Journal articles: 'Caregivers Memory' – Grafiati (2024)

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

The role of informal caregiver of cancer patients is considered a situation of chronic stress that could have impact on cognitive functioning. Our aim was to evaluate differences in perceived stress, subjective memory complaints, self-esteem, and resilience between caregivers and non-caregivers, as well as the possible mediational role of burden in caregivers. The sample was composed of 60 participants divided into two groups: (1) Primary informal caregivers of a relative with cancer (CCG) (n = 34); and (2) non-caregiver control subjects (Non-CG) (n = 26). All participants were evaluated through a battery of tests: Socio-demographic questionnaire, subjective memory complaints questionnaire (MFE-30), Rosenberg Self-Esteem Scale, resilience (CD-RISC-10), and perceived stress scale (PSS). The CCG group also completed the Zarit burden interview. Results indicated that CCG displayed higher scores than Non-CG in MFE-30 (p = 0.000) and PSS (p = 0.005). In the CCG group, Pearson correlations indicated that PSS showed a negative relationship with resilience (p = 0.000) and self-esteem (p = 0.002) and positive correlation with caregiver’s burden (p = 0.015). In conclusion, CCG displayed higher number of subjective memory complaints and higher perceived stress than Non-CG, whereas no significant differences were obtained on self-esteem and resilience. These results could aid in designing new intervention strategies aimed to diminish stress, burden, or cognitive effects in informal caregivers of cancer patients.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract The Integrated Memory Care Clinic (IMCC) at Emory Healthcare is a patient-centered medical home led by advanced practice registered nurses who seamlessly provide dementia care and primary care. This analysis explored predictors of significant changes in clients’ well-being and symptoms in clients’ first-year experience at the IMCC (N=42 caregivers, three assessments over nine months). The significant changes were decreases in caregivers’ distress regarding PLWDs’ delusions (Delusions-Distress) and PLWDs’ anxiety (Anxiety-Distress), and in PLWDs’ severity of delusions, depression, and total symptom severity. Mixed linear models were used to determine significant predictors among baseline sociodemographic characteristics that correlated significantly with outcomes that changed significantly over time. Caregivers not employed outside home had lower baseline Delusions-Distress (p=0.006) and slower decline in Delusions-Distress (p=0.015). The longer PLWD needed care, the lower baseline Delusions-Distress caregivers reported (p=0.023). Caregivers not living with their PLWD reported higher baseline Anxiety-Distress (p=0.016). Caregivers not employed outside home reported lower baseline Delusions-Severity for their PLWD (p=0.006). Caregivers not employed outside home reported PLWDs’ lower baseline depression severity (p=0.026). Older caregivers reported PLWDs’ lower baseline total symptom severity (p=0.002). Increase in caregiver’s age was associated with PLWDs’ higher total symptom severity (p=0.049). For PLWD with male caregivers, total baseline symptom severity was lower compared to PLWD with female caregivers (p=0.01). These findings highlight that PLWDs’ illness duration and caregivers’ employment status, living arrangement, age, and gender may determine their perception of their PLWDs’ symptoms. Clinicians may individualize caregiver education with the knowledge of such predictors.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract Problem behaviors among persons with Alzheimer’s Disease (AD) can have a major impact on caregivers. However, caregiver’s subjective reactions to the problem behaviors have a stronger impact on caregivers than the objective frequency of problem behaviors (Robinson et al., 2001). This study aims to examine the factors associated with caregiver’s subjective reactions to problem behaviors. Data were collected from a sample recruited from community agencies served AD caregivers in the southeastern region of the country (N=109). The caregivers’ reactions to problem behaviors were measured by the Revised Memory and Behavior Problem Checklist (Teri et al., 1992). Three subscale scores were used to measure the reactions to the behaviors related to memory loss, depression and disruption. Multivariate regression models were conducted including gender, race, employment, living arrangement, knowledge about the disease, resilience for caregivers; and ADL and IADL functioning, and frequency of problem behaviors for care recipients. Race (B=-.162; p<.05) and frequency of care-recipient problem behaviors (B= 0.733; p<.001) were significantly associated with caregiver’s reaction to problem behaviors. Caregiver’s knowledge about the disease (p<.01) only influence their reactions to memory loss problems but not for disruption and depression problems. African American caregivers had fewer reactions to disruption (p<.01) and more reactions to depression problems (p=0.06) than white caregivers, but no difference between the two groups in their reactions to memory loss problems. Personal resilience was not associated with reactions to any problem behaviors. Intervention should be tailored to the needs of caregivers to deal with behaviors of a person with AD.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Purpose: This study evaluated the longitudinal influence of an individualized evidence-based psychoeducational intervention for caregivers on frequency of behavioral symptoms in persons with dementia (PWD) and caregiver reaction to these symptoms. The intervention included information about the disease process using Progressively Lowered Stress Threshold (PLST) content and a family meeting based on Mittelman’s New York University Intervention. Method: A quasi-experimental study design was implemented. The Revised Memory and Behavior Problems Checklist was administered to N = 127 caregiver/care recipient dyads at baseline, 6, 12, and 18 months follow-up. All caregivers were enrolled in the intervention at baseline and followed over 18 months. Linear mixed models were developed to evaluate effects on frequency of behavioral symptoms in PWD and caregiver response. Results: The most frequently occurring behavior was memory problems, although depressive behaviors produced the most negative caregiver responses. Between baseline and 6-month follow-up, there was a significant decrease in frequency of behavioral symptoms. Overall, there was a significant decrease in caregiver’s reaction to behavioral symptoms from baseline to 18-month follow-up.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

ABSTRACTBackground: The use of standardized scales is critical for monitoring the interventions within and between different populations, but the current Spanish tools are dispersed in several scales. A simple tool for simultaneously and exhaustively evaluating patient's symptoms and caregiver's distress in Spanish-speaking groups is needed.Methods: RMBPC was translated into Spanish by cross-cultural adaptation. Comprehensibility and easiness of SpRMBPC were evaluated with 92 patient-caregiver dyads. Reliability, stability and scale structure were evaluated by Cronbach's α, test-retest and factor analysis respectively. Concurrent and discriminant validity were assessed by correlation with validated tools for measuring stage of dementia; memory, disruptive behaviors and depression symptoms of the patients; and anxiety, depression and burden of the caregivers (CDR, MMSE, NPIq, NPIdisruption, NPI depression, HADS-A; HADS-D and Zarit Burden Interview respectively).Results: Almost all caregivers completed the questionnaire (97% completeness; 7.5% missing data). Both the frequency of Patient's Symptoms and Caregiver Reaction scores and subscores displayed high stability and reliability. All of these scores correlated positively with their respective validated tools as predicted, except with MMSE. The patients' subscores for Disruptive Behaviors and Memory Impairment displayed their highest correlation with the disruptive symptoms and level of dementia validated tools.Conclusions: SpRMBPC is a validated tool for assessing the dementia stage and the psychiatric morbidity of patients and caregivers. The Frequency Disruption and Memory subscales assess specifically patient's disruptive symptoms and dementia stages. These tools can be applied to analyze the burden of the patient's disease and the caregiver's distress in Spanish-speaking populations.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

