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A typology of care-giving across neurodegenerative diseases presenting with dementia

Published online by Cambridge University Press:  18 July 2014

KAITLYN P. ROLAND  and
NEENA L. CHAPPELL
KAITLYN P. ROLAND*
Affiliation:
Centre on Aging, University of Victoria, British Columbia, Canada.
NEENA L. CHAPPELL
Affiliation:
Department of Sociology and Centre on Aging, University of Victoria, British Columbia, Canada.
*
Address for correspondence: Kaitlyn P. Roland, Centre on Aging, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada. E-mail: kroland@uvic.ca
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Abstract

The purpose of this study is to develop and extend our understanding of dementia care-giving by introducing a typology of informal care-giving across four different diseases. Care-giving factors were examined with respect to specific dementia presentation in mild cognitive impairment, Alzheimer's disease, dementia with Lewy bodies and Parkinson's disease-associated dementia. Informal care-giving literature in the four diseases was systematically searched to identify specific disease symptoms and resultant care-giving strains and outcomes. Key concepts were extracted and grouped thematically. The first classification, ‘role-shift’, reflects care-giving where cognitive deterioration results in changing roles, uncertainty and relational deprivation among married partners. The second classification, ‘consumed by care-giving’, refers to those caring for persons with dementia-motor decline that greatly increases worry and isolation. Finally, in the ‘service use’ classification, formal support is needed to help care-givers cope with daily responsibilities and behaviour changes. In each case, the dementia presentation uniquely impacts care-giver strains. A major conclusion is that the same support to all care-givers under the umbrella term ‘dementia’ is unwarranted; the development of targeted support is required.

Keywords

mild cognitive impairmentAlzheimer's diseasedementia with Lewy bodiesParkinson's disease dementiacare-givercare-giving
Type
Articles
Information
Ageing & Society , Volume 35 , Issue 9 , October 2015 , pp. 1905 - 1927
Copyright
Copyright © Cambridge University Press 2014 

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References

Aarsland, D., Brønnick, K., Ehrt, U., De Deyn, P. P., Tekin, S., Emre, M. and Cummings, J. L. 2007. Neuropsychiatric symptoms in patients with Parkinson's disease and dementia: frequency, profile and associated care giver stress. Journal of Neurology, Neurosurgery and Psychiatry, 78, 1, 36–42.CrossRefGoogle ScholarPubMed
Aarsland, D., Larsen, J. P., Karlsen, K., Lim, N. G. and Tandberg, E. 1999. Mental symptoms in Parkinson's disease are important contributors to caregiver distress. International Journal of Geriatric Psychiatry, 14, 10, 866–74.3.0.CO;2-Z>CrossRefGoogle ScholarPubMed
Adams, K. B. 2006. The transition to caregiving. Journal of Gerontological Social Work, 47, 3/4, 3–29.CrossRefGoogle ScholarPubMed
Agüera-Ortiz, L., Frank-García, A., Gil, P. and Moreno, A. 2010. Clinical progression of moderate-to-severe Alzheimer's disease and caregiver burden: a 12-month multicenter prospective observational study. International Psychogeriatrics, 22, Special Issue 8, 1265–79.CrossRefGoogle ScholarPubMed
