Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-19T00:28:36.839Z Has data issue: false hasContentIssue false

Factors influencing the resilience of carers of individuals with dementia

Published online by Cambridge University Press:  18 October 2013

MG Cherry*
Affiliation:
Division of Clinical Psychology, University of Liverpool, Liverpool
P Salmon
Affiliation:
Division of Clinical Psychology, University of Liverpool, Liverpool
JM Dickson
Affiliation:
Division of Clinical Psychology, University of Liverpool, Liverpool
D Powell
Affiliation:
Older People's Services, Mossley Hill Hospital, MerseyCare NHS Trust, Liverpool
S Sikdar
Affiliation:
Older People's Services, Waterloo Day Hospital, MerseyCare NHS Trust, Liverpool
J Ablett
Affiliation:
Liverpool Psychology Service for Cancer, Linda McCartney Centre, Royal Liverpool University Hospital, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool
*
Address for correspondence: M. Gemma Cherry, Division of Clinical Psychology, Room 2.06, Whelan Building, The University of Liverpool, The Quadrangle, Brownlow Hill, Liverpool L69 3GE. Email: [email protected]

Summary

Most individuals with dementia live in the community, receiving care from family or lay carers. Carers’ wellbeing, and the quality of the care they provide, depends on their resilience in the face of the challenges associated with caring for someone with dementia. However, factors associated with carers’ resilience are not yet fully understood. The aim of this review is to present a narrative synthesis of factors, materials and resources associated with carers’ resilience. Electronic and hand searches identified relevant published literature, which was narratively synthesized. A framework consisting of three inter-related domains of factors influencing carers’ resilience emerged, encompassing: social and cultural factors; properties of the care relationship; and carers’ psychological factors. Holistic assessment based on this framework can help practitioners to identify vulnerable carers and to target help on factors that help to make them vulnerable but that are amenable to change.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2013 

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

1World Health Organization, Alzheimer's Disease International. Dementia: A Public Health Priority 2012.Google Scholar
2Lakey, L, Chandaria, K, Quince, C, Kane, M, Saunders, T. Dementia 2012 : a national challenge. Alzheimer's Society, 2012; available at: http://www.alzheimers.org.uk/site/scripts/download_info.php?fileID=1389.Google Scholar
3Albanese, E, Banerjee, S, Dhanasiri, S, Fernandez, J-L, Ferri, C, Knapp, M et al. Dementia UK: The Full Report. London: Alzheimer's Society, 2007.Google Scholar
4National Audit Office. Improving services and support for people with dementia. London National Audit Office, 2007.Google Scholar
5National Institute for Health and Clinical Excellence, Social Care Institute for Excellence. Dementia: Supporting people with dementia and their carers in health and social care: National Institute for Health and Clinical Excellence, 2011.Google Scholar
6Zarit, SH, Todd, PA, Zarit, J. Subjective burden of husbands and wives as caregivers: a longitudinal study. Gerontologist 1986; 26: 260–66.CrossRefGoogle ScholarPubMed
7Andren, S, Elmstahl, S. The relationship between caregiver burden, caregivers’ perceived health and their sense of coherence in caring for elders with dementia. J Clin Nurs 2008; 17: 790–99.CrossRefGoogle ScholarPubMed
8Department of Health. Living well with dementia: A National Dementia Strategy. Leeds: Department of Health, 2009.Google Scholar
9Vitaliano, PP, Zhang, J, Scanlan, JM. Is caregiving hazardous to ones physical health? A meta-analysis. Psychol Bull 2003; 129: 946–72.CrossRefGoogle Scholar
10Ory, MG, Yee, JL, Tennestedt, SL, Schulz, R. The extent and impact of dementia care: Unique challenges experienced by family caregivers. In Schulz, R (ed), Handbook on Dementia Caregiving: Evidence-Based Interventions for Family Caregivers. New York: Springer; 2000.Google Scholar
11Goes, B, Higginson, I. Where people die (1974–2030): past trends, future projections and implications for care. Palliat Med 2008; 22: 3341.Google Scholar
