Dementia Patient Suffering and Caregiver Depression

Abstract

Cross-sectional and longitudinal analyses were carried out to assess the relationship between dementia patient suffering, caregiver depression, and antidepressant medication use in 1222 dementia patients and their caregivers. We assessed the prevalence of 2 types of patient suffering, emotional and existential distress, and examined their independent associations with caregiver depression and antidepressant medication use when controlling for sociodemographic characteristics of caregivers and patients, cognitive and physical disability of the patient, the frequency of patient memory problems and disruptive behaviors, and the amount of time spent caring for the patient. Multiple linear regression models showed that both aspects of perceived patient suffering independently contribute to caregiver depression (emotional distress: β = 1.24; P < 0.001; existential distress: β = 0.66; P < 0.01) whereas only existential suffering contributes to antidepressant medication use: odds ratio = 1.25 95% confidence interval, 1.10-1.42; P < 0.01. In longitudinal analyses, increases in both types of suffering were associated with increases in caregiver depression (emotional distress: β = 1.02; P < 0.01; existential distress: β = 0.64; P < 0.01). This is the first study to show in a large sample that perceived patient suffering independently contributes to family caregiver depression and medication use. Medical treatment of patients that maintain or improve memory but do not address suffering may have little impact on the caregiver. Alzheimer disease patient suffering should be systematically assessed and treated by clinicians. Keywordssuffering; dementia; caregiving; depression; anti-depressant use Illness and disability in a close relative is a major source of distress for family caregivers, frequently compromising their health and well-being. [1][2][3] Emotional distress, burden, impaired self-care, and increased biologic vulner-abilities are commonplace among caregivers. 3 The negative effects of caregiving are typically attributed to a variety of patient illness-related Copyright © 2008 factors, including functional disability, cognitive impairment and confusion, problem behaviors, and the care demands engendered by the illness. Clinicians would also emphasize that patient distress or suffering plays a role in this process as well, but little attention has been paid to this construct in studies on family caregiving. The notion of suffering may be implicit in existing conceptualizations of illness and disability, but empirical research has not focused on patient suffering as a unique and independent contributor to caregiver outcomes. The purpose of this article is to provide evidence-based support for the importance of suffering in understanding the effects of patient illness and disability on caregiver outcomes.Suffering is a broad construct defined as a state of distress associated with events that threaten the intactness of the person as a complex physical, social, psychologic, and spiritual being. [4][5][6] Some ...

The Role of Caregiver Burden in Quality of Life and Perception of Patients with Chronic Kidney Failure on Hemodialysis

“…Additionally, the results of regression analysis demonstrated that caregiver burden was able to predict 0.05 of physical quality of life and mental quality of life (dimensions of quality of life) and 0.07 of physical suffering (dimension of perception of suffering), 0.05 of mental suffering (dimension of perception of suffering), and 0.05 of existential suffering (another dimension of perception of suffering). These results are in line with the results obtained from some previously conducted studies determining that caregiver burden was significantly and positively related to physical and mental dimensions of quality of life and it was significantly and inversely correlated with physical, mental, and existential dimensions of perception of suffering (14)(15)(16)(17)(18)(20)(21)(22)(23)(24)(25).…”

“…Redinbaug et al reported that caregivers' perception of patients' suffering was closely related to caregivers' psychological stress and the level of patients' physical inability (20). Schulz et al, in their study, found that caregivers' perception of suffering was correlated with patients' pain and suffering (21). The findings obtained from a study carried out by Oshodi et al indicated that patients' caregivers suffered from high levels of psychological stress (22).…”

“…Schulz et al, in their study, found that caregivers' perception of suffering was correlated with patients' pain and suffering (21). The findings obtained from a study carried out by Oshodi et al indicated that patients' caregivers experienced high levels of psychological stress (22).…”

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“…While the stress of relatives assisting their loved ones has been widely investigated (11)(12)(13), fewer data can be found about stress in healthcare professionals, with the exception of personnel working with cancer patients (14).…”

Informal Social Support and Caregiver Burden of Caregivers of Elderly with Dementia

“…As a result they will suffer from physical health problems such as chronic backache, musculoskeletal pain, reduce social activities, poor mental health, cardiovascular problems and poor sleep [6,7,8] . Previous studies have shown that these symptoms will give an impact on their quality of life [9,10,11] . The existence of formal social support was widely available in country like Japan, USA and UK, which gave helps to most of dementia caregivers.…”