Auning, E., Rongve, A., Fladby, T., Booij, J., Hortobágyi, T., Siepel, F. J., Ballard, C. and Aarsland, D. 2011. Early and presenting symptoms of dementia with lewy bodies. Dementia and Geriatric Cognitive Disorders, 32, 3, 202–8.CrossRefGoogle ScholarPubMed
Austrom, M. G. and Lu, Y. 2009. Long term caregiving: helping families of persons with mild cognitive impairment cope. Current Alzheimer Research, 6, 4, 392–8.CrossRefGoogle ScholarPubMed
Bergvall, N., Brinck, P., Eek, D., Gustavsson, A., Wimo, A., Winblad, B. and Jönsson, L. 2011. Relative importance of patient disease indicators on informal care and caregiver burden in Alzheimer's disease. International Psychogeriatrics, 23, 1, 73–85.CrossRefGoogle ScholarPubMed
Blieszner, R. and Roberto, K. A. 2010. Care partner responses to the onset of mild cognitive impairment. The Gerontologist, 50, 1, 11–22.CrossRefGoogle Scholar
Bruce, J. M., McQuiggan, M., Williams, V., Westervelt, H. and Tremont, G. 2008. Burden among spousal and child caregivers of patients with mild cognitive impairment. Dementia and Geriatric Cognitive Disorders, 25, 4, 385–90.CrossRefGoogle ScholarPubMed
Carter, J. H., Lyons, K. S., Lindauer, A. and Malcom, J. 2012. Pre-death grief in Parkinson's caregivers: a pilot survey-based study. Parkinsonism & Related Disorders, 18, Supplement 3, S15–18.CrossRefGoogle ScholarPubMed
Cheng, S.-T., Lam, L. C. W., Kwok, T., Ng, N. S. S. and Fung, A. W. T. 2013. Self-efficacy is associated with less burden and more gains from behavioral problems of Alzheimer's disease in Hong Kong Chinese caregivers. The Gerontologist, 53, 1, 71–80.CrossRefGoogle ScholarPubMed
Chiong-Rivero, H., Ryan, G. W., Flippen, C., Bordelon, Y., Szumski, N. R., Zesiewicz, T. A. and Vickrey, B. G. 2011. Patients’ and caregivers’ experiences of the impact of Parkinson's disease on health status. Patient-related Outcome Measures, 2011, 2, 57–70. doi: 10.2147/PROM.S15986.CrossRefGoogle ScholarPubMed
Chou, H.-K., Yan, S.-H., Lin, I.-C., Tsai, M.-T., Chen, C.-C. and Woung, L.-C. 2012. A pilot study of the telecare medical support system as an intervention in dementia care: the views and experiences of primary caregivers. Journal of Nursing Research, 20, 3, 169–80.CrossRefGoogle ScholarPubMed
Christofoletti, G., Oliani, M. M., Bucken-Gobbi, L. T., Gobbi, S., Beinotti, F. and Stella, F. 2011. Physical activity attenuates neuropsychiatric disturbances and caregiver burden in patients with dementia. Clinics, 66, 4, 613–8.CrossRefGoogle ScholarPubMed
Clipp, E. C. and George, L. K. 1993. Dementia and cancer: a comparison of spouse caregivers. The Gerontologist, 33, 4, 534–41.CrossRefGoogle Scholar
Cupidi, C., Realmuto, S., Lo Coco, G., Cinturino, A., Talamanca, S., Arnao, V. and Lo Coco, D. 2012. Sleep quality in caregivers of patients with Alzheimer's disease and Parkinson's disease and its relationship to quality of life. International Psychogeriatrics, 24, 11, 1827–35.CrossRefGoogle ScholarPubMed
Davies, H. D., Newkirk, L. A., Pitts, C. B., Coughlin, C. A., Sridhar, S. B., Zeiss, L. M. and Zeiss, A. M. 2010. The impact of dementia and mild memory impairment (MMI) on intimacy and sexuality in spousal relationships. International Psychogeriatrics, 22, 4, 618–28.CrossRefGoogle ScholarPubMed