12Kalus, C, Beloff, H, Brennan, J, McWilliams, E, Payne, S, Royan, Let al. The role of psychology in end of life care. Leicester, UK: British Psychological Society 2008.Google Scholar
13Ablett, JR, Jones, RSP. Resilience and well-being in palliative care staff: a qualitative study of hospice nurses’ experience of work. Psycho-oncology 2007; 16: 733–40.CrossRefGoogle Scholar
14Windle, G. What is resilience? A review and concept analysis. Rev Clin Gerontol 2011; 21: 152–69.CrossRefGoogle Scholar
15Hjemdal, O, Friborg, O, Stiles, T, Rosenvinge, J, Martinussen, M. Resilience predicting psychiatric symptoms: A prospective study of protective factors and their role in adjustment to stressful life events. Clin Psychol Psychot 2006; 13: 194201.CrossRefGoogle Scholar
16Windle, G, Bennett, K. Caring relationships: How to promote resilience in challenging times. In Ungar, M (ed), The Social Ecology of Resilience: A Handbook of Theory and Practice, pp. 219–31. Springer, 2012.CrossRefGoogle Scholar
17Centre for Reviews and Dissemination. CRD's Guidance for undertaking reviews in healthcare, 2009; available at: http://www.york.ac.uk/inst/crd/pdf/Systematic_Reviews.pdf.Google Scholar
18Gaugler, J, Kane, R, Newcomer, R. Resilience and transitions from dementia caregiving. J Gerontol B Psychol Sci Social Sci 2007; 62: 3844.CrossRefGoogle ScholarPubMed
19Ashley, N, Kleinpeter, C. Gender differences in coping strategies of spousal dementia caregivers. J Human Behavior Social Env 2002; 6: 2946.CrossRefGoogle Scholar
20Garity, J. Stress, learning style, resilience factors, and ways of coping in Alzheimer family caregivers. Am J Alzheimer's Dis Other Dementias 1997; 12: 171–78.CrossRefGoogle Scholar
21Etters, L, Goodall, D, Harrison, BE. Caregiver burden among dementia patient caregivers: a review of the literature. J Am Acad Nurse Pract 2008; 20: 423–28.CrossRefGoogle ScholarPubMed
22Baker, K. Men caring for wives/partners with dementia. University of Leicester, Doctoral Thesis, 2006.Google Scholar
23Donaldson, C, Tarrier, N, Burns, A. Determinants of carer stress in Alzheimer's disease. Int J Geriatr Psychiatry 1998; 13: 248–56.3.0.CO;2-0>CrossRefGoogle ScholarPubMed
24Young, R, Kahana, E. Specifying caregiver outcomes: gender and relationship aspects of caregiver strain. Gerontologist 1989; 29: 660–66.CrossRefGoogle Scholar
25Atienza, A, Henderson, P, Wilcox, S, King, A. Gender differences in cardiovascular response to dementia caregiving. Gerontologist 2001; 41: 490–98.CrossRefGoogle ScholarPubMed
26Lazarus, R, Folkman, S. Stress, Appraisal and Coping. New York: Springer, 1984.Google Scholar
27Pearlin, L, Mullan, J, Semple, S, Skaff, M. Caregiving and the stress process: an overview of the concepts and their measures. Gerontologist 1990; 30: 583–94.CrossRefGoogle ScholarPubMed
28Hooker, K, Manoogian-O’Dell, M, Monahan, D, Frazier, L, Shifren, K. Does type of disease matter? Gender differences among Alzheimer's and Parkinson's disease spouse caregivers. Gerontologist 2000; 40: 568–73.CrossRefGoogle ScholarPubMed
29DeVries, H, Hamilton, D, Lovett, S, Gallagher-Thompson, D. Patterns of coping preferences for male and female caregivers of frail older adults. Psychol Aging 1997; 12: 263–67.CrossRefGoogle ScholarPubMed
30Baker, K, Robertson, N. Coping with caring for someone with dementia: Reviewing the literature about men. Aging Ment Health 2008; 12: 413–22.CrossRefGoogle ScholarPubMed
31Baker, KL, Robertson, N, Connelly, D. Men caring for wives or partners with dementia: masculinity, strain and gain. Aging Ment Health 2010; 14: 319–27.CrossRefGoogle ScholarPubMed
32Davies, H, Priddy, JM, Tinklenberg, JR. Support groups for male caregivers of Alzheimer's patients. Clinical Gerontologist 1986; 50: 385–95.CrossRefGoogle Scholar
33Kaye, L, Applegate, J. Men as elder caregivers: building a research agenda for the 1990s. J Aging Stud 1990; 4: 289–98.CrossRefGoogle Scholar
34Horowitz, A. Sons and daughters as caregivers to older parents: difference in role performance and consequences. Gerontologist 1985; 25: 612–17.CrossRefGoogle ScholarPubMed
35Kramer, B. Husbands caring for wives with dementia: a longitudinal study of continuity and change. Health Soc Work 2000; 25: 97108.CrossRefGoogle ScholarPubMed
36Neysmith, S. From community care to a social model of care. In Baines, C, Evans, P, Neysmith, S (eds), Women's Caring: Feminist Perspectives on Social Welfare, pp. 272–99. Toronto, ON: McClelland and Stewart, 1991.Google Scholar