We studied perceptions of dementia diagnosis and treatment in patient-caregiver dyads enrolled in a care coordination intervention trial for veterans with dementia. We compared patient and caregiver perceptions of diagnosis and treatment to information in the medical record and assessed concordance between patient and caregiver perceptions. Data were derived from medical record abstraction and structured interviews with 132 patients and 183 caregivers. Most caregivers, but only about one fourth of patients, reported having received information about a diagnosis related to memory loss. Caregivers were more accurate than patients in recalling the patient’s use of memory-enhancing medications. Within dyads there was poor agreement regarding a diagnosis of dementia. Our findings suggest that there is substantial room for improvement in disclosure and education of dementia diagnosis, especially at the level of the patient-caregiver dyad.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract Pearlin’s stress-process model (2010) depicts that functional decline in care-recipient would shape caregiving burden and impact on caregiver’s health. With this background, we explored how the changes in care-recipients’ physical and cognitive functioning are related to the caregivers’ physical health. A total of 853 care-recipients from the Rounds 1 and 5 of the National Health and Aging Trend Study (NHATS) and their 1,303 caregivers from Round 5 of National Study of Caregiving (NSOC) were included. Multiple regression analyses were conducted to identify correlates of self-rated health and the number of chronic conditions with the change in physical and cognitive functioning from Round 1 to 5 and multidimensional caregiver burden. Physical functioning measured by the NHATS short physical performance battery included balance stands, walking chair stands, grip strength, and peak airflow. Memory, orientation, and executive functioning measured cognitive functioning. Multidimensional caregiver burden includes four domains (emotional, psychological, relationship, and resilience) identified with factor analysis. Background factors (recipient’s age, assisting recipients for 5 years, race/ethnicity, and number of chronic conditions of recipient) were included as covariates. After controlling covariates, the data showed that 5-year change of physical functioning and caregiver’s emotional burden were negatively significant for self-rated health; and assisting care-recipients for 5 years or more was significant for more numbers of chronic conditions among caregivers. Findings highlight that caregivers’ physical health is closely associated with care-recipient’s functional decline for long-term caregiving experiences. Further investigation on caregiver’s physical health using multiple health outcomes is needed to promote physical health in long-term caregivers.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Arts programming for people living with dementia and their caregivers has gained popularity as a way to provide opportunities for social interaction, expression, and continual learning. The goal of the present study, referred to as Retaining Identity: Creativity & Caregiving is to: (1) describe the process of designing and implementing a structured art experience for people living with memory loss and their co-residing caregiver; and (2) to summarize feedback provided by caregivers at the conclusion of the program. Retaining Identity is an eight-week program offered by professional artists who instructed dementia caregivers in four visual art activities, which they then taught to their care recipient. The program was designed for individuals with no art experience and the art projects were carefully developed to be engaging for both people living with dementia and their caregivers. The evaluation process included a qualitative survey completed by the caregivers to measure the impact of the program on the caregiver/care recipient relationship. The main themes that emerged from the survey were: caregiver growth, caregiver awareness, and creative discovery. The participants’ artwork supports that art making has the potential to encourage an equitable exchange and outcome for people with memory loss and their caregivers. Although the survey is limited in scope, the results support the use of the arts to positively impact caregivers and their relationship with their care recipient.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

The primary objective of this study was to identify the needs of caregivers of individuals with Parkinson’s disease within the context of the common functional, memory, and behavioral problems experienced by Parkinson’s patients. A second objective was to evaluate any differences between caregivers of Parkinson’s patients and caregivers of adults with other forms of cognitive impairment. Data used for this analysis were collected in 1999, by the 11 Caregiver Resource Centers that form California’s statewide Caregiver Resource Center system, as part of the uniform caregiver assessment process. Parkinson’s disease caregivers requested assistance with emotional support, respite, and behavior management. Compared with caregivers of non-Parkinson’s patients served by the CRC system, caregivers of Parkinson’s patients were primarily older, entered the CRC system later, and demonstrated increased depression and other health conditions.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Summary In a cross-sectional study, 31 dementia caregivers were compared to a group of 25 noncaregiving controls to evaluate whether the stress of being the primary caregiver of a person with dementia produces cognitive dysfunction. Cognitive differences were examined to evaluate the relationships between cognitive function and stress-related physiological and psychological measures to contribute information regarding its potential mechanism. The cognitive assessments were 2 measures of attention-executive function and 1 word list memory task. Physiological and self-rated stress-related measurements included cortisol, perceived stress, depression, self-efficacy, mindfulness, sleep quality, fatigue, and neuroticism. Caregivers performed worse than noncaregivers on the 2 attention tasks but not on the word list memory test. There was no interaction of caregiver status and age on cognitive performance. The caregivers and noncaregivers differed in morning salivary cortisol and most of the self-rated stress-related measures with the caregiver values reflecting greater stress. Of note, impaired sleep was the only potential mediator of the caregiver effect on cognitive performance in our small sample.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Caring for an individual living with Alzheimer’s disease and other forms of dementia is especially challenging and impacts every aspect of the lives of the family caregivers. Family caregiving is defined as informal, unpaid care provided by family or friends to people with a chronic illness or disability. Caregiver burden, often experienced by a caregiver for a cognitively impaired family member, is multifaceted involving physical, psychological, social, and emotional problems. To date, little has been done to examine the relationship between the knowledge of Alzheimer’s disease and memory loss and caregiver burden. To fill this gap, a cross sectional, correlational design was employed to collect data from a convenience sample ( N = 104) of African American and Caucasian dementia family caregivers. For this study, caregivers ranged from 25 to 89 years of age with African American caregivers possessing significantly lower levels of knowledge about Alzheimer’s disease and other dementias compared to Caucasian caregivers, p < .001. There were 44 caregivers who scored 41 or greater on the Caregiver Burden Inventory corresponding to moderate to severe and higher levels of burden. Results of hierarchical multiple regression models indicated that higher levels Alzheimer’s disease knowledge was significantly associated with lower caregiver burden for all caregivers, B = −0.294, p < .01. Additionally, employment status was significantly associated with caregiver burden. This study highlights the benefits of including disease specific knowledge within educational components of dementia related interventions and programs involving families.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract The Integrated Memory Care Clinic (IMCC) at Emory Healthcare is a patient-centered medical home led by advanced practice registered nurses (APRNs) who provide dementia and primary care. This presentation describes the experiences of persons living with dementia and their caregivers during their first year at the IMCC, through the lens of the IMCC as a healthcare network. Forty-two caregivers were evaluated in three survey-based assessments over nine months. Twelve caregivers completed qualitative interviews about their experience at the IMCC. Severity of depression and delusions and total symptom severity improved significantly for persons living with dementia. Caregivers described their sense of belonging to the IMCC healthcare team and valued direct telephone access to APRNs. By enhancing care access and engaging clients in their care, the IMCC serves as a reliable and professional healthcare network for patient-caregiver dyads who often receive suboptimal dementia care in mainstream healthcare.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

ABSTRACTBackground: This paper determines care recipient and caregiver characteristics and caregiving dimensions – associated with depression among caregivers of older adults, using path analysis and assesses whether the identified path model differs between spousal and adult child caregivers.Methods: Data from 1,190 dyads comprising care recipients (community-dwelling adults aged ≥75 years with at least one activity of daily living (ADL) limitation) and caregivers (family member/friend most involved in providing care/ensuring provision of care to care recipient), who were interviewed through the Singapore Survey on Informal Caregiving (2010–2011), were used. Using path analysis, we assessed the direct and indirect associations between primary stressors (care recipient's ADL and instrumental ADL status, and memory and behavior problems), caregiver health status, receipt of assistance from a foreign domestic worker/maid, amount of caregiving, negative reaction to caregiving, caregiver's self-esteem, perceived emotional support, and caregiver depressive symptoms.Results: Our analysis showed that primary stressors, receipt of assistance from a foreign domestic worker/maid, perceived emotional support, and caregiver health status were directly or indirectly associated with caregiver depressive symptoms, and this association was mediated by negative reaction to caregiving. Caregiver self-esteem mediated the relationship between perceived emotional support and negative reaction to caregiving only among adult child caregivers.Conclusions: The results provide insights into factors associated with depressive symptoms among spousal and adult child caregivers, and help identify targeted interventions for improving caregiver mood.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