Davies, H. D., Sridhar, S. B., Newkirk, L. A., Beaudreau, S. A. and O'Hara, R. 2012. Gender differences in sexual behaviors of AD patients and their relationship to spousal caregiver well-being. Aging & Mental Health, 16, 1, 89–101.CrossRefGoogle ScholarPubMed
Dean, K. and Wilcock, G. 2012. Living with mild cognitive impairment: the patient's and carer's experience. International Psychogeriatrics, 24, 6, 871–81.CrossRefGoogle ScholarPubMed
DeFries, E. L., McGuire, L. C., Andresen, E. M., Brumback, B. A. and Anderson, L. A. 2009. Caregivers of older adults with cognitive impairment. Prev Chronic Dis, 6, 2, A46.Google ScholarPubMed
Ducharme, F., Lévesque, L. L., Lachance, L. M., Kergoat, M.-J., Legault, A. J., Beaudet, L. M. and Zarit, S. H. 2011. ‘Learning to become a family caregiver’: efficacy of an intervention program for caregivers following diagnosis of dementia in a relative. The Gerontologist, 51, 4, 484–94.CrossRefGoogle ScholarPubMed
Egan, M., Bérubé, D., Racine, G., Leonard, C. and Rochon, E. 2010. Methods to enhance verbal communication between individuals with Alzheimer's disease and their formal and informal caregivers: a systematic review. International Journal of Alzheimer's Disease, 2010, 2010, Article ID 906818, 1–12.CrossRefGoogle ScholarPubMed
Elliott, A. F., Burgio, L. D. and DeCoster, J. 2010. Enhancing caregiver health: findings from the resources for enhancing Alzheimer's caregiver health II intervention. Journal of the American Geriatrics Society, 58, 1, 30–7.CrossRefGoogle ScholarPubMed
Erder, M. H., Wilcox, T. K., Chen, W.-H., O'Quinn, S., Setyawan, J. and Saxton, J. 2012. A new measure of caregiver burden in Alzheimer's disease: the Caregiver Perceived Burden Questionnaire. American Journal of Alzheimer's Disease and Other Dementias, 27, 7, 474–82.CrossRefGoogle ScholarPubMed
Fauth, E., Hess, K., Piercy, K., Norton, M., Corcoran, C., Rabins, P. and Tschanz, J. 2012. Caregivers’ relationship closeness with the person with dementia. Aging & Mental Health, 16, 6, 699–711.CrossRefGoogle ScholarPubMed
Ferreri, F., Agbokou, C. and Gauthier, S. 2006. Recognition and management of neuropsychiatric complications in Parkinson's disease. Canadian Medical Association Journal, 175, 12, 1545–52.CrossRefGoogle ScholarPubMed
Galvin, J. E., Duda, J. E., Kaufer, D. I., Lippa, C. F., Taylor, A. and Zarit, S. H. 2010 a. Lewy body dementia. Alzheimer Disease & Associated Disorders, 24, 2, 177–81.CrossRefGoogle ScholarPubMed
Galvin, J. E., Duda, J. E., Kaufer, D. I., Lippa, C. F., Taylor, A. and Zarit, S. H. 2010 b. Lewy body dementia: the caregiver experience of clinical care. Parkinsonism & Related Disorders, 16, 6, 388–92.CrossRefGoogle ScholarPubMed
Garand, L., Dew, M. A., Eazor, L. R., DeKosky, S. T. and Reynolds, C. F. 3rd. 2005. Caregiving burden and psychiatric morbidity in spouses of persons with mild cognitive impairment. International Journal of Geriatric Psychiatry, 20, 6, 512–22.CrossRefGoogle ScholarPubMed
Garand, L., Lingler, J. H., Deardorf, K. E., DeKosky, S. T., Schulz, R., Reynolds, C. F. and Dew, M. A. 2012. Anticipatory grief in new family caregivers of persons with mild cognitive impairment and dementia. Alzheimer Disease & Associated Disorders, 26, 2, 159–65.CrossRefGoogle ScholarPubMed