37Stommel, M, Collins, C, Given, B, Given, C. Correlates of community services attitudes among family caregivers. J Appl Gerontol 1999; 18: 145–61.CrossRefGoogle Scholar
38Calasanti, T, King, N. Taking ‘Women's Work’ ‘Like a Man’: Husbands’ Experiences of Care Work. Gerontologist 2007; 47: 516–27.CrossRefGoogle Scholar
39Kaye, L, Applegate, J. Family support groups for male caregivers: benefits of participation. J Gerontol Soc Work 1993; 20: 167–85.CrossRefGoogle Scholar
40McFarland, P, Sanders, S. Educational support groups for male caregivers of individuals with Alzheimer's disease. Am J Alzheimer's Dis Other Dementias 2000; 15: 367–73.CrossRefGoogle Scholar
41Roth, DL, Haley, WE, Owen, JE, Clay, OJ, Goode, KT. Latent growth models of the longitudinal effects of dementia caregiving: a comparison of African American and White family caregivers. Psychol Aging 2001; 16: 427–36.CrossRefGoogle ScholarPubMed
42Kosberg, JI, Kaufman, AV, Burgio, LD, Leeper, JD, Sun, F. Family caregiving to those with dementia in rural Alabama: racial similarities and differences. J Aging Health 2007; 19: 321.CrossRefGoogle ScholarPubMed
43Hilgeman, MM, Durkin, DW, Sun, F, DeCoster, J, Allen, RS, Gallagher-Thompson, Det al.Testing a theoretical model of the stress process in Alzheimer's caregivers with race as a moderator. Gerontologist 2009; 49: 248–61.CrossRefGoogle Scholar
44Clay, OJ, Roth, DL, Wadley, VG, Haley, WE. Changes in social support and their impact on psychosocial outcome over a 5-year period for African American and White dementia caregivers. Int J Geriatr Psychiatry 2008; 23: 857–62.CrossRefGoogle Scholar
45Depuis, S, Epp, T, Smale, B. Caregivers of persons with dementia: roles, experiences, supports and coping. A literature review. University of Waterloo, 2004.Google Scholar
46Chu, I. Family care of the elderly with dementia in Hong Kong. Int Social Work 1991; 34: 365–72.CrossRefGoogle Scholar
47Chan, C. Factors associated with depressive mood among elderly family caregivers of patients with dementia in the community. Doctoral Thesis, University of Hong Kong, 2010.Google Scholar
48Harwood, DG, Barker, WW, Ownby, RL, Bravo, M, Aguero, H, Duara, R. Predictors of positive and negative appraisal among Cuban American caregivers of Alzheimer's disease patients. Int J Geriatr Psychiatry 2000; 15: 481–87.3.0.CO;2-J>CrossRefGoogle ScholarPubMed
49Mangone, CA. Behavioral and psychological signs and symptoms of dementia: implications for research and treatment. Cross-cultural perspectives. Argentina. Int Psychogeriatr 1996; 8 suppl 3: 473–78; discussion 91–92.CrossRefGoogle ScholarPubMed
50Arai, Y, Kudo, K, Hosokawa, T, Washio, M, Miura, H, Hisamichi, S. Reliability and validity of the Japanese version of the Zarit Caregiver Burden interview. Psychiatry Clin Neurosci 1997; 51: 281–87.CrossRefGoogle ScholarPubMed
51Kar, N, Sharma, PS, Sengupta, S. Behavioural and psychological symptoms in dementia-clinical features in an Indian population. Int J Geriatr Psychiatry 2001; 16: 540–41.CrossRefGoogle Scholar
52Adams, B, Aranda, M, Temp, B, Takaji, K. Ethnic and gender differences in distress among Anglo American, African American, Japanese American and Mexican American spousal caregivers of persons with dementia. J Clin Geropsychol 2002; 8: 279301.CrossRefGoogle Scholar
53Dilworth-Anderson, P, Gibson, B. The cultural influence of values, norms, meanings, and perceptions in understanding dementia in ethnic minorities. Alzheimer Dis Assoc Disord 2002; 16: S5663.CrossRefGoogle ScholarPubMed
54Cox, C. Comparing the experiences of black and white caregivers of dementia patients. Soc Work 1995; 40: 343–49.Google ScholarPubMed
55Werner, P. Correlates of family caregivers’ knowledge about Alzheimer's disease. Int J Geriatr Psychiatry 2001; 16: 3238.3.0.CO;2-2>CrossRefGoogle ScholarPubMed
56Proctor, R, Martin, C, Hewison, J. When a little knowledge is a dangerous thing . . .: a study of carers’ knowledge about dementia, preferred coping style and psychological distress. Int J Geriatr Psychiatry 2002; 17: 1133–39.CrossRefGoogle Scholar
57Graham, C, Ballard, C, Sham, P. Carers’ knowledge of dementia, their coping strategies and morbidity. Int J Geriatr Psychiatry 1997; 12: 931–36.3.0.CO;2-8>CrossRefGoogle ScholarPubMed
