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Recovery from burden: informal caregiver profiles that predict treatment success

Published online by Cambridge University Press:  19 June 2018

Jacqueline van der Lee ,
Ton J. E. M. Bakker  and
Rose-Marie Dröes
Jacqueline van der Lee*
Affiliation:
Geriatric Centre ‘DrieMaasStede’, Argos Zorggroep, Schiedam, and Department of Nursing Home Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, the Netherlands
Ton J. E. M. Bakker
Affiliation:
University of Applied Science, and Stichting Wetenschap Balans (Foundation for Scientific Research Geriatric Health Care), Rotterdam, the Netherlands
Rose-Marie Dröes
Affiliation:
Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Centre, and GGZ inGeest, Amsterdam, the Netherlands
*
Correspondence should be addressed to: Jacqueline van der Lee, Geriatric Centre ‘DrieMaasStede’, Argos Zorggroep, Voorberghlaan 35, 3123 AX Schiedam (or P.O. Box 4023, 3102 GA Schiedam), the Netherlands. Fax: +31-10-4719379. Email: j.vanderlee@argoszorggroep.nl.
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Abstract

Background:

Neuropsychiatric symptoms (NPI) of dementia are important determinants of caregiver burden, while caregiver coping styles and competences can relieve burden. Caregivers differ in coping with the demands made on them and in experienced burden. What changes in caregivers explain recovery from burden, and which caregiver characteristics predict recovery from burden over time, and does treatment make a difference?

Methods:

This study into recovery from burden was a secondary analysis of data collected in a formerly conducted randomized controlled trial (RCT) on the integrated reactivation and rehabilitation (IRR) programme in a psychiatric-skilled nursing home, compared to usual care (UC; i.e. day care, assisted living arrangements, and nursing home wards). For this secondary analysis, longitudinal data on persons with dementia and caregivers were used from baseline (T1), end of treatment (T2), and at nine months (T3).

Results:

Caregivers with an improved sense of competence (SCS) who care for persons with dementia with a decreased severity of NPI have the highest chance of recovering from burden (CSI). Caregivers with a tendency to feel involved with others and sympathize with others (affiliation, ICL-R) have a slightly lower probability of improvement with respect to their sense of competence in the short term. The number of improved caregivers was higher in IRR than UC.

Conclusion:

Recovery depends on both an improved sense of competence and a decreased severity of NPI. Combined interventions that address both NPI and focus on enhancing caregiver's sense of competence have added value when it comes to decreasing caregiver burden.

Keywords

dementianeuropsychiatric symptomscaregiver burdencompetencecopingprofilerecovery
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 3: Issue Theme: Caregiving for People with Dementia , March 2019 , pp. 317 - 329
Copyright
Copyright © International Psychogeriatric Association 2018 

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