Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-25T04:31:35.214Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of the burdens of family caregivers and foreign paid caregivers of the individuals with dementia

Published online by Cambridge University Press:  03 August 2012

Wei-Chen Lin ,
Chia-Fen Tsai ,
Shuu-Jiun Wang ,
Jeng-Ping Hwang  and
Jong-Ling Fuh
Wei-Chen Lin
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Chia-Fen Tsai
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan Brain Research Center, National Yang-Ming University, Taipei, Taiwan
Shuu-Jiun Wang
Affiliation:
Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan Brain Research Center, National Yang-Ming University, Taipei, Taiwan
Jeng-Ping Hwang
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Jong-Ling Fuh*
Affiliation:
Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan Brain Research Center, National Yang-Ming University, Taipei, Taiwan
*
Correspondence should be addressed to: Dr Jong-Ling Fuh, MD, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan. Phone: +886-2-28762522; Fax: +886-2-28765215. Email: [email protected].
Get access

Abstract

Background: The caregiver burden on foreign paid caregivers (FPCs) is currently not well understood. This study identified predictors and differences in caregiver burden between FPCs and family caregivers who provided care for patients with dementia.

Methods: We recruited 489 patients with dementia (diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition) and used the Neuropsychiatric Inventory (NPI) and Clinical Dementia Rating (CDR) Scale to assess their neuropsychiatric behavioral problems and severity of dementia. All caregivers [FPCs (n = 42) and family caregivers with (n = 42) and without (n = 447) FPCs] completed three questionnaires: the Zarit Burden Interview (ZBI), the Center for Epidemiological Studies–Depression Scale (CES-D), and caregivers’ knowledge of dementia (KD). To understand caregiver burden, we analyzed the correlations between ZBI and other variables and investigated the differences between family caregivers and FPCs.

Results: NPI and CDR scores were higher among patients assisted by FPCs than among those whose families did not employ FPCs. Burdens were greater among family caregivers assisted by FPCs than among FPCs and family caregivers who were not assisted by FPCs. Family caregivers had greater knowledge of dementia than did FPCs. For family caregivers, CES-D scores (Spearman's r = 0.650; p < 0.01) and patients’ NPI scores (Spearman's r = 0.471; p < 0.01) were correlated with caregiver burden. For FPCs, only CES-D scores (Spearman's r = 0.511; p < 0.01) were correlated with caregiver burden. A linear regression model showed that CES-D scores contributed most to caregiver burden in all groups [β = 0.560 (family caregivers without FPCs), 0.546 (family caregivers with FPCs), and 0.583 (FPCs); p < 0.005].

Conclusion: Both family caregivers and FPCs need emotional support. Adequate treatment to reduce the neuropsychiatric symptoms of patients with dementia might reduce the burden on family caregivers.