58Miller, S. Monitoring and blunting: validation of a questionnaire to assess style of information seeking under threat. J Pers Soc Psychol 1987; 52: 345–53.CrossRefGoogle ScholarPubMed
59Schindler, M, Engel, S, Rupprecht, R. The impact of perceived knowledge of dementia on caregiver burden. GeroPsych: J Gerontopsychol Geriatric Psychiatry 2012; 25: 127–34.CrossRefGoogle Scholar
60Hinrichsen, G, Ramirez, M. Black and white dementia caregivers: a comparison of their adaptation, adjustment, and service utilization. Gerontologist 1992; 32: 375–81.CrossRefGoogle ScholarPubMed
61Picot, S. Choice and social exchange theory and the rewards of African-American caregivers. J Natl Black Nurses Assoc 1994; 7: 2940.Google ScholarPubMed
62Robinson, K, Kaye, J. The relationship between spiritual perspective, social support, and depression in caregiving and non-caregiving wives. Sch Inq Nurs Pract 1994; 8: 375–89.Google Scholar
63Coen, RF, O’Boyle, CA, Coakley, D, Lawlor, BA. Individual quality of life factors distinguishing low-burden and high-burden caregivers of dementia patients. Dement Geriatr Cogn Disord 2002; 13: 164–70.CrossRefGoogle ScholarPubMed
64Farran, C, Miller, B, Kaufman, J, Davis, L. Race, finding meaning, and caregiver distress. J Aging Health 1997; 9: 316–33.CrossRefGoogle ScholarPubMed
65Burgener, S. Caregiver religiosity and well-being in dealing with Alzheimer's dementia. J Relig Health 1994; 33: 175–89.CrossRefGoogle ScholarPubMed
66Karlin, N. An analysis of religiosity and exercise as predictors of support group attendance and caregiver burden while caring for a family member with Alzheimer's disease. J Mental Health Aging 2004; 10: 99106.Google Scholar
67Lee, H, Kim, S, You, K. Learning from other lands. Caring for elderly demented Koreans. J Gerontol Nurs 1997; 23: 2131.CrossRefGoogle ScholarPubMed
68Meller, S. A comparison of the well-being of family caregivers of elderly patients hospitalized with physical impairments versus the caregivers of patients hospitalized with dementia. J Am Med Dir Assoc 2001; 2: 6065.CrossRefGoogle ScholarPubMed
69Cohen, C, Teresi, J, Blum, C. The role of caregiver social networks in Alzheimer's disease. Soc Sci Med 1994; 38: 1483–90.CrossRefGoogle ScholarPubMed
70Rabins, P, Fitting, M, Eastham, J, Zabora, J. Emotional adaptation over time in care-givers for chronically ill elderly people. Age Ageing 1990; 19: 185–90.Google ScholarPubMed
71Stuckey, J. Blessed assurance: the role of religion and spirituality in Alzheimer's disease caregiving and other significant life events. J Aging Stud 2001; 15: 6984.CrossRefGoogle Scholar
72Wilks, SE, Vonk, ME. Private prayer among Alzheimer's caregivers: mediating burden and resiliency. J Gerontol Soc Work 2008; 50: 113–31.CrossRefGoogle ScholarPubMed
73Haley, W, Levine, E, Brown, S, Bartolucci, A. Stress, appraisal, coping, and social support as predictors of adaptational outcome among dementia caregivers. Psychol Aging 1987; 2: 323–30.CrossRefGoogle ScholarPubMed
74George, L, Gwyther, L. Caregiver well-being: a multidimensional examination of family caregivers of demented adults. Gerontologist 1986; 26: 253–59.CrossRefGoogle ScholarPubMed
75Barnes, B, Given, C, Given, B. Caregivers of elderly relatives: spouses and adult children. Health Soc Work 1992; 17: 282–89.CrossRefGoogle ScholarPubMed
76Conde-Sala, JL, Garre-Olmo, J, Turro-Garriga, O, Vilalta-Franch, J, Lopez-Pousa, S. Differential features of burden between spouse and adult-child caregivers of patients with Alzheimer's disease: an exploratory comparative design. Int J Nurs Stud 2010; 47: 1262–73.CrossRefGoogle ScholarPubMed
77Abel, E. The ambiguities of social support: adult daughters caring for frail elderly parents. J Aging Stud 1989; 3: 211–30.CrossRefGoogle Scholar
78Scharlach, A. Caregiving and employment: competing or complementary roles? Gerontologist 1994; 34: 378–85.CrossRefGoogle ScholarPubMed
79Pinquart, M, Sörensen, S. Spouses, adult children and children-in-law as caregivers of older adults: a meta-analytic comparison. Psychol Aging 2011; 26: 114.CrossRefGoogle ScholarPubMed
80Van Den Wijngaart, MAG, Vernooij-Dassen, MJFJ, Felling, AJA. The influence of stressors, appraisal and personal conditions on the burden of spousal caregivers of persons with dementia. Aging Ment Health 2007; 11: 626–36.CrossRefGoogle ScholarPubMed