Gaugler, J. E., Wall, M. M., Kane, R. L., Menk, J. S., Sarsour, K., Johnston, J. A. and Newcomer, R. 2011. Does caregiver burden mediate the effects of behavioral disturbances on nursing home admission? American Journal of Geriatric Psychiatry, 19, 6, 497–506.CrossRefGoogle ScholarPubMed
Germain, S., Adam, S., Olivier, C., Cash, H., Ousset, P. J., Andrieu, S. and Salmon, E. 2009. Does cognitive impairment influence burden in caregivers of patients with Alzheimer's disease? Journal of Alzheimer's Disease, 17, 1, 105–14.CrossRefGoogle ScholarPubMed
Goldsworthy, B. and Knowles, S. 2008. Caregiving for Parkinson's disease patients: an exploration of a stress-appraisal model for quality of life and burden. Journals of Gerontology, 63B, 6, 372–6.CrossRefGoogle Scholar
Gómez-Gallego, M., Gómez-Amor, J. and Gómez-García, J. 2012. Determinants of quality of life in Alzheimer's disease: perspective of patients, informal caregivers, and professional caregivers. International Psychogeriatrics, 24, 11, 1805–15.CrossRefGoogle ScholarPubMed
Hanagasi, H. A. and Emre, M. 2005. Treatment of behavioural symptoms and dementia in Parkinson's disease. Fundamental & Clinical Pharmacology, 19, 2, 133–46.CrossRefGoogle ScholarPubMed
Harris, S. M., Adams, M. S., Zubatsky, M. and White, M. 2011. A caregiver perspective of how Alzheimer's disease and related disorders affect couple intimacy. Aging & Mental Health, 15, 8, 950–60.CrossRefGoogle ScholarPubMed
Hooker, K., Manoogian-O'Dell, M., Monahan, D. J., Frazier, L. D. and Shifren, K. 2000. Does type of disease matter? Gender differences among Alzheimer's and Parkinson's disease spouse caregivers. The Gerontologist, 40, 5, 568–73.CrossRefGoogle ScholarPubMed
Hooker, K., Monahan, D. J., Bowman, S. R., Frazier, L. D. and Shifren, K. 1998. Personality counts for a lot: predictors of mental and physical health of spouse caregivers in two disease groups. Journals of Gerontology: Psychological Sciences and Social Sciences, 53B, 2, 73–85.CrossRefGoogle Scholar
Kelsey, S. G., Laditka, S. B. and Laditka, J. N. 2010. Caregiver perspectives on transitions to assisted living and memory care. American Journal of Alzheimer's Disease and Other Dementias, 25, 3, 255–64.CrossRefGoogle ScholarPubMed
Leggett, A. N., Zarit, S., Taylor, A. and Galvin, J. E. 2011. Stress and burden among caregivers of patients with Lewy body dementia. The Gerontologist, 51, 1, 76–85.CrossRefGoogle ScholarPubMed
Leroi, I., Harbishettar, V., Andrews, M., McDonald, K., Byrne, E. J. and Burns, A. 2012 a. Carer burden in apathy and impulse control disorders in Parkinson's disease. International Journal of Geriatric Psychiatry, 27, 2, 160–6.CrossRefGoogle ScholarPubMed
Leroi, I., McDonald, K., Pantula, H. and Harbishettar, V. 2012 b. Cognitive impairment in Parkinson disease: impact on quality of life, disability, and caregiver burden. Journal of Geriatric Psychiatry and Neurology, 25, 4, 208–14.CrossRefGoogle ScholarPubMed
Letts, L., Edwards, M., Berenyi, J., Moros, K., O'Neill, C., O'Toole, C. and McGrath, C. 2011. Using occupations to improve quality of life, health and wellness, and client and caregiver satisfaction for people with Alzheimer's disease and related dementias. American Journal of Occupational Therapy, 65, 5, 497–504.CrossRefGoogle ScholarPubMed
Leverenz, J. B. and McKeith, I. G. 2002. Dementia with Lewy bodies. The Medical Clinics of North America, 86, 3, 519–35.CrossRefGoogle ScholarPubMed
