The aim of this study was to evaluate the effects of geriatric day care on patients and caregivers. Day care patients (n = 43) were compared with an untreated matched control group (n = 40). Matching criteria were age, gender, physical and mental health status, and socioeconomic status. The mean age of both groups was 79.5 years. Data were collected at three measurement points: T1 took place during the first 10 days of service use, T2 was conducted 6 months later, and T3 took place 9 months after service use began. In addition, a short follow-up was conducted 6 months after T3. Well-being, dementia symptoms, health indicators, and activities of daily living were investigated. Individual growth curves of these patient variables were computed and analyzed with multivariate analyses of variance. The results show significant positive effects of day care on well-being and dementia symptoms. Patients in day care stabilized or improved on various measures, whereas the untreated control participants worsened. Follow-up data showed a significant decline in health in the control group in comparison with the day care users. Results concerning effects on caregivers were not that clear. Individual change parameters in subjective well-being and burden did not differ between the two groups of caregivers in the longitudinal follow-up. In a semistructured interview, however, caregivers of patients in the treatment group reported substantial positive change due to use of day care.
Zusammenfassung. Theoretischer Hintergrund: Die Prävalenz demenzieller Erkrankungen steigt und die meisten Erkrankten werden von Familienangehörigen zu Hause betreut. Das “Berliner Inventar zur Angehörigenbelastung - Demenz“ (BIZA-D) dient der Erfassung von objektiven und subjektiven Belastungen, die durch die Pflege demenziell Erkrankter entstehen. Fragestellung: Das Inventar wird in der Längsschnittstudie zur Belastung pflegender Angehöriger von demenziell Erkrankten (LEANDER) eingesetzt und dient zur differenzierten Beschreibung von Pflegeverläufen und zur Evaluation von Interventionen. Methode: Das Instrument enthält 20 Subskalen mit 88 Items. Die psychometrischen Qualitäten werden an einer Stichprobe von 594 pflegenden Angehörigen dargestellt. Ergebnisse: Faktorenanalysen belegen die Mehrdimensionaliät des Inventars. Die Reliabilitäten der Subskalen liegen zwischen .74 und .95. Validität und Veränderungssensitivität des Inventars werden belegt. Schlussfolgerung: Das Inventar erweist sich als reliables, valides und veränderungssensitives Instrument.
This study reports findings from an evaluation of adult day care that are drawn from ANOVAs based on a comparative longitudinal design. To obtain a suitable outcome measure considering all relevant dimensions of caregiver stress, qualitative data from semistructured caregiving interviews were analyzed using content analytical techniques. Response scales were developed to assess the intensity of caregiving stress to allow for further statistical analyses. Results from the ANOVAs showed that use of day care significantly reduced conflicts between caregiving and job requirements, caregiving and family needs, and recreational constrictions. It is important to note that day care is effective in reducing specific, but not all, aspects of caregiving stress. For an adequate assessment of interventions meant to alleviate caregiving stress, the different dimensions of the concept must be considered.
According to several theoretical models, crises or demands can result in enhanced cognitive maturity. Two studies examined whether demands on caregivers provide an opportunity to experience increased cognitive maturity (e.g., cognitive complexity, personal growth through caregiving). In Study 1 (126 relatives of dementia patients; cross-sectional design), personal growth through caregiving was associated with two specific caregiving demands: duration of caregiving and lack of social acknowledgment. Cognitive complexity correlated with duration of caregiving and crystallized intelligence. The caregivers in the second study (N = 321) were participants in LEANDER, The Longitudinal Dementia Caregiver Stress Study. Caregivers were examined in four waves over 27 months. The results indicated an increase in personal growth over time.Using latent growth models, we found that increases in personal growth through caregiving were predicted by increases in the objective caregiving tasks. Cognitive processes (e.g., ruminative thoughts, life reflection) provide a possible explanation for an increase in cognitive maturity.
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