Caregivers’ relationship closeness with the person with dementia predicts both positive and negative outcomes for caregivers’ physical health and psychological well-being

Abstract

Closer relationships between caregivers and care recipients with dementia are associated with positive outcomes for care recipients, but it is unclear if closeness is a risk or protective factor for the health and psychological well-being of caregivers. We examined 234 care dyads from the population-based Cache County Dementia Progression Study. Caregivers included spouses (49%) and adult offspring (51%). Care recipients mostly had dementia of the Alzheimer’s type (62%). Linear mixed models tested associations between relationship closeness at baseline, or changes in closeness prior to versus after dementia onset, with baseline levels and changes over time in caregiver affect (Affect Balance Scale; ABS), depression (Beck Depression Inventory; BDI), and mental and physical health (components of the Short-Form Health Survey; SF-12). After controlling for demographic characteristics of the caregiver, number of caregiver health conditions, and characteristics of the care recipient (type of dementia, functional ability, and behavioral disturbances), we found that higher baseline closeness predicted higher baseline SF-12 mental health scores (better mental health), and lower depression. Higher baseline closeness also predicted greater worsening over time in ABS and SF-12 mental health. In addition, caregivers who reported a loss of closeness in their relationship with the care recipient from pre- to post-dementia displayed improved scores on ABS and SF-12 mental health, but worse SF-12 physical health over the course of the study. These results suggest that closeness and loss of closeness in the care dyad may be associated with both positive and adverse outcomes for caregivers, both cross-sectionally and over time.

Relationship status and depressive symptoms among older co-resident caregivers

“…Meta-analyses of research have concluded that weak emotional ties between caregiver and care recipient were associated with higher levels of caregiver depression (Quinn, Clare, & Woods, 2009). Similar findings reported by Fauth et al (2012) showed that higher levels of closeness between the caregiver and care recipient were significantly associated with less depression and better mental health ratings in caregiver outcomes. Furthermore, research suggests that it is the deterioration of the interpersonal relationship, as perceived by the caregiver, which contributes to heightened caregiver burden and ultimately more depressive symptoms (Adams, McClendon, & Smyth, 2008).…”

Coping as a caregiver: A question of strain and its consequences on life satisfaction and health-related quality of life

“…Previous studies referred to in this paper (Collins & Swartz, 2011; The National Board of Health and Welfare 2012a; The National Alliance for Caregiving, 2009;Andrén & Elmståhl, 2005;Andrén & Elmståhl, 2008a;Bruvik, Ulstein, Hylen Ranhoff, & Engedal, 2012;Roth, Perkins, Wadley, Temple, & Haley, 2009;Roth et al, 2013;Pinguart andSörensen, 2011 Lautenschlager et al, 2012;van der Lee, Bakker, Duivenvoorden, & Dröes, 2014;Ekwall, Sivberg, Rahm, & Hallberg, 2006;Buyck et al, 2011;Broe et al,1999;Schultz & Sherwood, 2008;Fauth et al, 2012;Iecovich, 2011) have given us some answers. In this study we aim to broaden the knowledge on this topic by discussing how perceived strain affects informal caregivers' health-related quality of life (HRQoL) and life satisfaction (LS).…”

“…Schultz and Sherwood (2008) state that depression is common and has a negative effect on the caregiver, especially among spouses caring for a person with dementia, and that caregiving often results in chronic stress. Fauth et al (2012) studied the caregivers' relationship closeness with the person with dementia before and after the onset of the disease, and its consequences for caregivers' psychological and physical well-being. They found that higher closeness before the onset of dementia was associated with higher SF12-MCS but also a worsening in the SF12-MCS over time, indicating that closeness has both positive and negative consequences for the caregiver.…”

“…We also lack information on the feeling of closeness between caregiver and care recipient. Fauth et al (2012) found that closeness has both positive and negative consequences for the caregiver. In a study by Iecovich (2011), the relationship quality was the most significant variable in explaining both burden and satisfaction in the caregiver role.…”

Factors influencing the person–carer relationship in people with anxiety and dementia

“…They did, however, find that increased behavioural disturbances in the person with dementia were associated with a higher degree of conflict and criticism and lower levels of warmth in the relationship. Fauth et al (2012) evaluated the impact of 'closeness' in relationship, as rated by the carer, finding that higher ratings of closeness predicted better mental health and lower depression in the carer.…”