Li, H., Kyrouac, G. A., McManus, D. Q., Cranston, R. E. and Hughes, S. 2012. Unmet Home Care Service Needs of Rural Older Adults With Alzheimer's Disease: A Perspective of Informal Caregivers. Journal of Gerontological Social Work, 5, 5, 409–25.CrossRefGoogle Scholar
Lowery, K., Mynt, P., Aisbett, J., Dixon, T., O'Brien, J. and Ballard, C. 2000. Depression in the carers of dementia sufferers: a comparison of the carers of patients suffering from dementia with Lewy Bodies and the carers of patients with Alzheimer's disease. Journal of Affective Disorders, 59, 1, 61–5.CrossRefGoogle ScholarPubMed
Lu, Y.-F. Y., Austrom, M. G., Perkins, S. M., Bakas, T., Farlow, M. R., He, F. and Gamst, A. 2007. Depressed mood in informal caregivers of individuals with mild cognitive impairment. American Journal of Alzheimer's Disease and Other Dementias, 22, 4, 273–85.CrossRefGoogle ScholarPubMed
Lu, Y.-F. Y. and Haase, J. E. 2009. Experience and perspectives of caregivers of spouse with mild cognitive impairment. Current Alzheimer Research, 6, 4, 384–91.CrossRefGoogle ScholarPubMed
Marciniak, C. M., Choo, C. M., Toledo, S. D., Semik, P. E. and Aegesen, A. L. 2011. Do co-morbidities and cognition impact functional change and discharge needs in Parkinson disease? American Journal of Physical Medicine & Rehabilitation, 90, 4, 272–80.CrossRefGoogle ScholarPubMed
Mausbach, B. T., Coon, D. W., Patterson, T. L. and Grant, I. 2008. Engagement in activities is associated with affective arousal in Alzheimer's caregivers: a preliminary examination of the temporal relations between activity and affect. Behavior Therapy, 39, 4, 366–74.CrossRefGoogle ScholarPubMed
McCurry, S. M., Gibbons, L. E., Logsdon, R. G., Vitiello, M. V. and Teri, L. 2009. Insomnia in caregivers of persons with dementia: who is at risk and what can be done about it? Sleep Medicine Clinics, 4, 4, 519–26.CrossRefGoogle Scholar
McIlvane, J. M., Popa, M. A., Robinson, B., Houseweart, K. and Haley, W. E. 2008. Perceptions of illness, coping, and well-being in persons with mild cognitive impairment and their care partners. Alzheimer Disease & Associated Disorders, 22, 3, 284–92.CrossRefGoogle ScholarPubMed
Morley, D., Dummett, S., Peters, M., Kelly, L., Hewitson, P., Dawson, J. and Jenkinson, C. 2012. Factors influencing quality of life in caregivers of people with Parkinson's disease and implications for clinical guidelines. Parkinson's Disease, 2012, 2012, Article ID 190901, 1–6.CrossRefGoogle ScholarPubMed
Naismith, S. L., Pereira, M., Shine, J. M. and Lewis, S. J. G. 2011. How well do caregivers detect mild cognitive change in Parkinson's disease? Movement Disorders: Official Journal of the Movement Disorder Society, 26, 1, 161–4.CrossRefGoogle ScholarPubMed
Nikzad-Terhune, K. A., Anderson, K. A., Newcomer, R. and Gaugler, J. E. 2010. Do trajectories of at-home dementia caregiving account for burden after nursing home placement? A growth curve analysis. Social Work in Health Care, 49, 8, 734–52.CrossRefGoogle ScholarPubMed
Norton, M. C., Piercy, K. W., Rabins, P. V., Green, R. C., Breitner, J. C. S., Østbye, T., Corcoran, C., Welsh-Bohmer, K., Lyketsos, C. G. and Tschanz, J. T. 2009. Caregiver–recipient closeness and symptom progression in Alzheimer disease. Journals of Gerontology, 64B, 5, 560–8.CrossRefGoogle Scholar
