (CMHTs)...

AIM: The aim of this was to evaluate the effectiveness of interventions provided by a Community Mental Health Team (CMHT) in reducing stress in carers of individuals with dementia. BACKGROUND: The CMHT had been created to working specifically with older people with mental health problems and their carers. Following initial multidisciplinary assessment a range of interventions were provided to both clients and carers according to assessed need. There is an established need for mental health services to focus on the need of carers and the study attempts to see if the interventions provided were useful in reducing carer stress...

The rising number of people with cognitive impairment is placing health care budgets under significant strain. Dementia related behavioural change is a major independent risk factor for admission to expensive institutional care, and aggressive symptoms in particular are poorly tolerated by carers and frequently precipitate the collapse of home coping strategies. Aggressive change may result from known genetic risk factors for Alzheimer's disease (AD) and therefore accompany conventional markers such as apolipoprotein E (ApoE)...

BACKGROUND: Rapid demographic ageing will soon lead to large increases in the numbers of persons with dementia in developing countries. This study is the first comprehensive assessment of care arrangements for people with dementia in those regions. METHODS: A descriptive and comparative study of dementia care; caregiver characteristics, the nature of care provided, and the practical, psychological (Zarit Burden Interview, General Health Questionnaire) and economic impact upon the caregiver in 24 centres in India, China and South East Asia, Latin America and the Caribbean and Africa...

OBJECTIVES: Amyotrophic lateral sclerosis (ALS) is a fatal disease with unique demands on patients and carers. PATIENTS AND METHODS: The total burden of care and burden components in 37 ALS carers were measured using validated questionnaires. Furthermore, influencing factors (functional impairment of the patient, additional carers, participation in support groups) were assessed. RESULTS: The mean total burden of care for ALS was low compared with dementia, mixed neuropsychiatric and internal diseases, but was correlated with functional impairment (P = 0...

Satisfaction with respite care may be bound up with a variety of factors. The interaction of social support with ratings of a carer's satisfaction with respite care has not been explored in published work. The present authors postulated that social support, both during caring and during periods of relief from caring whilst in receipt of respite care, would be associated with greater satisfaction with respite care. They embarked upon a pilot study of carers who were looking after dependants with dementia, a particularly demanding form of care...

OBJECTIVES: The aim of this study was to improve understanding of the relationship between carers' existing knowledge about dementia, their coping style and psychological morbidity. METHOD: Fifty carers and patients attending day services were recruited. Carers were given questionnaires to assess knowledge of dementia, preferred coping style, anxiety, depression and strain. RESULTS: The results indicated that carers who demonstrated more knowledge about the biomedical aspects of dementia were more anxious (p < 0...

Alzheimer's disease (AD) imposes a severe burden upon patients and their carers. In particular, family carers of AD patients face extreme hardship and distress that represents a major but often hidden burden on healthcare systems. Carers often experience clinically significant alterations in physical and mental health, particularly depression. A number of individual features of the dementia syndrome that are known to be particularly burdensome to carers include the degree of cognitive impairment, amount of help required with activities of daily living, personality changes and the presence of psychiatric symptoms and behavioural disturbances...

The burden of caregivers of patients suffering from of Alzheimer type dementia (DAT) and vascular dementia (VD) was analysed at the critical time, the "breaking-point", when home care becomes insufficient and/or inadequate and the caregiver burden has probably reached its upper limit. Primary family caregivers of 39 DAT and 40 VD patients who were being considered for relocation into group-living units were studied. Total caregiving burden and different aspects of the burden: general strain, isolation, disappointment, and emotional involvement, were correlated with the patients' diagnoses, abilities, and symptoms...

BACKGROUND: There are many reports of psychological morbidity in spousal carers of patients with dementia. The consequences of this increased stress on the immune system are unclear. We investigated whether antibody responses to influenza vaccination differed between carers and a control group, and the relation of the antibody response to the hypothalamic-pituitary-adrenal (HPA) axis. METHODS: 50 spousal carers of dementia patients, median age 73 years (IQR 66-77), and 67 controls (68 years [66-71]) of similar socioeconomic status were enrolled...

OBJECTIVE: To identify stressors and their correlates in spouses of patients with mild dementia. DESIGN: Retrospective study of patient records. SETTING: Patients attending a Memory Clinic at Ullevaal Hospital in Oslo. SUBJECTS: 92 mildly demented patients living at home (mean age 75.7 years, 51% women, mean MMSE score 22.3) and their spouses. MAIN OUTCOME MEASURES: Frequency and types of stress suffered by spouses using validated and factor-analyzed instruments as measures...

OBJECTIVE: This study aimed to: (i) replicate previous findings that women experience more strain and distress than men when caring for dementing spouses; (ii) explore what factors underlie this sex difference. DESIGN: Two closely matched subsamples of spouse carers, husbands and wives respectively, were selected and the two groups compared. SETTING: An urban psychogeriatric service in the UK. SUBJECTS: 48 spouses of referred dementia cases...

A sample of 129 supporters caring for an elderly mentally infirm relative consecutively referred to psychogeriatric daycare services was interviewed. Information was obtained on the problems encountered by their dependant, the extent of their involvement, the amount of formal and informal support received, the subjective strain and burden reported, and their expectations of their ability to continue in the caring role. An attempt has been made to use this information to describe the extent of strain and some of the determinants of strain involved in caring...

Research has shown that the supporters of relatives with dementia suffer high levels of stress and strain and it is the severity of stress which determines whether the dependent remains in the community or becomes institutionalized. This study evaluated the outcome of a 6-week, closed group, educational programme on reported levels of stress and strain on five supporters. Results showed an increase in the severity of problems presented by the carers whilst there was a decrease in their emotional distress. However, these results suggest that the carers in the present study were experiencing much higher levels of stress and strain than those of supporters in a larger investigation, where the eventual outcome was institutionalization of the dependents...

Twenty-five women who were the primary carers for a parent with dementia rated for expressed emotion (EE) and then divided into two groups: 11 with low-EE ratings and 14 with high-EE ratings. Although there were no differences between these groups in the levels of their parents' cognitive impairment, when such impairment was taken into account, high-EE subjects were found to report higher levels of strain and distress. More efficient coping strategies were reported by subjects who made fewer critical comments and more positive remarks...

Recent research shows that the demands of the caregiving role are experienced differently by men and women. Both the subjective and the objective strain and burden appear to be greater in female carers of dementia sufferers, and factors that influence this include differences in role expectations and coping strategies. These findings have implications for the provision of services for dementia sufferers and their carers.