16 Background: GBM is a largely incurable, highly aggressive cancer with high incidence of CD. Caregivers face heightened stress with loved one’s limited life expectancy and additional duties. To better understand this unique group, a survey tool was developed to examine effect of CD on caregiver burden. Methods: Four of 10 planned academic centers are enrolling towards achieving 200+ completed surveys. The survey was developed step-wise: 1) literature review of primary brain tumors, Alzheimer’s disease, and dementia to identify domains; 2) focus groups with neurooncologists and American Brain Tumor Association advocates to narrow domains; 3) caregiver interviews to verify selected domains; 4) single-site pilot study to confirm content (n=20). Dyads with caregiver survey and respective patient’s clinical data are created as possible. Results: Complete data from 31 caregivers and 28 dyads enrolled at Huntsman Cancer Institute, University of Utah and University of California, Los Angeles are currently available. Response rate was 88% for caregivers and 90% for patients. Among caregivers, 87% were patient spouse/partner, 84% female, average age 56 years, 42% currently employed, 32% have no additional help, and 26% are primary caregivers for others. Patients were male (74%), average age 59 years, not working (84%), and being treated for initial diagnosis (67%). Proportion of caregivers performing ≥ 1 caregiving task, i.e. meal preparation, doubled from before to after diagnosis (48% vs. 97%). The majority of caregivers (90%) perceived memory problems in a loved one over last 14 days. Trouble remembering recent events or things interfered with 71% of caregivers’ daily life "somewhat", "quite a bit", or "very much". When ranking effect of CD on caregiver’s general quality of life on a scale of 0 (none) to 10 (significant), 60% and 23% of caregivers indicated ≥ 5 and ≥ 8, respectively. Caregivers’ responses to survey satisfaction questions showed only 23% feel enough is being done to understand caregiving in GBM and 76% were satisfied overall with the survey. Conclusions: Caregivers are affected daily and significantly by GBM-related CD. Results will be updated at time of presentation.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

ABSTRACTCaregivers of demented patients are under significant stress along with physical, psychological or social problems. Standardized and validated instruments are required for measuring consequences of caregiving or efficacy of support interventions. Reliability of French translation of these instruments has to be verified in order to confirm their psychometric properties. The goal of the present study is to assess reliability of the French translation of three instruments designed for evaluation of caregivers of demented patients. The Zarit's Burden Interview (BI) is a 22-items scale measuring the subjective burden of the caregiver. The Revised Memory and Behavior Problems Checklist (RMBPC), a 53 item scale, measures frequency of memory and behaviour problems of demented patients and the caregiver's reaction to these problems, which is another mean of burden assessment. The Alzheimer's Disease Knowledge Test (ADKT) assesses knowledge of caregivers about demented diseases and resources available using 20 multiple choice questions. A reliability study was conducted on a sample of 40 caregivers. The caregivers were questioned twice, the second time after one (N = 26) or eight (N = 14) weeks. The BI internal consistency (Cronbach alpha) yielded a coefficient of 0.85 and test-retest reliability (intra-class correlation coefficient) was 0.89. The RMBPC's Cronbach Alpha was 0.93 for frequency and 0.94 for reaction. Intra-class correlation coefficients were 0.77 (frequency) and 0.90 (reaction) for RMBPC and 0.71 for ADKT.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract Informal caregivers can provide assistance that can help family members and friends live in the community longer but can place caregivers at increased risk for poorer health outcomes. Subjective cognitive decline (SCD) is the self-reported experience of worsening or more frequent confusion or memory loss. The objective of this study is to describe SCD in caregivers. Data were analyzed from 21 states, Puerto Rico, and District of Columbia who administered both the Caregiver and Cognitive Decline modules of the Behavioral Risk Factor Surveillance System in the same year for 2015–2017. A higher proportion of caregivers reported SCD (13.4%) compared to non-caregivers (10.2%). Of those who did need assistance with daily activities due to SCD, 1 in 8 non-caregivers were unable to the necessary assistance compared to 1 in 4 caregivers. SCD among caregivers is of particular concern because it affects both the caregiver and care recipient.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Despite considerable gains in public awareness of dementia, dementia patients and their caregivers continue to be stigmatized. Previous work has explored stigma and burden among adult children of persons with dementia in Israel, but no similar data exist for spousal caregivers or caregivers in general in the United States. This study examines the differences in stigma and burden experienced by spousal and adult child caregivers and male and female caregivers of persons with dementia. Eighty-two caregivers were given the Zarit Burden Inventory Short Form (ZBI) and the Caregiver Section of the Family Stigma in Alzheimer’s Disease Scale (FS-ADS-C). Scores on the FS-ADS-C and ZBI were positively correlated (rs=.51,p<.001). Female caregivers reported experiencing more stigma on the FS-ADS-C (t(80)= −4.37,p<.001) and more burden on the ZBI (t(80)= −2.68,p=.009) compared to male caregivers, and adult child caregivers reported experiencing more stigma on the FS-ADS-C (t(30.8)= −2.22,p=.034) and more burden on the ZBI (t(80)= −2.65,p=.010) than spousal caregivers. These results reinforce the importance of support for caregivers, particularly adult child and female caregivers who may experience higher levels of stigma and burden.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

