Depressive Symptoms among Spousal Caregivers of Institutionalized Mates with Alzheimer's: Boundary Ambiguity and Mastery as Predictors

Abstract

The goal of this study was to identify factors that predict whether or not community-dwelling spouses experience depressive symptoms upon institutionalization of a mate with Alzheimer's disease. Eighty-four community-dwelling spouses (50 wives/34 husbands) completed questionnaires. Boundary ambiguity alone accounted for 51% of the variability in the depressive symptoms score, while mastery alone was found to account for 32%. The total explained variance, when controlling for demographic variables, was 68%. In the stepwise regression analysis, it was observed that mastery did not add significantly to the explanation of the depressive symptom score over and above boundary ambiguity. However, boundary ambiguity and mastery were somehow linked together and were powerful in explaining caregiver symptoms of depression. If a goal is to keep caregivers healthy, then interventions and education about how to live with ambiguity and how to be masterful in spite of the ambiguous status of one's mate seem necessary. Clinical implications are discussed. Future research might build upon this study's limitations for an even better understanding of factors that relate to caregiver depressive symptoms.

The Trauma and Complicated Grief of Ambiguous Loss

“…Ambiguous loss leads to ambivalence, not psychiatric ambivalence, but what is called sociological ambivalence (Boss 2006;Kaplan and Boss 1999;Merton and Barber 1963;Weigert 1991). Something in the relational environment leads to a person's conflicted feelings and emotions.…”

Association of unmet need with self-rated health in a community dwelling cohort of disabled seniors 75 years of age and over

“…The CDS successfully predicts both hospitalization and mortality and is correlated with physician ratings of disease severity (r = 0.57) (von KorV et al 1992). Mastery was assessed using Pearlin's personal mastery scale (Pearlin and Schooler 1978), a widely used scale with good construct validity (Pearlin et al 1981) and reasonable internal reliability (Cronbach's alpha = 0.79) (Kaplan and Boss 1999). Scores range from 7 to 28 with a higher score indicating higher personal mastery.…”

Complaints of informal caregivers providing home care for dementia patients: The Pixel study

“…Being forced to change working hours in order to look after a parent is a source of problems specific to daughters of dementia patients. The female caregivers are themselves vulnerable as far as their health is concerned (Adler et al, 1996;Annerstedt et al, 2000;Burns, 2000), and exposed to depression (Pruchno and Resch, 1989;Boss et al, 1990;Mittelman et al, 1995;Livingston et al, 1996;Kaplan and Boss, 1999;Clyburn et al, 2000) as is the case in this study. Support for caregivers should therefore be directed both at the concept of quality of life (Yates et al, 1999), and at ensuring that the caregiver is in good health (Boss et al, 1990;Zarit et al, 1999).…”

“…Supporting family caregivers of AD patients does play an important role in relieving the distress of family caregivers, who are often fragile and isolated (Ostwald et al, 1999), and sometimes depressive (Novak and Guest, 1989;Kaplan and Boss, 1999;Butt and Strauss, 2001). The way to help caregivers is to provide them with the information they need, mainly medical information and information on the progression of the disease.…”

“…The sensation of burden is not only connected with the physical load caused by the patient (Novak and Guest, 1989). It arises partly from the caregiver not knowing what he or she can ask of the patient (Boss et al, 1990;Kaplan and Boss, 1999). It is connected with the stress that weighs on the informal caregiver's daily life (Adler et al, 1996;Yates et al, 1999;Zarit et al, 1999).…”