81Hazan, C, Shaver, P. Romantic love conceptualized as an attachment process. J Pers Soc Psychol 1987; 52: 511–24.CrossRefGoogle ScholarPubMed
82McGovern, J. Couple meaning-making and dementia: challenges to the deficit model. J Gerontol Soc Work 2011; 54: 678–90.CrossRefGoogle Scholar
83Department of Health. Transforming the Quality of Dementia Care: Consultation on a National Dementia Strategy. London: Department of Health, 2008.Google Scholar
84O’Rourke, N, Wenaus, C. Marital aggrandizement as a mediator of burden among spouses of suspected dementia patients. Can J Aging/La Revue canadienne du vieillissement 1998; 17: 3844.Google Scholar
85Svanberg, E, Stott, J, Spector, A. ‘Just helping’: children living with a parent with young onset dementia. Aging Ment Health 2010; 14: 740–51.CrossRefGoogle ScholarPubMed
86Kupferschmidt, AL. Psychological resilience in spousal caregivers of memory clinic patients with Alzheimer disease. Simon Fraser University, Master's Thesis, 2009.Google Scholar
87 Heinz M. Dementia caregiving characteristics, elder impairment, and caregiver strain and burden. Graduate Theses and Dissertations, Doctoral Thesis, 2010.Google Scholar
88Betts-Adams, K, Sanders, S. Alzheimer's caregiver differences in experience of loss, grief reactions and depressive symptoms across stage of disease. Dementia 2004; 3: 195210.CrossRefGoogle Scholar
89Lopez, J, Lopez-Arrieta, J, Crespo, M. Factors associated with the positive impact of caring for elderly and dependent relatives. Arch Gerontol Geriatr 2005; 41: 8194.CrossRefGoogle ScholarPubMed
90Quinn, C, Clare, L, Woods, B. The impact of the quality of relationship on the experiences and wellbeing of caregivers of people with dementia: a systematic review. Aging Ment Health 2009; 13: 143–54.CrossRefGoogle ScholarPubMed
91Covinsky, KE, Newcomer, R, Fox, P, Wood, J, Sands, L, Dane, Ket al.Patient and caregiver characteristics associated with depression in caregivers of patients with dementia. J Gen Intern Med 2003; 18: 1006–14.CrossRefGoogle ScholarPubMed
92Brody, E, Dempsey, N, Pruchno, R. Mental health of sons and daughters of the institutionalized aged. Gerontologist 1990; 30: 212–19.CrossRefGoogle ScholarPubMed
93Riddick, C, Cohen-Mansfield, J, Fleshner, E, Kraft, G. Caregiver adaptations to having a relative with dementia admitted to a nursing home. J Gerontol Soc Work 1992; 19: 51–76.CrossRefGoogle Scholar
94Brody, E. Women in the middle and family help to older people. Gerontologist 1981; 25: 1929.CrossRefGoogle Scholar
95Loomis, L, Booth, A. Multigenerational caregiving and well-being: the myth of the beleaguered sandwich generation. J Fam Issues 1995; 16: 131–48.CrossRefGoogle Scholar
96Doress-Worters, PB. Adding elder care to women's multiple roles: a critical review of the caregiver stress and multiple roles literatures. Sex Roles 1994; 31: 597616.CrossRefGoogle Scholar
97Chorn-Dunham, C, Dietz, BE. ‘If I’m not allowed to put my family first’: challenges experienced by women who are caregiving for family members with dementia. J Women Aging 2003; 15: 5569.CrossRefGoogle Scholar
98Lee, J, Walker, M, Shoup, R. Balancing elder care responsibilities and work: the impact on emotional health. J Business Psychol 2001; 16: 277–89.CrossRefGoogle Scholar
99Rosenthal, CJ, Hayward, L, Martin-Matthew, A, Denton, M. Help to older parents and parents-in-law: does paid employment constrain women's helping behavior? Can J Aging/La Revue canadienne du vieillissement 2004; 23: 115–30.CrossRefGoogle Scholar
100Rands, G. Working people who also care for the elderly. Int J Geriatr Psychiatry 1997; 12: 3944.3.0.CO;2-2>CrossRefGoogle ScholarPubMed
101Pavalko, EK, Woodbury, S. Social roles as process: caregiving careers and women's health. J Health Soc Behav 2000; 41: 91105.CrossRefGoogle ScholarPubMed
102Cannuscio, CC, Colditz, GA, Rimm, EB, Berkman, LF, Jones, CP, Kawachi, I. Employment status, social ties, and caregivers’ mental health. Soc Sci Med 2004; 58: 1247–56.CrossRefGoogle ScholarPubMed
103Rutter, M, Rutter, M. Developing minds: Challenge and continuity across the lifespan. New York: Basic Books; 1993.Google Scholar
104Wilks, S, Croom, B. Perceived stress and resilience in Alzheimer's disease caregivers: testing moderation and mediation models of social support. Aging Ment Health 2008; 12: 357–65.CrossRefGoogle ScholarPubMed