ABSTRACTBackground: Caregivers of patients with mild cognitive impairment (MCI) already experience a need for increased services comparable to that of individuals caring for Alzheimer's disease patients. However, there have been only a few studies on the MCI caregiver burden. In this study, we examined MCI caregiver burden in a larger number of consecutive outpatients in Japan.Methods: One hundred and four consecutive caregivers of people with MCI participated in this study. The caregiver burden was evaluated by the short version of the Japanese version of the Zarit Burden Interview (sZBI).Results: About 20% of the caregivers reported a clinically significant burden. The multiple linear regression analysis showed that the caregiver burden was significantly associated with neurobehavioral symptoms (p < 0.001) and memory problems (p = 0.022) of the patient.Conclusions: The caregiver burden of MCI patients should be given more attention. The management of neurobehavioral symptoms may be important to reduce the burden on caregivers of MCI patients.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract People living with dementia (PwD) can often reliably self-report their health; yet, there are limited data on their and their primary caregiver’s self-reported overall health (excellent, very good, good, fair, and poor). We used data from the Aging, Demographics, and Memory Study (2001-2009) to quantify the association between PwD’s cognitive impairment (Mini-mental State Exam), physical limitations (scale [0-10] of activities of daily living), and behaviors (scale [0-12] of behavioral symptoms on the Neuropsychiatric Inventory Questionnaire) and self-reported health. We estimated two ordered logistic regressions estimating: 1) PwD’s self-reported health (analyzed n=308); 2) primary caregiver’s self-reported health (analyzed n=135; 173 PwD did not have primary caregiver in the survey). We controlled for the PwD demographics, chronic conditions, and if they lived in the community. The regression estimating caregiver’s self-reported health also controlled for the caregiver’s relationship to the PwD, and whether the caregiver lived with the PwD. PwD’s self-reported health was lower (4% excellent; 16% very good; 22% good; 30% fair; 30% poor) than caregivers (14% excellent; 27% very good; 32% good; 23% fair; 4% poor). For PwD, one-additional physical limitation, but not cognition or behavior, was associated with 1.15 (95%CI: 1.01,1.30) times greater odds of self-reporting poor health compared to all other categories. For caregivers, one-additional behavior, but not cognition or physical limitations, was associated with 1.17 (95%CI: 1.01,1.37) times greater odds of self-reporting poor health. For PwD, interventions targeting physical limitations may increase self-reported health, but for caregivers, interventions targeting behavioral symptoms may increase self-reported health.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Background: The outbreak of the COVID-19 pandemic seems to have mental health implications for both people with neurocognitive disorder and their caregivers. Objective: The study aimed to shed light on relations between caregiver mental reaction to the pandemic and caregiver distress related to neuropsychiatric symptoms, memory impairment progression, and functional impairment of people with neurocognitive disorder during the period of confinement in Greece. Methods: The study included caregivers of patients with mild (N = 13) and major (N = 54) neurocognitive disorder. The caregiver-based telephone interview was based on items of the neuropsychiatric inventory questionnaire, the AD8 Dementia Screening Instrument, and the Bristol Activities of Daily Living Scale. Regarding the mental impact of the COVID-19 crisis on caregivers, four single questions referring to their worries in the last seven days were posed, in addition to the scales Generalized Anxiety Disorder 7-Item (GAD-7) and the 22-item Impact of Event Scale-revised (IES-R). A stepwise linear regression model was employed for studying the relationship between caregiver distress and demographic and clinical data and caregiver mental reaction to COVID-19 pandemic outbreak. Results: Caregiver distress severity during the confinement period was influenced not only by memory deficits (p = 0.009) and neuropsychiatric symptoms (p < 0.001) of patients, but also by caregiver hyperarousal (p = 0.003) and avoidance symptoms (p = 0.033) and worries directly linked to the COVID-19 crisis (p = 0.022). Conclusion: These observations provide further evidence for the urgent need for support of caregivers of patients with neurocognitive disorder during the COVID-19 pandemic.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract. Research shows that caregivers of dementia patients experience burden and psychological distress, but it is unclear whether or not caregivers of individuals with cognitive impairments that do not meet a diagnosis for dementia also experience similar burdens and psychological problems. Sixty patients and their caregivers participated in this study designed to examine caregiver burden. The patients completed activities-of-daily-living tasks and several neuropsychological tests assessing memory, abstract reasoning, and language. Caregivers completed self-report measures assessing caregiver burden and psychological distress. Results revealed that the caregivers of patients with mild Alzheimer’s disease (mAD) reported greater physical burden and feelings of missing out on life compared to individuals with mild cognitive impairment (MCI) caregivers. The mAD caregivers indicated greater depression and anxiety relative to MCI caregivers. Stepwise regression found that patient neuropsychological scores were worse predictors of caregiver burden than patients’ daily functioning. The conclusions of this study suggest that (1) caregivers of mAD are likely to experience more severe types of burden and psychological distress relative to caregivers of MCI patients, and that (2) patients’ daily functional abilities better predict caregivers’ burden and psychological distress than patients’ neuropsychological functioning. Study findings suggest that caregivers of those in the early stages of dementia, even in persons not yet meeting a diagnosis, experience psychological symptoms and burden, and that these caregivers’ experiences can be best predicted by the patients daily functional ability than by patients’ neuropsychological test scores.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Introduction “The Roth Project - Music and Memory” is a music based intervention program, implemented by the Alzheimer’s Association of Central and Western Kansas, which provides a nonpharmacologicalmeans for addressing neuropsychiatric symptoms in individuals with dementia. Methods Participants were individuals with dementia who were enrolled in The Roth Project - Music and Memory. Post-intervention surveys were distributed to caregivers of participants which assessed caregiver satisfaction with the program as well as caregiver perception of the impact of individualized music on mood and behavioralsymptoms. Results Of returned surveys (n = 79), 99% of caregivers indicated they were satisfied or very satisfied with the program and 94% of caregivers perceived participants to like or very much like listening to the music. While a substantial number of participants required assistance with iPod use (95%), the majority of participants were observed to listen to the music with stable or increased frequency over time. Personalized music was observed to improve mood in 78% of cases, with the most frequent benefits being improved overall happiness, decreased anxiety, increased positive emotional expression, and decreased depression. Conclusions The Roth Project - Music and Memory was well received by caregivers and was perceived to benefit mood of individuals with dementia. These results provided ongoing support for individualized music-based interventions and demonstrated that such interventions, when implemented by community agencies, can be well received by those who use them.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Caregiver burden—the stress associated with caring for a loved one with chronic illness—is rated as high or very high by about two-thirds of Alzheimer's caregivers. At Wake Forest School of Medicine, both patients with memory loss or cognitive impairment and caregivers are evaluated at a geriatrician-led co-located Memory Assessment Clinic (MAC). In a sample of 100 MAC-evaluated patient-caregiver dyads this study assessed both patient severity of Alzheimer's disease or other dementia, self-reported behavioral disturbances, degree of functional independence in general activities of daily living and instrumental activities of daily living (IADLs), and caregiver stress as measured by the Caregiver Burden Scale (CBS). Several patient factors were found to be related to high caregiver stress (CBS score &gt; 25), in particular moderate-severe dementia; inability to perform most IADLs, especially managing medications; and most behavioral disturbances, especially agitation/aggression and appetite/eating problems. The article also suggests ways medical and mental health providers and researchers can help reduce caregiver stress.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract BACKGROUND GBM is an aggressive cancer with poor prognosis. We explored impact of disease on caregivers by characterizing caregiver burden and QOL associated with patient characteristics. METHODS Primary caregivers of living adult GBM patients with cognitive dysfunction completed a GBM-specific caregiver burden survey and the validated Caregiver Quality of Life Index–Cancer Scale (CQOLC). Patient data were abstracted from medical records (7/2018-4/2019). Patient characteristics were compared between highest and lowest tertile of CQOLC scores (range 0–140); higher scores suggest better QOL. RESULTS There were 140 patient-caregiver dyads enrolled in the study. Mean patient age was 57 years (range 24–63); majority white males (62.9%), unifocal lesion (90%) and normal activity level at diagnosis. Forty-percent had methylated MGMT promoter status. Caregivers were mostly white (61.4%), college-educated female spouses of similar age; 87.8% were caregiving for >6 months. Median CQOLC score was 82 (tertiles: < 76 and >92). More caregivers in the lowest vs highest CQOLC tertile reported ‘not employed due to caregiving’ (52.4% vs 12%, P< 0.01), ‘changes in patients’ personality’ (73.3% vs 42.6%, P< 0.01), ‘patient memory problems’ (93.5% vs 77.1%, P=0.02), and caring for patient with recurrence treated with ‘chemotherapy other than temozolomide’ ([TMZ], 27.7% vs 8.3%, P=0.01). There was > 10% difference in proportion of caregivers in the lowest vs highest CQOLC tertile for the following patient characteristics: largest lesion in right temporal lobe at baseline and partial resection at initial treatment. Conversely, there was > 10% difference in the highest vs lowest CQOLC tertile for Karnofsky score (> 80), largest lesion in right frontal lobe at baseline, surgical clean margins, TMZ for initial treatment, and surgery for recurrence. CONCLUSION Unemployment, patient personality/memory changes, and chemotherapy other than TMZ use had significant impact on caregiver burden/QoL. This may help identify caregivers to receive support and intervention.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

OBJECTIVE: The aim of this study was to evaluate caregiver burden based on Zarit Burden Interview (ZBI) and depression in caregivers on the Beck Depression Inventory-II (BDI-II). METHODS: Literate individuals, 18 years or older, who spoke Spanish as their native language were included. Demographic characteristics: Age, sex, education, relationship to person with dementia, length of time caregiving, other sources of help for caring, impact on the household economy, family support, and perception of impaired health; and Clinical data on care-recipients: type of dementia, time since diagnosis, treatment, and Global Deterioration Scale (GDS); the ZBI and BDI-II. Descriptive and analytical statistics were employed to assess caregiver burden and predictors of higher burden in caregivers. RESULTS: A total of 92 informal caregivers were evaluated. Regarding care-recipients, 75% were 69 years old or over, 75% had at least one year since diagnosis, 73.9% had Alzheimer's disease, 84.8% received treatment, 75% scored 5 or over on the GDS. For caregivers, 75% were 55.5 years old or over, predominantly female (81.5%), married (83.7%), the spouse of care-recipients (60.87%), had at least 10 years of education (75.0%) and one year of caregiving (75%), reduced entertainment time (90.2%) and self-perception of impaired health (83.7%). Median score on the ZBI was 37.5 (minimum value = 3; and maximum value = 74). The coefficient of BDI was 1.38 (p-value <0.001). CONCLUSION: This sample of Peruvian informal caregivers showed elevated ZBI values. Self-perception of worsened health, repercussion on the family economy and time caregiving were the main determinants of ZBI, although only BDI was a consistent predictor of ZBI.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Background: Young-onset dementia (YOD) patients and their caregivers face unique challenges in diagnosis and management. We aimed to compare the characteristics of rural YOD and late-onset dementia (LOD) patients. Methods: A total of 333 consecutive patients (YOD=61, LOD=272) at a rural and remote memory clinic between March 2004 and July 2016 were included in this study. Each patient had neuropsychological assessment. Health, mood, function, behaviour, and social factors were also measured. Both groups were compared using χ2 tests and independent sample tests. Results: YOD patients were more likely to be married, employed, current smokers, and highly educated. They reported fewer cognitive symptoms, but had more depressive symptoms. YOD patients were less likely to live alone and use homecare services. YOD caregivers were also more likely to be a spouse and had higher levels of distress than LOD caregivers. Conclusions: Our findings indicate YOD and LOD patients have distinct characteristics and services must be modified to better meet YOD patient needs. In particular, the use of homecare services and caregiver support may alleviate the higher levels of distress found in YOD patients and their caregivers. Additional research should be directed to addressing YOD patient depression, caregiver distress, and barriers to services.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

