Predictors of the decision to yield care of a person with dementia

Abstract

Objective: The aim of this study is to determine the relative contributions of caregiver and patient characteristics to the subsequent decision to yield care of a person with dementia.Method: The sample comprised 158 people with dementia and their spouse caregivers. The inclusion criteria were that the patient had a diagnosis of Alzheimer's disease, the patient and caregiver were both at least 65 years of age, were co‐resident, that the caregiver was the spouse of the patient, and was actively providing care. Caregiver measures were the Geriatric Depression Scale, SF36, Adelaide Activities Profile, self‐rated health, use of respite services and time as a caregiver. Patient measures were the Functional Dementia Scale, Adelaide Activities Profile, and time since diagnosis. Age and sex were also recorded. Data were obtained by personal interview with caregivers. Two years later, all caregivers were re‐contacted by telephone. At this time 60 (38%) were still providing care; the remaining 98 (62%) had yielded their role to formal institutional care, on average 11.2 months previously.Results: Caregiver characteristics significantly associated with yielding care included greater age, greater use of respite services, less social activities, poorer mental health and greater depression. Patient characteristics significantly associated with yielding care included greater dementia severity, lower activity level, and more frequent incontinence.Conclusion: Dementia severity was the key predictor of the decision to relinquish care. However, it is important to recognise the full range of factors that might indicate that a caregiver is in need of assistance and might be close to yielding the role.