These findings indicate that individuals with early-stage dementia and their family caregivers are able to participate in and benefit from a structured intervention that focuses on care planning for future needs.

Although predictors of nursing home placement have attracted a good deal of attention in gerontological research, the type and amount of family assistance offered to caregivers prior to institutionalization has not been extensively examined. This study analyzed the impact of family help on the timing of placement among cognitively impaired care recipients. Using longitudinal data from the Adult Day Care Collaborative Study, an event-history analysis was performed to determine the effects of family help after sociodemographic characteristics, caregiving stressors, and indicators of caregiver well-being were taken into account. Results showed that caregivers were far less likely to institutionalize their relatives when family members provided overnight help and assisted with activities of daily living care. These findings suggest that specific types of family help play an important role in delaying nursing home placement among older adults suffering from dementia.

These findings demonstrate caregivers' vulnerability to the effects of stressors across three dimensions of health and also underscore the importance of subjective appraisals of stress.

The study examines physical and functional health problems and their relationship to the activity of daily living (ADL) disability experience of a cross-section of Swedish men and women aged over 80 years (N = 203). Using a model of disablement, the relationships among disability variables were simultaneously explored. Results confirmed relatively high rates of disability in this age group, with 36% of respondents having some basic ADL difficulty. Functional impairments (vision and grip strength) and functional limitations (upper and lower body limitations and cognition) were strongly related to disability, with functional limitations being a main driving force for disability. The role of psychosocial variables (depression, subjective health, and social integration) was explored through subsequent model testing. Results showed depression, subjective health, and social integration to potentially mediate the influence of risk factors, impairments, and limitations in the model. The study suggests that modifying psychosocial experiences can greatly affect the disability experience.

Total exposure to stressors and stress appraisals decreased significantly over time on ADS days compared with non-ADS days. Most of this difference was accounted by the time the person with dementia was away from the caregiver, but there were also significant reductions in behavioral problems during the evening and improved sleep immediately following ADS use. DISCUSSION. ADS use lowered caregivers' exposure to stressors and may improve behavior and sleep for people with dementia on days they have ADS. The study highlights how a within-person design can identify the effects of an intermittent intervention, such as ADS.