ABSTRACT:Background:Young-onset dementia (YOD) is defined as the onset of dementia symptoms before the age of 65 years and accounts for 2–8% of dementia. YOD patients and their caregivers face unique challenges in diagnosis and management. We aimed to compare the characteristics of rural YOD and late-onset dementia (LOD) patients at a rural and remote memory clinic in Western Canada.Methods:A total of 333 consecutive patients (YOD = 61, LOD = 272) at a rural and remote memory clinic between March 2004 and July 2016 were included in this study. Each patient had neuropsychological assessment. Health, mood, function, behaviour and social factors were also measured. Both groups were compared using χ2 tests and independent sample tests.Results:YOD patients were more likely to be married, employed, current smokers and highly educated. They reported fewer cognitive symptoms, but had more depressive symptoms. YOD patients were less likely to live alone and use homecare services. YOD caregivers were also more likely to be a spouse and had higher levels of distress than LOD caregivers. Both YOD and LOD patient groups were equally likely to have a driver’s licence.Conclusions:Our findings indicate YOD and LOD patients have distinct characteristics and services must be modified to better meet YOD patient needs. In particular, the use of homecare services and caregiver support may alleviate the higher levels of distress found in YOD patients and their caregivers. Additional research should be directed to addressing YOD patient depression, caregiver distress and barriers to services.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

ABSTRACTBackground: Difficulties with memory and communication are prominent and distressing features of dementia which impact on the person with dementia and contribute to caregiver stress and burden. There is a need to provide caregivers with strategies to support and maximize memory and communication abilities in people with dementia. In this project, a team of clinicians, researchers and educators in neuropsychology, psychogeriatrics, nursing and speech pathology translated research-based knowledge from these fields into a program of practical strategies for everyday use by family and professional caregivers.Methods: From the available research evidence, the project team identified compensatory or facilitative strategies to assist with common areas of difficulty, and structured these under the mnemonics RECAPS (for memory) and MESSAGE (for communication). This information was adapted for presentation in a DVD-based education program in accordance with known characteristics of effective caregiver education.Results: The resultant DVD comprises (1) information on the nature and importance of memory and communication in everyday life; (2) explanations of common patterns of difficulty and preserved ability in memory and communication across the stages of dementia; (3) acted vignettes demonstrating the strategies, based on authentic samples of speech in dementia; and (4) scenarios to prompt the viewer to consider the benefits of using the strategies.Conclusion: Using a knowledge-translation framework, information and strategies can be provided to family and professional caregivers to help them optimize residual memory and communication in people with dementia. Future development of the materials, incorporating consumer feedback, will focus on methods for enabling wider dissemination.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Alzheimer's disease (AD) has a major impact by limiting the ability to live independently. This condition of dependency involves all members of the family, particularly those who take direct care of patients. The changes that take place in caregivers' lives may alter their health and have an effect on the care of the sick. OBJECTIVE: To determine the presence of burden, anxiety and depression in caregivers of Alzheimer's patients. METHOD: A descriptive cross-sectional study was performed in 67 family caregivers from the Alzheimer's Clinic Research Unit, Memory and Alzheimer, in the city of Santiago, Dominican Republic. Caregivers were evaluated for burden intensity with the Zarit scale and for both depression and anxiety using the respective Hamilton scales. Descriptive statistical analysis and Pearson correlation were used. RESULTS: 84% of caregivers were female, and 52% were older than 50 years. A total of 36% exhibited caregiver burden; 19% anxiety symptoms; and 43% depressive symptoms. No statistical significance was found between age, sex and number of hours of care. A significant association was found in the Pearson correlation coefficient between caregiver burden, anxiety and depression. CONCLUSION: Caregiver burden was associated with anxiety and depression. It is important for health professionals to include caregiver assessments in the treatment protocols of dementia. Policy should include support programs for carers.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract People with Alzheimer’s disease use more medical services (Eaker et al., 2002) and are admitted to inpatient facilities at higher rates (Zhu et al., 2015) than normal controls. In addition, social services provide support for caregivers and are associated with positive outcomes for care-recipients and their caregivers (Neville, Beattle, Fielding, & MacAndrew, 2014). Despite high level of need, utilization of mental health services and social agencies for caregiver support remains low (Goodarzi, Mele, Roberts & Holroyd-Leduc, 2017; Weber, Pirraglia & Kunik, 2011). Following the Andersen and Newman model (1973), we examined whether predisposing factors (i.e., age of the caregiver and type of PWD-caregiver relationship), needs (i.e., memory impairment, disruptive behaviors, depression, anxiety, pain, functional impairment, caregiver burden, total number of prescribed medications), and enabling factors (i.e., PWD and caregiver income, quality of the PWD-caregiver relationship) differentially predicted the presence of medical, social, and mental health service use. A total of 228 dyads (PWD and the caregiver) were included. We examined each PWD and caregiver characteristic individually (univariate models) and then as a unique predictor of each of the three service use outcomes (multivariate models). A greater number of medications uniquely predicted higher medical service use, greater pain severity and PWD income were uniquely associated with higher social service use, and a greater number of medications and increased memory impairment predicted more mental health service use. These results show that distinct factors predict use of different types of service use among PWD and their caregivers.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract As cases of Alzheimer’s disease and related dementias (ADRD) continue to rise, informal caregivers are critical resources in providing dementia care, yet caregiving is associated with high levels of burden, stress, anxiety and depression. Caregiving can be a prolonged and stressful experience, and impaired cognitive functioning in caregivers could impact their own health and quality of life and compromise the quality of care provided to their care-recipient. Thus, the purpose of the current study is to use the Stress Process Model as a guiding theoretical framework to identify whether primary stressors (e.g., care recipient functional status, cognitive problems) or secondary stressors (e.g., loss of self, economic conflict) predict performance across seven domains of cognition in 50 primary ADRD caregivers. Hierarchical regression analyses were used to examine which primary and secondary stressors emerge as predictors of cognitive performance. Results indicated that primary stressors (e.g., problematic dementia behaviors and relational deprivation) significantly predicted working memory performance and secondary stressors (e.g., economic strain, loss of self) significantly predicted implicit memory performance. Additionally, higher levels of caregiver burden predicted worse performance on executive functioning and implicit memory measures. Overall, the findings of this study indicate that the stress associated with caregiving may have adverse effects beyond psychosocial outcomes, and findings can be used to inform policies and practices with regard to caregiver health and well-being.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