105Gomes, B, Higginson, IJ. Home or hospital? Choices at the end of life. J Royal Soc Med 2004; 97: 413–14.CrossRefGoogle ScholarPubMed
106Dunkin, JJ, Anderson-Hanley, C. Dementia caregiver burden: a review of the literature and guidelines for assessment and intervention. Neurology 1998; 51: 5360.CrossRefGoogle ScholarPubMed
107Neill, J, Dias, K. Adventure education and resilience: a double-edged sword. J Adventure Educ Outdoor Leadership 2001; 1: 3542.CrossRefGoogle Scholar
108Higginson, IJ. Place of care in advanced cancer: a qualitative systematic literature review of patient preferences. J Palliat Med 2000; 3: 287300.CrossRefGoogle Scholar
109Parrish, M, Adams, S. Caregiver comorbidity and the ability to manage stress. J Gerontol Soc Work 2003; 42: 4158.CrossRefGoogle Scholar
110Collins, C, Jones, R. Emotional distress and morbidity in dementia caregivers: a matched comparison of husbands and wives. Int J Geriatr Psychiatry 1997; 12: 1168–73.3.0.CO;2-F>CrossRefGoogle ScholarPubMed
111Ingersoll-Dayton, B, Starrels, ME, Dowler, D. Caregiving for parents and parents-in-law: is gender important? Gerontologist 1996; 36: 483–91.CrossRefGoogle ScholarPubMed
112Sun, F, Lee Roth, L, Klemmack, D, Burgio, L. The influences of gender and religiousness on Alzheimer disease caregivers’ use of informal support and formal services. J Aging Health 2008; 20: 937–53.CrossRefGoogle ScholarPubMed
113Wallsten, SS. Effects of caregiving, gender, and race on the health, mutuality, and social supports of older couples. J Aging Health 2000; 12: 90111.CrossRefGoogle ScholarPubMed
114Pinquart, M, Sörensen, S. Gender differences in caregiver stressors, social resources, and health: an updated meta-analysis. J Gerontol B Psychol Sci Social Sci 2006; 61: 3345.CrossRefGoogle ScholarPubMed
115Stoller, EP. Males as helpers: the role of sons, relatives, and friends. Gerontologist 1990; 30: 228–35.CrossRefGoogle ScholarPubMed
116Stoller, EP, Cutler, SJ. The impact of gender on configurations of care among married elderly couples. Res Aging 1992; 14: 313–30.CrossRefGoogle Scholar
117Weuve, J, Boult, C, Morishita, L. The effects of outpatient geriatric evaluation and management on caregiver burden. Gerontologist 2000; 40: 429–36.CrossRefGoogle ScholarPubMed
118Gitlin, L, Corcoran, M, Winter, L, Boyce, A, Hauck, W. A randomized controlled trial of a home environmental intervention: effect on efficacy and upset in caregivers and on daily function of persons with dementia. Gerontologist 2001; 41: 414.CrossRefGoogle ScholarPubMed
119Mohide, E, Pringle, D, Streiner, D, Gilbert, J, Muir, G, Tew, M. A randomized trial of family caregiver support in the home management of dementia. J Am Geriatr Soc 1990; 38: 446–54.CrossRefGoogle ScholarPubMed
120Winslow, B. Family caregivers’ experiences with community services: a qualitative analysis. Public Health Nurs 2003; 20: 341–48.CrossRefGoogle ScholarPubMed
121Bookwala, J, Zdaniuk, B, Burton, L, Lind, B, Jackson, S, Schulz, R. Concurrent and long-term predictors of older adults’ use of community-based long-term care services: the Caregiver Health Effects Study. J Aging Health 2004; 16: 88115.CrossRefGoogle ScholarPubMed
122Markle-Reid, M, Browne, G. Explaining the use and non-use of community-based long-term care services by caregivers of persons with dementia. J Eval Clin Pract 2001; 7: 271–87.CrossRefGoogle ScholarPubMed
123Brodaty, H, Thomson, C, Thompson, C, Fine, M. Why caregivers of people with dementia and memory loss don't use services. Int J Geriatr Psychiatry 2005; 20: 537–46.CrossRefGoogle ScholarPubMed
124Pedlar, D, Biegel, D. The impact of family caregiver attitudes on the use of community services for dementia care. J Appl Gerontol 1999; 18: 201–21.CrossRefGoogle Scholar
125Robinson, K, Buckwalter, K, Reed, D. Predictors of use of services among dementia caregivers. West J Nurs Res 2005; 27: 126–40.CrossRefGoogle ScholarPubMed
126Kosloski, K, Montgomery, R, Karner, T. Differences in the perceived need for assistive services by culturally diverse caregivers of persons with dementia. J Appl Gerontol 1999; 18: 239–56.CrossRefGoogle Scholar
127Bass, D, Noelker, L. The influence of family caregivers on elder's use of in home services: an expanded conceptual framework. J Health Soc Behav 1987; 28: 184–96.CrossRefGoogle ScholarPubMed