O'Rourke, N., Kupferschmidt, A. L., Claxton, A., Smith, J. Z., Chappell, N. and Beattie, B. L. 2010. Psychological resilience predicts depressive symptoms among spouses of persons with Alzheimer disease over time. Aging & Mental Health, 14, 8, 984–93.CrossRefGoogle ScholarPubMed
Ornstein, K., Gaugler, J. E., Devanand, D. P., Scarmeas, N., Zhu, C. and Stern, Y. 2012. The differential impact of unique behavioral and psychological symptoms for the dementia caregiver: how and why do patients’ individual symptom clusters impact caregiver depressive symptoms? American Journal of Geriatric Psychiatry, 21, 12, 1277–86.CrossRefGoogle Scholar
Pearlin, L. I., Mullan, J. T., Semple, S. J. and Skaff, M. M. 1990. Caregiving and the stress process: an overview of concepts and their measures. The Gerontologist, 30, 5, 583–94.CrossRefGoogle ScholarPubMed
Petersen, R. C., Doody, R., Kurz, A., Mohs, R. C., Morris, J. C., Rabins, P. V., Ritchie, K., Rossor, M., Thal, L. and Winblad, B. 2001. Current concepts in mild cognitive impairment. Archives of Neurology, 58, 12, 1985–92.CrossRefGoogle ScholarPubMed
Pinquart, M. and Sörensen, S. 2003. Differences between caregivers and noncaregivers in psychological health and physical health: a meta-analysis. Psychology and Aging, 18, 2, 250–67.CrossRefGoogle ScholarPubMed
Pioli, M. F. 2010. Global and caregiving mastery as moderators in the caregiving stress process. Aging & Mental Health, 14, 5, 603–12.CrossRefGoogle ScholarPubMed
Pucci, E. 2006. Message for caregivers of dementia with Lewy bodies patients: hallucinations can be pleasurable for your patient. Cope with your embarrassment and empathize. European Journal of Neurology, 13, 6, 666–6.CrossRefGoogle ScholarPubMed
Ricci, M., Guidoni, S. V., Sepe-Monti, M., Bomboi, G., Antonini, G., Blundo, C. and Giubilei, F. 2009. Clinical findings, functional abilities and caregiver distress in the early stage of dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). Archives of Gerontology and Geriatrics, 49, 2, 101–4.CrossRefGoogle ScholarPubMed
Roberto, K. A., Blieszner, R., McCann, B. R. and McPherson, M. C. 2011. Family triad perceptions of mild cognitive impairment. Journals of Gerontology, 66B, 6, 756–68.CrossRefGoogle Scholar
Roberto, K. A., McCann, B. R. and Blieszner, R. 2013. Trajectories of care: spouses coping with changes related to mild cognitive impairment. Dementia, 12, 1, 45–62.CrossRefGoogle ScholarPubMed
Romero-Moreno, R., Losada, A., Mausbach, B. T., Márquez-González, M., Patterson, T. L. and López, J. 2011. Analysis of the moderating effect of self-efficacy domains in different points of the dementia caregiving process. Aging & Mental Health, 15, 2, 221–31.CrossRefGoogle ScholarPubMed
Rosa, E., Lussignoli, G., Sabbatini, F., Chiappa, A., Di Cesare, S., Lamanna, L. and Zanetti, O. 2010. Needs of caregivers of the patients with dementia. Archives of Gerontology and Geriatrics, 51, 1, 54–8.CrossRefGoogle ScholarPubMed
Rowe, M. A., McCrae, C. S., Campbell, J. M., Pe Benito, A. and Cheng, J. 2008. Sleep pattern differences between older adult dementia caregivers and older adult noncaregivers using objective and subjective measures. Journal of Clinical Sleep Medicine, 4, 4, 362–9.CrossRefGoogle ScholarPubMed