The Revised Memory and Behavior Problems Checklist (RMBPC) is a 24-item caregiver report that measures observable behavioral and memory problems in dementia patients and their caregivers' reaction to these problems. The purpose of the present study was to evaluate the applicability of the RMBPC for use in Taiwanese patients with Alzheimer's disease (AD). The subjects included 76 AD patients (39 men and 37 women, mean age 72.3) and their caregivers (34 men and 42 women, mean age 53.5) who participated in a comprehensive assessment at the Veterans General Hospital-Taipei. The Chinese version of the Cognitive Abilities Screening Instrument was administered to the patients. Their caregivers rated the RMBPC and the short version of the Geriatric Depression Score (GDS). To assess the test-retest reliability, 30 caregivers rated a second RMBPC 3 days after the first evaluation. The mean score for the frequency rating on the RMBPC was 32.63 (SD = 12.44, range = 5–61) and the mean reaction score was 10.96 (SD = 11.53). The reaction score was significantly correlated with the GDS score (r = .363, p = .001). The Cronbach's alpha coefficients for frequency and reaction scores were .816 and .895 respectively. The test-retest reliabilities of total frequency and reaction scores were significantly correlated; overall correlations were .89 for frequency (p < .001) and .74 for reaction (p < .001). These findings suggest that the RMBPC be recommended as a reliable tool to assess behavioral and memory disturbance in Taiwanese AD patients.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

ABSTRACTBackground: People with dementia have a range of needs that are met by informal caregivers. A DVD-based training program was developed using research-based strategies for memory and communication in dementia. The effectiveness of the training on the caregiver experience and the well-being of the person with dementia was evaluated.Methods: A pre-test/post-test controlled trial was undertaken with caregiver–care-recipient dyads living in the community. Measures of the carers’ knowledge of memory and communication strategies, burden, positive perceptions of caregiving, and perceptions of problem behaviors were taken pre- and three months post-intervention. The depression and well-being of the person with dementia were also evaluated. Satisfaction with the training and feedback were measured.Results: Twenty-nine dyads (13 training group, 16 control group) participated. Bonferroni's correction was made to adjust for multiple comparisons, setting α at 0.00385. A significant improvement was found in caregivers’ knowledge for the training group compared to the control group (p = 0.0011). The training group caregivers reported a reduction in the frequency of care recipient disruptive behaviors (p = 0.028) and increased perceptions of positive aspects of caregiving (p = 0.039), both at a level approaching significance. The training group care recipients had increased frequency of verbally communicated depressive behaviors at a level approaching significance (p = 0.0126). The frequency of observed depressive behaviors was not significantly different between groups.Conclusions: This approach to training for caregivers of people with dementia appears promising for its impact on knowledge and the caregiving experience. Further research could monitor the impact of the training on broader measures of depression and well-being, with a larger sample.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract The daily lives of family caregivers of persons with dementia (PwD) often require that they manage multiple competing demands in a context of unpredictability. Memory and behavior changes associated with dementia can cause PwD to act in random and irrational ways that create stress and influence all aspects of caregivers’ everyday life. Supportive others, including informal helpers and formal service professionals, should provide relief to primary caregivers; however, help may not alleviate caregiver stress and can sometimes compound the burden of care. This symposium draws on daily diary surveys and face-to-face interviews to focus on four aspects of managing everyday care of PwD among family caregivers in rural areas. Brandy Renee McCann explores how caregivers’ vigilance on behalf of PwD care quality interacts with service use. Karen Roberto examines the ways in which caregivers manage PwD resistance to help, including their use of forceful care strategies. Rosemary Blieszner focuses on competing caregiver roles and demands that may contribute to or alleviate caregiver stress. Tina Savla addresses the unexpected, and often hidden, challenges involved in using formal services. Collectively, the four presentations provide in-depth insight into the complicated daily lives of families coping with dementia and the ways in which they meet the demands of full-time caregiving under often difficult and challenging circ*mstances. Discussant Steve Zarit considers the efficacy of these management strategies for various aspects of everyday care and offers suggestions for future research and person-centered programs and interventions to reduce health disparities among caregivers in rural areas.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

This study examined the types of questions caregivers use and their outcomes when conversing with their spouse with Alzheimer’s disease (AD). Of particular interest was caregivers’ use of yes-no and open-ended questions and the demands they make on the memory of the person with AD. It was hypothesized that communication between caregivers and their spouses would be more successful when caregivers used yes-no rather than open-ended questions; however, it was also predicted that a more positive communication outcome would occur when caregivers used open-ended questions that requested information from semantic rather than episodic memory. Eighteen caregivers and their spouses diagnosed with AD were audiotaped while they conversed for approximately 10 min on a topic of their choosing. The conversations were transcribed and coded according to the occurrence of questions, the type of question (yes-no, choice, or open-ended), the type of memory required to respond to a question (semantic or episodic), and the outcome of a response to a question (communication breakdown). The results indicated that caregivers used yes-no and open-ended questions to a similar extent, whereas episodic questions were used almost twice as frequently as semantic questions. Communication was more successful when caregivers used yes-no compared with open-ended questions and when questions placed demands on semantic rather than episodic memory. The findings from this study suggest that caregivers can reduce communication problems by avoiding the use of questions that depend on episodic memory. In addition, while yes-no questions were associated with more favorable outcomes than open-ended questions, the latter do not need to be avoided if they refer to information that draws only on semantic memory.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

