Predictors of Desire to Institutionalization in Dementia Caregivers From a Developing Country

Abstract

Older adults with dementia have higher rates of institutionalization than those without dementia. Desire to institutionalization (DTI) is an important factor influencing the actual institutionalization but is less well studied. This cross-sectional study examines the DTI with the scale of same name developed by Morycz, in 1985, in a sample of 50 caregivers of patients with dementia in a tertiary clinical care setting in a developing country. Caregiver burden associated with personal strain (by factor analyzed Zarit Burden Interview scale), and stress perceived out of caregiving (by Perceived Stress Scale) predicted higher DTI. Besides, those who were married had lower DTI scores. The factors which didn't affect DTI were total caregiver burden, family and social support, age of patient and caregiver, education of caregiver, severity and duration of dementia, and treatment duration. These results were different from those of developed country-based DTI studies and may indicate sociocultural differences.

Factors of Dementia Caregiver Burden Differentially Contribute to Desire to Institutionalize

“…Previous work examining associations between caregiver burden and desire to institutionalize found medium effects (r = .38). 17 To examine minimum sample size for multiple regression analysis examining the extent to which individual burden factors on the ZBI contribute to a caregiver’s score on the DIS, a priori statistical power analysis using G*Power 31 was conducted. It indicated that a minimum sample size of N = 109 would be sufficient with α = .05 and power (1-β) = .08, suggesting adequate power for the proposed analyses.…”

“…Past work suggests specific aspects of burden contribute differentially to a caregiver’s consideration of moving their loved one into formal care. For example, in a small sample, Sinha and colleagues 17 demonstrated that personal strain (i.e., affective experiences, such as feeling angry when around the care recipient) was related to consideration of institutionalization, whereas role strain (i.e., impact on the caregiver’s life, such as reduced time for self or social life) was not. While this study was the first to examine how individual Zarit Burden Interview (ZBI) 2 factors of caregiver burden contribute to steps taken toward a decision to move a care recipient, it relied on a 2-factor conceptualization of caregiver burden generated from work with caregivers for individuals with acquired brain injury, 18 which may not fully generalize to dementia caregiving samples.…”

Adaptation of an online training and support program for caregivers of people with dementia to Indian cultural setting

“…It has been extensively documented that caregiving in dementia is associated with higher levels of burden, more serious depressive symptoms, psychological stress and physical ill-health (Chiao et al, 2015;Gilhooly et al, 2016;Tremont, 2011). The situation is challenging, especially in India, where caregiving is almost entirely family based, with limited resources and few facilities of continued care to meet the complex needs of the persons with dementia and their family caregivers, indicating the need for scaling up dementia education, training and support programs (Dias and Patel, 2009;Ganesh et al, 2016;Lamech et al, 2017;Prince et al, 2012;Sinha et al, 2017).…”

Mediating effect of spiritual coping strategies on caregiving burden and mental health in caregivers of Iranian patients with dementia

“…[14] Furthermore, early institutionalization of the patients along with the significant impairment of daily activity can also be associated with a high level of caregiving burden. [15] In another study, a similar level of burden has been reported among approximately 70% of carers for the PWD. [16] Such burden may have a negative impact on the quality of care and lead to aggressive behaviors such as vocal abuse, violence, and threatening the patients with nursing home care.…”