Keywords

caregiver burdendementiaforeign paid caregiverdepression
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 12 , December 2012 , pp. 1953 - 1961
Copyright
Copyright © International Psychogeriatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington, DC: American Psychiatric Press.Google Scholar
Arai, Y., Arai, A. and Zarit, S. H. (2008). What do we know about dementia? A survey on knowledge about dementia in the general public of Japan. International Journal of Geriatric Psychiatry, 23, 433–438.Google Scholar
Ayalon, L. (2010). Reports of neuropsychiatric symptoms of older care recipients by their family members and their foreign home care workers: results from triadic data. Journal of Geriatric Psychiatry and Neurology, 23, 115–122.Google Scholar
Baumgarten, M., Battista, R. N., Infante-Rivard, C., Hanley, J. A., Becker, R. and Gauthier, S. (1992). The psychological and physical health of family members caring for an elderly person with dementia. Journal of Clinical Epidemiology, 45, 61–70.Google Scholar
Bergman-Evans, B. (1994). A health profile of spousal Alzheimer's caregivers: depression and physical health characteristics. Journal of Psychosocial Nursing and Mental Health Services, 32, 25–30.Google Scholar
Coen, R. F., O'Boyle, C. A., Coakley, D. and Laulor, B. A. (1999). Dementia carer education and patient behaviour disturbance. International Journal of Geriatric Psychiatry, 14, 302–306.Google Scholar
Cohen, J. (1988). Statistical Power Analysis for Behavioral Sciences, 2nd edn. Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
Connell, C. M., Scott Roberts, J., McLaughlin, S. J. and Akinleye, D. (2009). Racial differences in knowledge and beliefs about Alzheimer disease. Alzheimer Disease and Associated Disorders, 23, 110–116.Google Scholar
Crist, J. D., McEwen, M. M., Herrera, A. P., Kim, S. S., Pasvogel, A. and Hepworth, J. T. (2009). Caregiving burden, acculturation, familism, and Mexican American elders’ use of home care services. Research and Theory for Nursing Practice, 23, 165–180.Google Scholar
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.Google Scholar
Donaldson, C., Tarrier, N. and Bruns, A. (1998). Determinants of carer stress in Alzheimer's disease. International Journal of Geriatric Psychiatry, 13, 248–256.Google Scholar
Draper, B. M., Poulos, C. J., Cole, A. M., Poulos, R. G. and Ehrlich, F. (1992). A comparison of caregivers for elderly stroke and dementia victims. Journal of the American Geriatric Society, 40, 896–901.CrossRefGoogle ScholarPubMed
Fuh, J. L., Wang, S. J., Liu, H. C., Liu, C. Y. and Wang, H. C. (1999). Predictors of depression among Chinese family caregivers of Alzheimer patients. Alzheimer Disease and Associcated Disorders, 13, 171–175.Google Scholar
Fuh, J. L., Liu, C. K., Mega, M. S., Wang, S. J. and Cummings, J. L. (2001). Behavioral disorders and caregivers’ reaction in Taiwanese patients with Alzheimer's disease. International Psychogeriatrics, 13, 121–128.Google Scholar
Gallagher-Thompson, D. and Coon, , , D. W. (2007). Evidence-based psychological treatments for distress in family caregivers of older adults. Psychology and Aging, 22, 37–51.Google Scholar
Gilleard, C. J., Belford, H., Gilleard, E., Whittick, J. E. and Gledhill, K. (1984). Emotional distress amongst the supporters of the elderly mentally infirm. British Journal of Psychiatry, 145, 172–177.CrossRefGoogle ScholarPubMed
Gitlin, L. N., Winter, L., Corcoran, M., Dennis, M. P., Schinfeld, S. and Hauck, W. W. (2003). Effects of the home environmental skill-building program on the caregiver-care recipient dyad: 6-month outcomes from the Philadelphia REACH Initiative. Gerontologist, 43, 532–546.Google Scholar
Goncalves-Pereira, M., Carmo, I., Alves da Silva, J., Papolia, A. L., Mateos, R. and Zarit, S. H. (2010). Caregiving experiences and knowledge about dementia in Portuguese clinical outpatient settings. International Psychogeriatrics, 22, 270–280.Google Scholar
Graham, C., Ballard, C. and Sham, P. (1997). Carers’ knowledge of dementia, their coping strategies and morbidity. International Journal of Geriatric Psychiatry, 12, 931–936.Google Scholar
Huang, H. L., Shyu, Y. L. and Chen, S. T. (2008). Feasible models for dementia care service. Journal of Research, Development and Evolution Commision, 32, 22–33.Google Scholar
Ko, K. T., Yip, P. K., Liu, S. I. and Huang, C. R. (2008). Chinese version of the Zarit caregiver Burden Interview: a validation study. American Journal of Geriatric Psychiatry, 16, 513–518.CrossRefGoogle ScholarPubMed
Machnicki, G., Allegri, R. F., Dillon, C., Serrano, C. M. and Taragano, F. E. (2009). Cognitive, functional and behavioral factors associated with the burden of caring for geriatric patients with cognitive impairment or depression: evidence from a South American sample. International Journal of Geriatric Psychiatry, 24, 382–389.Google Scholar
Martin-Carrasco, M. et al. (2009). Effectiveness of a psychoeducational intervention program in the reduction of caregiver burden in Alzheimer's disease patients’ caregivers. International Journal of Geriatric Psychiatry, 24, 489–499.Google Scholar
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA work group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939–944.Google Scholar
Mohamed, S., Rosenheck, R., Lyketsos, C. G. and Schneider, L. S. (2010). Caregiver burden in Alzheimer disease: cross-sectional and longitudinal patient correlates. American Journal of Geriatric Psychiatry, 18, 917–927.Google Scholar
Morris, J. C. (1993). The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology, 43, 2412–2414.Google Scholar
Patterson, T. L. et al. (1998). The cultural context of caregiving: a comparison of Alzheimer's caregivers in Shanghai, China and San Diego, California. Psychological Medicine, 28, 1071–1084.Google Scholar
Proctor, R., Martin, C. and Hewison, J. (2002). When a little knowledge is a dangerous thing. . .: a study of carers’ knowledge about dementia, preferred coping style and psychological distress. International Journal of Geriatric Psychiatry, 17, 1133–1139.CrossRefGoogle Scholar
Radloff, L. (1977). The CES-D Scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.Google Scholar
Rosa, E., Ambrogio, M., Binetti, G. and Zanetti, O. (2004). Immigrant paid caregivers’ and primary caregivers’ burden. International Journal of Geriatric Psychiatry, 19, 1103–1104.Google Scholar
Rosa, E. et al. (2008). The immigrant paid caregivers’ role in the care of patients with severe dementia. International Journal of Geriatric Psychiatry, 23, 331–333.Google Scholar
Siegler, I. C., Brummett, B. H., Williams, R. B., Haney, T. L. and Dilworth-Anderson, P. (2010). Caregiving, residence, race, and depressive symptoms. Aging Mental Health, 14, 771–778.Google Scholar
Teri, L., McCurry, S. M., Logsdon, R. and Gibbons, L. E. (2005). Training community consultants to help family members improve dementia care: a randomized controlled trial. Gerontologist, 45, 802–811.Google Scholar
Zarit, S. H., Reever, K. E. and Bach-Peterson, J. (1980). Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist, 20, 649–655.Google Scholar