Hope Mediates Stress to Reduce Burden in Family Caregivers of Persons with Alzheimer’s Disease

Abstract

The experience of burden among family caregivers of persons with Alzheimer’s disease and other forms of dementia may be deleterious for their health and well-being. Little is known, however, about the degree to which internal positive psychological resources, such as hope, influence burden perceptions in this population. The current study is novel in that it examined how multiple dimensions of hope, hope–agency and hope–pathway, influenced burden in a sample of one-hundred and fifty-five family caregivers of persons with Alzheimer’s disease. The stress process model was used as the theoretical framework for variable specification in this study. Hope was conceptualized using Snyder and colleagues’ hope theory. Supporting our first hypothesis, we found that burden was negatively associated with hope–agency, r = −0.33, p < 0.001 and hope–pathway, r = −0.24, p < 0.01. Multiple regression was used to determine if hope–agency and hope–pathway independently contributed to burden. Analysis revealed that hope–agency but not hope–pathway influenced burden when other key variables were taken into consideration. Findings from mediation analysis affirmed that hope–agency had a small but significant mediation effect between stress and burden in this sample. This study provides evidence for the relevance of assessing multiple dimensions of hope when working with caregivers of persons with Alzheimer’s. Although replication studies are warranted, the current study confirms a need for further development and refinement of hope-bolstering behavioral interventions which may mediate stress and burden in this population. These interventions should be systematically assessed for efficacy and effectiveness via implementation studies in real-world settings.

Gratitude Predicts Meaning in Life in Family Caregivers of Persons with Alzheimer’s Disease

“…A possible interpretation for our discovery that gratitude strongly predicts meaning in life presence, even in the context of burden, is that gratitude functions as an internal positive psychological asset. The research literature suggests that internal psychological resources such hope [ 18 ] and practicing positive spiritual techniques [ 14 , 15 , 16 , 17 , 48 ] impact meaning in life and one’s sense of purpose in this population [ 48 ]. Gratitude’s beneficial influence on meaning in life may also enhance a caregiver’s coping skills, buffering the impact of caregiving challenges [ 37 ].…”

“…There is some evidence that caregivers who identify as Black or African American tend to have worse physical wellbeing outcomes as compared to their White counterparts, even when their overall psychological well-being may be similar or better [ 12 ]. Conversely, having greater social support [ 13 ], drawing from one’s religious and spiritual beliefs and practices [ 14 , 15 , 16 , 17 ], and hope [ 18 ] can reduce the degree of burden experienced in family caregivers of persons with Alzheimer’s.…”