Ryan, K. A., Weldon, A., Huby, N. M., Persad, C., Bhaumik, A. K., Heidebrink, J. L. and Giordani, B. 2010. Caregiver support service needs for patients with mild cognitive impairment and Alzheimer's disease. Alzheimer Disease and Associated Disorders, 24, 2, 171–6.CrossRefGoogle Scholar
Savla, J., Roberto, K. A., Blieszner, R., Cox, M. and Gwazdauskas, F. 2011. Effects of daily stressors on the psychological and biological well-being of spouses of persons with mild cognitive impairment. Journals of Gerontology, 66B, 6, 653–64.CrossRefGoogle Scholar
Schölzel-Dorenbos, C. J. M., Draskovic, I., Vernooij-Dassen, M. J. and Olde Rikkert, M. G. M. 2009. Quality of life and burden of spouses of Alzheimer disease patients. Alzheimer Disease & Associated Disorders, 23, 2, 171–7.CrossRefGoogle ScholarPubMed
Seeher, K., Low, L.-F., Reppermund, S. and Brodaty, H. 2013. Predictors and outcomes for caregivers of people with mild cognitive impairment: a systematic literature review. Alzheimer's & Dementia, 9, 3, 346–55.CrossRefGoogle ScholarPubMed
Shin, H., Youn, J., Kim, J. S., Lee, J.-Y. and Cho, J. W. 2012. Caregiver burden in Parkinson disease with dementia compared to Alzheimer disease in Korea. Journal of Geriatric Psychiatry and Neurology, 25, 4, 222–6.CrossRefGoogle ScholarPubMed
Stella, F., Banzato, C. E. M., Quagliato, E. M. A. B., Viana, M. A. and Christofoletti, G. 2009. Psychopathological features in patients with Parkinson's disease and related caregivers’ burden. International Journal of Geriatric Psychiatry, 24, 10, 1158–65.CrossRefGoogle ScholarPubMed
Stella, F., Canonici, A. P., Gobbi, S., Santos-Galduroz, R. F., de Castilho Cação, J. and Gobbi, L. T. B. 2011. Attenuation of neuropsychiatric symptoms and caregiver burden in Alzheimer's disease by motor intervention: a controlled trial. Clinics, 66, 8, 1353–60.CrossRefGoogle ScholarPubMed
Thommessen, B., Aarsland, D., Braekhus, A., Oksengaard, A. R., Engedal, K. and Laake, K. 2002. The psychosocial burden on spouses of the elderly with stroke, dementia and Parkinson's disease. International Journal of Geriatric Psychiatry, 17, 1, 78–84.CrossRefGoogle ScholarPubMed
Watson, G. S. and Leverenz, J. B. 2010. Profile of cognitive impairment in Parkinson's disease. Brain Pathology, 20, 3, 640–5.CrossRefGoogle ScholarPubMed
Wilks, S. E., Little, K. G., Gough, H. R. and Spurlock, W. J. 2011. Alzheimer's aggression: influences on caregiver coping and resilience. Journal of Gerontological Social Work, 54, 3, 260–75.CrossRefGoogle ScholarPubMed
Williams, C. 2011. Marriage and mental health: when a spouse has Alzheimer's disease. Archives of Psychiatric Nursing, 25, 3, 220–2.CrossRefGoogle Scholar
Yeager, C. A., Hyer, L. A., Hobbs, B. and Coyne, A. C. 2010. Alzheimer's disease and vascular dementia: the complex relationship between diagnosis and caregiver burden. Issues in Mental Health Nursing, 31, 6, 376–84.CrossRefGoogle ScholarPubMed
Zarit, S. H., Kim, K., Femia, E. E., Almeida, D. M., Savla, J. and Molenaar, P. C. M. 2011. Effects of adult day care on daily stress of caregivers: a within-person approach. Journals of Gerontology, 66, 5, 538–46.CrossRefGoogle ScholarPubMed
Zucchella, C., Bartolo, M., Pasotti, C., Chiapella, L. and Sinforiani, E. 2012. Caregiver burden and coping in early-stage Alzheimer disease. Alzheimer Disease & Associated Disorders, 26, 1, 55–60.CrossRefGoogle ScholarPubMed