ABSTRACTBackground: Behavioral and psychological symptoms of dementia (BPSD) cause caregiver distress and earlier institutionalization. We compared the prevalence and characteristics of BPSD between institution residents and memory clinic outpatients with Alzheimer's disease (AD) to test the hypothesis that there is more BPSD among institution residents than among their outpatient counterparts.Methods: We assessed BPSD by interviewing the patients’ principal caregivers, either family or professionals, using the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). Data from 138 patients with probable AD from the memory clinic and 173 residents with possible AD living in the long-term care facilities were collected. The diagnoses followed the NINCDS-ADRDA criteria.Results: BPSD profiles of the two groups were similar but not identical. The prevalence of at least one BPSD was high in both groups (community 81.9%, institution 74.9%). Activity disturbance was the most frequently reported BPSD in both groups (community 52.2%, institution 38.7%). Delusions, hallucinations, anxiety and aggressiveness were seen more frequently in memory clinic outpatients. The outpatients also had higher scores of BEHAVE-AD subscales in delusion/paranoid ideation, affective disturbance, and global rating of severity. With the increase of disease severity there were significantly more activity disturbance, psychosis, and aggressiveness in patients with AD.Conclusions: Caregiver factor and institution effect were two possible reasons for the higher prevalence and the greater severity of BPSD in community patients. BPSD caused more distress to family caregivers than the professional caregivers. High levels of psychotropic prescriptions for patients living in the long-term care facilities may also play a role.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract Poor sleep among family caregivers of individuals with dementia is associated with higher levels of caregiver stress. Modifiable factors that increase risk of stress among caregivers with poor sleep are targets for intervention. This analysis aimed to identify factors associated with greater caregiver stress among caregivers with poor sleep. Baseline data from an ongoing trial of a dyadic sleep intervention program for individuals with dementia and their caregivers with poor sleep quality (defined by Pittsburgh Sleep Quality Index total score &gt; 5; N=21 dyads; mean age 70.8± 11.1 for caregivers, 80.5± 8.3 for care-recipients) were analyzed. Caregiving factors included Zarit Burden Index (ZBI) and SF-12 Short Form Health Survey (SF-12v2). Care-recipient factors included Mini-Mental State Examination (MMSE) and Revised Memory and Behavior Problems Checklist (RMBPC). Stress was measured with the Perceived Stress Scale (PSS). Analyses included Pearson correlations and t-tests. Caring for multiple care-recipients (n=5: 24.8±2.7) was associated with higher (worse) PSS scores than caring for one care-recipient only (n=16: 19.6±3.7, p=0.011). Caregivers with higher PSS also had a significantly higher ZBI score (r=0.53, p=0.015), higher distress related to care-recipient behaviors on the RMBPC (r=0.57, p=0.009) and worse mental health on the SF-12v2 (r= -0.47, p=0.037). PSS was not associated with care-recipient MMSE. These findings suggest that caregivers with poor sleep who care for multiple care-recipients may be at higher risk of stress. This work also identified potential targets (e.g., caregiver burden, mental health, distress related to care-recipient behavior) for reducing stress in this population.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Older adults with memory loss often require assistance from caregivers to manage their medications. This study examined the efficacy of a problem-solving-based intervention focused on caregiver medication management, problem solving, self-efficacy, and daily hassles. Caregiver health-related quality of life (HRQoL) and patient health care utilization were secondary outcomes. Totally, 83 patients (age 79.9±8.8 years) and their informal caregivers (age 66.9±12 years, female 69.9%, White 85.5%) were randomized; data collection occurred at baseline, 8, 16, and 24 weeks. Linear mixed modeling showed significant decreases in medication deficiencies which were sustained over time. No significant changes in caregiver problem solving, daily hassles, or patient health care utilization occurred between groups or over time. In addition, caregiver self-efficacy and mental HRQoL decreased in both groups. Physical HRQoL decreased in the intervention group, yet increased in the usual care group. Future research should investigate these outcomes in larger and more diverse samples.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract The Integrated Memory Care Clinic (IMCC) at Emory Healthcare is a patient-centered medical home led by advanced practice registered nurses (APRNs) who provide both dementia care and primary care. We explored the experiences of informal caregivers of persons living with dementia at the IMCC during their first year post-enrollment. Twelve caregivers completed semi-structured telephone interviews that lasted 29 minutes on average. The data were analyzed via directed content analysis guided by attention only to caregivers’ accounts of their experience at the IMCC. Caregivers’ experiences clustered around two major considerations: the strengths of the IMCC, and ways to enhance the IMCC. Overall, caregivers’ viewed the IMCC as their wished-for care model. Caregivers felt a sense of belonging to the IMCC team, as they understood that the IMCC personnel incorporate caregivers’ input to deliver care. Participants valued APRNs’ competence in dementia care and having direct telephone access to an on-duty APRN around the clock. Caregivers appreciated the care organization at the IMCC with adequate time dedicated for in-person visits. Areas for the IMCC improvement included clarifying the IMCC scope of practice, explaining dementia progression, involving physicians, and providing more medical and non-medical resources at the IMCC. Caregivers’ willingness to have more resources provided by the IMCC emphasizes how many unmet needs caregivers and their persons have. Clarification of the clinics’ scope of practice – what can be done to manage dementia, its symptoms, and comorbidities – highlighted the need to educate caregivers about ways in which dementia, albeit incurable, can be managed.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Background and Objectives: Currently, one in eight people over the age of 65 have dementia, and approximately 75% of caregiving is provided by volunteer family members with little or no training. This study aimed to quantify points of stress for home-based caregivers with the aim of reducing stress for them while concurrently supporting quality of life for the people with dementia whom they cared for. The overreaching purpose was to increase our knowledge of the caregiver stress burden and explore potential technologies and behaviors to ease it. Materials and Methods: We interviewed home-based and professional caregivers regarding causes of emotional and physical stress and methods they used to alleviate it. Results: This study found that: (1) dementia symptoms created a burden of stress for home-based caregivers primarily in the areas of medication management, memory loss, hygiene care and disruptive behaviors; (2) home-based caregivers identified “finding available resources” as the most important source of stress relief; (3) a minority of home-based caregivers possessed a resource network and knew how to find resources but all professional caregivers were able to find resources and support; (4) home-based caregivers combated dementia symptoms with positive distractions and human touch with little use of technology, since it was mostly unknown; and (5) facility-based caregivers were knowledgeable and readily used dementia-based technology. Conclusion: Since professional caregivers have access to technological resources that our home-based caregivers lack, one might logically conclude that we should transfer technology used by professionals to those with dementia. However, great caution needs to be in place before we take that step. Successful technology should address the human experience as home-based caregivers try to use new technologies. Human-centric technology addresses the needs of both people with dementia and the home-based caregiver.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

The aim of this study was to assess in practice whether assistive technologies support and facilitate the work of a family caregiver or care staff, and whether these technologies support the independence of a person with a memory disorder. A comprehensive set of supportive devices and alarm systems were experimentally tested in the care of five test subjects in an assisted living facility by eight nurses, and in the care of four test subjects in a home environment by three family caregivers and one care team. Questionnaires, diaries and logged data were used to evaluate the benefits of the devices. Simple aids and alarm systems that did not need much adjusting were considered most useful by caregivers and nurses, though multiple false alarms occurred during the test period. Technical connection problems, complex user interface, and inadequate sound quality were the primary factors reducing the utility of the tested devices. Further experimental research is needed to evaluate the utility of assistive technologies in different stages of a memory disorder.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

ABSTRACTBackground: Sexuality and intimacy in couples in which one partner is affected by dementia has been widely researched. Few studies have explored these issues in couples where one partner is affected by mild memory impairment (MMI) or mild cognitive impairment (MCI). The objectives of this study were to (1) identify and contrast issues of intimacy and sexuality that spousal caregivers of persons with MMI and dementia may experience, and (2) identify future lines of research in this population.Methods: Fourteen dementia and nine MMI spousal caregivers participated in focus groups conducted between 2008 and 2009 at the Stanford/VA Alzheimer's Research Center. Content analyses were conducted to identify themes.Results: Five themes emerged: communication, marital cohesion, affectional expression, caregiver burden, and ambiguity concerning the future of the relationship. Dementia caregivers reported more difficulties with communication, cohesion, and perceptions of increased burden than their MMI counterparts. Both groups indicated reduced sexual expression due to physical limitations; substitute activities including hand-holding, massaging, and hugging were noted. Both groups reported difficulty anticipating the future of the relationship due to present stressors. While dementia caregivers could consider future romantic relationships with others, MMI caregivers were primarily able to consider future relationships only for companionship and emotional intimacy.Conclusion: Early therapeutic interventions may assist couples in modifying activities, behaviors, and expectations about the future of the relationship. Such modifications may help maintain relationship satisfaction, decrease burden, preserve quality of life, and delay time-to-placement. Extending time-to-placement could have cost savings implications for families and the healthcare system.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract The purpose of this presentation is to identify burden and problems experienced by caregivers of patients with Alzheimer’s Disease (AD). AD results in gradual deterioration of cognition, language, and memory that can impact an individual’s ability to independently perform daily functional activities (CDC, 2019). The role of caregivers is significant in providing assistance to the patients with chronic AD which can be a source of strain for caregiver population. About 16.3 million informal AD caregivers have spent 18.5 billion hours, which is equal to value of $234 billion, to assist patients with other dementia types and AD in 2018 (Alzheimer’s Association, 2019). In-depth literature synthesis was carried out using multiple databases. Recent and relevant articles were selected to be added in the review. Due to responsibility of constant vigilance of AD patients, the caregivers may overlook their self-care needs and detach themselves from social life. Literature analysis revealed common challenges and needs of AD care partners including limited social engagement, concerns of sexuality, and sleep problems. Understanding caregiver problems will help nurses and other health care professionals to support families by planning preventive measures. Resources can be invested to improve physical and mental well-being of caregivers. Researches can be planned to bridge the knowledge gap identified through literature review on this topic. References Alzheimer’s Association. (2019). Alzheimer’s disease caregivers. http://act.alz.org/site/DocServer/caregivers_fact_sheet.pdf?docID=3022 Centers for Disease Control and Prevention. (2019). Alzheimer’s disease and healthy aging. https://www.cdc.gov/aging/aginginfo/alzheimers.htm