128Gottlieb, BH, Johnson, J. Respite programs for caregivers of persons with dementia: a review with practice implications. Aging Ment Health 2000; 4: 119–29.CrossRefGoogle Scholar
129Powell, J, Roberts, H. Identifying ‘value’ in day care provision for older people. J R Soc Promot Health 2002; 122: 158–64.CrossRefGoogle ScholarPubMed
130Sussman, T, Regehr, C. The influence of community-based services on the burden of spouses caring for their partners with dementia. Health Soc Work 2009; 34: 2939.CrossRefGoogle ScholarPubMed
131Strang, VR, Haughey, M. Factors influencing the caregiver's ability to experience respite. J Fam Nurs 1998; 4: 231–54.CrossRefGoogle Scholar
132Hooker, K, Bowman, SR, Coehlo, DP, Lim, SR. Behavioural change in persons with dementia: relationships with mental and physical health of caregivers. J Gerontol B Psychol Sci Social Sci 2002; 57B: 453–63.CrossRefGoogle Scholar
133Fernandez-Lansac, V, Crespo López, M, Caceres, R, Rodriguez-Poyo, M. [Resilience in caregivers of patients with dementia: A preliminary study]. Rev Esp Geriatr Gerontol 2012; 47: 102–9.Google ScholarPubMed
134Kumamoto, K, Arai, Y, Hashimoto, N, Ikeda, M, Mizuno, Y, Washio, M. Problems family caregivers encounter in home care of patients with frontotemporal lobar degeneration. Psychogeriatrics 2004; 4: 3339.CrossRefGoogle Scholar
135Mourick, JC, Rosso, SM, Niermeijer, MF, Duivenvoorden, HJ, van Swieten, JC, Tibben, A. Frontotemporal dementia: behavioural symptoms and caregiver distress. Dement Geriatr Cogn Disord 2004; 183: 299306.CrossRefGoogle Scholar
136Wilks, SE, Little, KG, Gough, HR, Spurlock, WJ. Alzheimer's aggression: influences on caregiver coping and resilience. J Gerontol Soc Work 2011; 54: 260–75.CrossRefGoogle ScholarPubMed
137Nicolaou, P, Egan, S, Gasson, N, Kane, R. Identifying needs, burden, and distress of carers of people with frontotemporal dementia compared to Alzheimer's disease. Dementia 2010; 9: 215–35.CrossRefGoogle Scholar
138Robinson, KM, Adkinsson, P, Weinrich, S. Problem behaviour, caregiver reactions, and impact among caregivers of persons with Alzheimer's disease. J Adv Nurs 2001; 36: 573–82.CrossRefGoogle ScholarPubMed
139Crespo, M, Lopez, J, Zarit, SH. Depression and anxiety in primary caregivers: a comparative study of caregivers of demented and non-demented older persons. Int J Geriatr Psychiatry 2005; 20: 591–92.CrossRefGoogle Scholar
140Coon, DW, Thompson, L, Steffen, A, Sorocco, K, Gallagher-Thompson, D. Anger and depression management: psychoeducational skills training interventions for women caregivers of a relative with dementia. Gerontologist 2003; 43: 678–89.CrossRefGoogle ScholarPubMed
141Rinaldi, P, Spazzafuma, L, Mastriforti, R, Mattioli, P, Marvardi, M, Polidori, MCet al.Predictors of high level of burden and distress in caregivers of demented patients: results of an Italian multicenter study. Int J Geriatr Psychiatry 2005; 20: 168–74.CrossRefGoogle ScholarPubMed
142Zanetti, O, Frisoni, GB, Bianchetti, A, Tamanza, G, Cigoli, V, Trabucchi, M. Depressive symptoms of Alzheimer caregivers are mainly due to personal rather than patient factors. Int J Geriatr Psychiatry 1998; 13: 358–67.3.0.CO;2-J>CrossRefGoogle ScholarPubMed
143Grant, I. Caregiving may be hazardous to your health. Psychosom Med 1999; 61: 420–23.CrossRefGoogle ScholarPubMed
144Ciechanowski, P, Worley, L, Russo, J, Katon, W. Using relationship styles based on attachment theory to understand specialty choice in medicine. BMC Med Educ 2006; 6: 3.CrossRefGoogle ScholarPubMed
145Adshead, G. Becoming a caregiver: attachment theory and poorly performing doctors. Med Educ 2010; 44: 125–31.CrossRefGoogle ScholarPubMed
146Collins, NL, Feeney, BC. A safe haven: support-seeking and caregiving processes in intimate relationships. J Pers Soc Psychol 2000; 78: 1053–73.CrossRefGoogle ScholarPubMed
147Cooper, C, Owens, C, Katona, C, Livingston, G. Attachment style and anxiety in carers of people with Alzheimer's disease: results from the LASER-AD study. Int Psychogeriatr 2008; 20: 494507.CrossRefGoogle ScholarPubMed
148Crispi, EL, Schiaffino, K, Berman, WH. The contribution of attachment to burden in adult children of institutionalized parents with dementia. Gerontologist 1997; 37: 5260.CrossRefGoogle ScholarPubMed
