Family care of patients with dementia: differential significance of specific stress dimensions for the well-being of caregivers and the stability of the home nursing situation

Abstract

In Germany more than 60% of those elderly who suffer from dementia are being cared for by family members within the community. The objective conditions are perceived as extremely burdensome by many caregivers and can seriously affect their psychological and physical well-being. The aim of this study was to discrimininatively analyze the meaning of various dimensions of burden for the carers' well-being and the stability of the caregiving situation. Thus, an explicit distinction is made between caregiver burden which directly refers to the situation and the more general concept of well-being which is potentially, but not necessarily, affected by the caregiving situation. Caregivers' life satisfaction, self-esteem, and their subjective perception of the stability of the caregiving situation (subjective probability of patient's institutionalization within the next 12 months) were regarded as indicators for potential outcomes of caregiving. Regression analysis revealed that to the caregiver's life satisfaction perceived role conflicts are most significant. For the caregiver's self-esteem patient's objective cognitive impairment is decisive. Here the direction of the relation is remarkable: The more severe the patient's impairment, the higher the caregiver's self-esteem. Regarding the stability of the caregiving situation the perceived inadequacy of caregiving resources proves to be of prime importance. Results suggest that a differentiated examination of the complex relations between specific dimensions of burden and potential caregiving outcomes is an adaquate approach to a deeper understanding of the consequences of family caregiving.