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

The goal of this research is to provide a conceptual service design framework based on literature reviews to help people living with dementia and their caregivers cope with the symptoms of dementia through the use of person-centered reminiscence therapy with Artificial Intelligence in immersive environments. Dementia impairs cognitive functions, such as memory and communication, and there is currently no cure for the condition. Treating people with dementia requires long care hours and is physically and psychologically demanding for caregivers. Brodaty and Donkin (2009) and Poulshock and Deimling (1984) have found a strong correlation between the caregiver’s stress and the person with dementia’s quality of life, and, in some cases, the caregiver’s stress and the vulnerable person with dementia’s situation has resulted in abuse. Colomer and de Vries (2016) insist that the caregivers’ lack of understanding about people with dementia’s needs results in repeated communication difficulties that often escalate to friction between the caregivers and the people with dementia in dementia care. In reminiscence dementia care, the emphasis is put on understanding a person with dementia’s life to find out their underlying dementia care needs, since symptoms and coping methods differ according to individual situations. This understanding provides the necessary information to create a tailored approach that is vital to enhance communication between people with dementia and caregivers. However, collecting relevant personal data from a person with dementia and their family is more complicated if the dementia is already in an advanced stage. This difficulty is exacerbated by high caregiver turnover and inexperienced caregivers, many of whom are young or non-native speakers. These issues make the lack of information about the person with dementia's specific needs harder to address. Therefore, innovative solutions are required to share common data about people with dementia, so that the caregivers can better understand their needs, which, in turn, will help to improve the quality of dementia care. How might we enable people at the onset of dementia to collect their memories, with the help of their families, in a smooth, guided, category-specific reminiscence event in a platform while avoiding any of the possible ethical problems associated with personal data gathering? Such a platform could employ the strength of immersive technology to expand the scope of existing reminiscence therapy and be used to store personal memories for people living with dementia. --- www.mymemorymuseum.org

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Background: Little information exists about how cognitive impairment in multiple sclerosis (MS) patients impacts on their caregivers’ health-related quality of life (HRQoL). Background: The objective of this paper is to examine the extent to which cognitive impairment in MS patients contributes to caregivers’ HRQoL. Methods: A total of 63 MS patients, 63 caregivers and 59 matched controls were recruited. Patients and controls underwent a neuropsychological assessment, including tests of working memory, speed of information processing, executive function, and verbal fluency. HRQoL of the caregivers was assessed by CAREQOL-MS. In logistic regression models, we adjusted for the effects of confounding variables. In these models, the dependent variable was the CAREQOL-MS (higher median of CAREQOL-MS (worse HRQoL) vs. lower median of CAREQOL-MS (better HRQoL) (reference)), and the independent variable was the impairment on each neuropsychological test vs. its integrity (reference). Results: Cognitive impairment in MS patients was significantly associated with worse caregiver HRQoL (adjusted odds ratio (OR) = 3.10, 95% confidence interval (CI) = 1.07–11.55, p = 0.04). In secondary analyses in which each neuropsychological test was entered in the analyses separately, only Symbol Digit Modalities Test (a measurement of information processing speed) impairment (OR = 4.22, 95%, CI = 1.16–14.53, p = 0.03) was significantly associated with worse caregiver HRQoL. Conclusions: MS patients’ caregivers’ HRQoL is significantly influenced by information processing speed impairment of MS patients.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Memory disorders have become a major public, social, and health concern among the aging population, and many of those who are affected are cared for at home by their spouse. The aim of this qualitative study was to describe the individual experiences of 10 older caregivers who were looking after a spouse with a memory disorder in 2016. Data were collected from volunteers who were recruited from a memory clinic at a Finnish health center using the thematic interview method and processed using inductive content analysis. The participants were six female and four male caregivers who had been married for over 10 years. The results indicated that caring for a spouse with a memory disorder involved a number of factors. These included the impact of social networks and changes in their everyday life, collaboration with service providers, and the caregivers’ well-being. However, our study showed that caregivers felt that the formal multiprofessional services they received were fragmented, which means that they were less likely to provide a holistic approach to caregivers’ situations. Better multiprofessional cooperation is needed in the community, including services such as memory clinics, home care and practical services, day centers, and short-term respite in care homes.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract Cognitive Stimulation Therapy (CST) is a non-pharmacological approach for individuals with mild to moderate dementia. It is one of the age friendly community activities of the GWEP to engage older adults with memory challenges. We explored the impact of caregiver-assisted CST (CA-CST) on participants’ overall memory, mood, and retention in the groups. We also investigated the impact of this CST format on the overall well-being of dementia caregivers. Four CST groups (N=28) entered the CA-CST groups meeting once per week for 14 weeks in a university setting. 61 % of participants who completed the group (n=17) showed a .5 point improvement on the Saint Louis University Mental Status Exam (SLUMS), a 2-point decrease on the Cornell Scale for Depression in Dementia (p&lt;.01), and 1.5 point increase in overall caregiver well-being. Continued psychosocial interventions for dementia are needed not just in university settings, but healthcare organizations and other age-friendly settings.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

ABSTRACTThe Saskatchewan Mood Inventory (SMI) is a caregiver-focused assessment and research tool that was designed to enhance understanding of the emotional experiences of individuals with dementia and to identify relationships between level of cognitive impairment and family member ratings of pleasant and unpleasant emotional responses during daily activities. Family members were instructed to use the semi-structured written log to document prospectively the type and intensity of emotion expressed by the individual with dementia, to describe the associated emotion-evoking events or activities, and to monitor and record their own emotional reactions. Twenty-seven family caregivers recruited from Alzheimer support groups used the log consistently during a 2-week monitoring period to document an average of three emotion-evoking events per day. Average emotion ratings were more positive for individuals with moderate levels of dementia than for those with severe cognitive impairment, and caregivers' ratings of their family members' and their own emotional states were positively correlated. The event-reporting procedures produced narrative descriptions of emotion-evoking activities that were subsequently coded for content. Inter-rater reliability estimates were high. Event-category summaries are reported in association with positive, negative, and neutral emotional responses for individuals with moderate and severe levels of dementia. Level of impairment was related both to the relative frequency of positive and negative emotions and to the type of event category reported by caregivers.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Objective: To investigate the relationship between Expressed Emotion (EE) and working memory (WM) capacity in the caregivers of patients with psychosis, controlling for the potential confounds, namely, personality traits, subsyndromal psychotic symptoms, burden of care and the patient’s illness severity. Materials and Methods: The study covered 152 related caregivers of psychotic patients diagnosed with schizophrenia, schizoaffective disorder, or bipolar disorder with a psychotic component. The study continued with 120 participants who met the recruitment criteria. Patients were assessed with a Structured Clinical Interview for Axis I Disorders (SCID-I), the Brief Psychiatric Rating Scale (BPRS), and the Clinical Global Impression Scale (CGI). For related caregivers; SCID-I, Expressed Emotion Scale (EES), Temperament and Character Inventory (TCI); Magical Ideation Scale; Physical Anhedonia Scale; Social Anhedonia Scale; Zarit Caregiver Burden Scale (ZCBS), and Auditory Consonant Trigram Test (ACT) were used. A stepwise regression analysis was employed to analyze the relevant variables that had an independent impact on EES scores. Results: There was a significant negative relationship between the ACT and EES scores (r=-.25, p<0.01). The ZCBS score (beta: 0.355, p<0.01), Harm Avoidance subscale of the TCI (beta: 0.231, p<0.01), and CGI overall improvement subscale (beta: 0.237, p<0.01) were independently associated with the EES score. Conclusions: There have been few studies investigating the biological basis of this clinical characteristic. The present study found no significant relationship between WM and EE in terms of the effect of WM in the caregivers of patients with psychosis.

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Internal resourcefulness is defined as the repertoire of skills and behaviors individuals employ to deal with negative affective states. The relationships among caregivers' internal resourcefulness, demands of the caregiving situation, and caregivers' self-reported coping behaviors were examined relative to changes in dysphoric affect over time. Primary caregivers of the frail elderly ( N = 143) completed the following measures, at two time periods, approximately four months apart: Rosenbaum's Self Control Schedule, assessing internal resourcefulness [1]; Poulshock and Deimling's list of tasks carried out for the frail elder [2]; Zarit et al.'s Memory and Behavior Problem Check List assessing caregiver burden [3]; Moos et al.'s Indices of Coping [4]; and Beck et al.'s Depression Inventory as a means of assessing dysphoric affect [5]. Although caregivers' reactions to the care recipients' annoying behaviors predicted negative affect at time 1 and avoidant coping behavior predicted negative affect at times 1 and 2, internal resourcefulness was the only significant predictor of changes in dysphoric affect over time. Decreased dysphoric affect among caregivers was linked to possession of a larger initial set of internal resources to deal with negative internal experiences.