149McCrae, RR, Costa, PT Jr. Updating Norman's ‘adequate taxonomy’: intelligence and personality dimensions in natural language and in questionnaires. J Personality Social Psychol Health 1985; 49: 710–21.CrossRefGoogle ScholarPubMed
150DiBartolo, M, Soeken, K. Appraisal, coping, hardiness and self-perceived health in community-dwelling spouse caregivers of persons with dementia. Res Nurs Health 2003; 26: 445–58.CrossRefGoogle ScholarPubMed
151Hooker, K, Frazier, L, Monahan, D. Personality and coping among caregivers of spouses with dementia. Gerontologist 1994; 34: 386–92.CrossRefGoogle ScholarPubMed
152Hooker, K, Monahan, DJ, Bowman, SR, Frazier, LD, Shifren, K. Personality counts for a lot: predictors of mental and physical health of spouse caregivers in two disease groups. J Gerontol B Psychol Sci Social Sci 1998; 53: 7385.CrossRefGoogle ScholarPubMed
153Monahan, D, Hooker, K. Health of spouse caregivers of dementia patients: the role of personality and social support. Soc Work 1995; 40: 305–14.Google Scholar
154Hooker, K, Monahan, D, Shifren, K, Hutchinson, C. Mental and physical health of spouse caregivers: the role of personality. Psychol Aging 1992; 7: 367–75.CrossRefGoogle ScholarPubMed
155Reis, M, Gold, D, Andres, D, Markiewicz, D, Gauthier, S. Personality traits as determinants of burden and health complaints in caregiving. Int J Aging Hum Dev 1994; 39: 257–71.CrossRefGoogle ScholarPubMed
156Kenyon, D, Koerner, S. Understanding ‘good days’ and ‘bad days’: emotional and physical reactivity among caregivers for elder relatives. Family Relations 2007; 56: 111.Google Scholar
157Bookwala, J, Schultz, R. The role of neuroticism and mastery in spouse caregivers’ assessment of and response to a contextual stressor. J Gerontol B Psychol Sci Social Sci 1998; 53: 155–64.CrossRefGoogle ScholarPubMed
158Silverberg Koerner, S, Kenyon, D, Shirai, Y. Caregiving for elder relatives: which caregivers experience personal benefits/gains? Arch Gerontol Geriatr 2009; 48: 238–45.CrossRefGoogle Scholar
159Rodney, V. Nurse stress associated with aggression in people with dementia: its relationship to hardiness, cognitive appraisal and coping. J Adv Nurs 2000; 31: 172–80.CrossRefGoogle ScholarPubMed
160Antonovsky, A. Unraveling the Mystery of Health: How People Manage Stress and Stay Well. London: Jossey-Bass; 1987.Google Scholar
161Kristensson Ekvall, A. Informal caregiving at old age, content, coping, difficulties and datisfaction. Lund University, Doctoral Thesis. 2004.Google Scholar
162O’Rourke, N, Kupferschmidt, AL, Claxton, A, Smith, JZ, Chappell, N, Beattie, BL. Psychological resilience predicts depressive symptoms among spouses of persons with Alzheimer disease over time. Aging Ment Health 2010; 14: 984–93.CrossRefGoogle ScholarPubMed
163Farran, C, Keane-Hagerty, E, Salloway, S, Kupferer, S, Wilken, C. Finding meaning: an alternative paradigm for Alzheimer's disease family caregivers. Gerontologist 1991; 31: 483–89.CrossRefGoogle ScholarPubMed
164Noonan, A, Tennstedt, S, Rebelsky, F. Making the best of it: themes of meaning among informal caregivers to the elderly. J Aging Stud 1996; 10: 313–27.CrossRefGoogle Scholar
165Pearlin, L, Mullan, J, Selmple, S, Skaff, M. Caregiving and the stress process: an overview of concepts and their measures. Gerontologist 1990; 30: 583–94.CrossRefGoogle ScholarPubMed
166Folkman, S, Moskowitz, J. Positive affect and the other side of coping. Am Psychol 2000; 55: 647–54.CrossRefGoogle ScholarPubMed
167Quinn, C, Clare, L, Woods, RT. The impact of motivations and meanings on the wellbeing of caregivers of people with dementia: a systematic review. Int Psychogeriatr 2010; 22: 4355.CrossRefGoogle ScholarPubMed
168Rubenstein, R. Themes in the meaning of caregiving. J Aging Stud 1989; 3: 119–38.CrossRefGoogle Scholar
169Lee, E, Farran, C, Tripp-Reimer, T, Sadler, G. Assessing the cultural appropriateness of the Finding Meaning Through Caregiving Scale for Korean caregivers. J Nursing Measurement 2003; 11: 1928.CrossRefGoogle ScholarPubMed
170Cooke, DD, McNally, L, Mulligan, KT, Harrison, MJG, Newman, SP. Psychosocial interventions for caregivers of people with dementia: a systematic review. Aging Ment Health 2001; 5: 120–35.CrossRefGoogle ScholarPubMed
171Fergus, S, Zimmerman, M. Adolescent resilience: a framework for understanding healthy development in the face of risk. Ann Rev Public Health 2005; 26: 399419.CrossRefGoogle ScholarPubMed