Ambivalent Feelings and Relationship Quality in Dementia Family Caregivers: Associations with Depressive Symptomatology

ABSTRACT

Objectives

Ambivalent feelings in dementia family caregivers have been found to be related to caregivers´ stress associated with the behavioral and psychological symptoms of dementia (BPSD-related stress), and depressive symptoms. Ambivalent feelings may also affect caregivers´ perceived quality of the relationship with the person living with dementia (PLwD), but this variable has been scarcely studied. This study analyzes the role of ambivalent feelings in the association between caregivers’ BPSD-related stress, perceived quality of the relationship with the PLwD, and depressive symptomatology.

Methods

A theoretical model was developed and tested in a sample of 390 family caregivers.

Results

The obtained tested model had an excellent fit to the data, explaining 24% of the variance of depressive symptomatology. A significant association was found between caregivers’ BPSD-related stress, ambivalent feelings, and depressive symptomatology. Also, an indirect effect in the association between ambivalent feelings and depressive symptomatology was found through the perceived quality of the relationship.

Conclusions

Ambivalent feelings in dementia family caregivers are associated with caregivers’ BPSD-related stress, perception of a lower relationship quality, and higher depressive symptomatology.

Clinical Implications

Targeting caregivers’ ambivalent feelings and the quality of the relationship in interventions for dementia family caregivers may decrease their distress.

KEYWORDS:

• Ambivalent feelings
• behavioral and psychological symptoms of dementia
• caregiving dyad
• dementia family caregivers
• depression
• relationship

Clinical implication

• Addressing feelings of ambivalence in interventions may decrease caregiver distress and improve the dyad’s relationship, enhancing PLwD´s well-being.

• Incorporating strategies to improve relationship quality in dementia caregiving interventions can help both caregivers and PLwD cope more adaptively without damaging their bond.

• Considering ambivalent feelings and relationship quality when developing interventions can reduce caregiver depressive symptoms and improve the quality of life for both members of the dyad, potentially increasing intervention effectiveness.

Acknowledgments

We thank all the caregivers for their participation in the study and the following centers for collaborating with us in the project: Hospital Gregorio Marañón, Centros de día STIMA, Cognitiva Unidad de Memoria, Centros de día Albertia, FOGAR, AFA Valdemoro, Centro de día Pirámides, Activa Edades, MIT centro de día, and Asociación de Familiares de Enfermos de Alzheimer de Madrid (AFEAM).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The study materials, analytic methods, and data are available upon request from the corresponding author on reasonable request.

Additional information

Funding

This work was supported by the Spanish Ministry of Science and Innovation under Grants [PID2019-106714RB-C22] and [PID2019-106714RB-C21]; the Spanish Ministry of Economy and Competitiveness under Grants [PSI2015-65152-C2-2-R] and [PSI2015-65152-C2-1-R.] Laura Mérida-Herrera is supported by a Pre-Doctoral Grant from the Spanish Ministry of Science and Innovation (FPI/525644).