Spouse caregivers of Alzheimer patients: problem responses to caregiver burden

Abstract

This paper reports on comparisons of patterns of responses by 199 spouses of Alzheimer disease patients to stresses of functioning as caregivers. Focusing on gender and age of spouses, we examine effects of the total burden of caregiving and perceived patient problems on a set of emotional and social responses of caregivers. We also examine ways in which depressive symptoms and anxiety of spouse caregivers were associated with patterns of their responses to caregiving stresses. Total patient problem burden was most strongly associated positively with caregiver anger-resentment toward the patient, followed by caregiver concerns about personal time restriction and limitation of social life. Among individual areas of patient problems, emotional lability of the patient rather than cognitive impairment appeared strongest by far in affecting caregiver response measures. Negative impact of caregiving on their social life and associations appeared to have particularly marked effects on effects on caregiver depressive symptoms and anxiety scores. Spouse caregivers did not differ by age in clinically significant ways in their patterns of reaction to stresses of caregiving. The study suggests the importance of considering potential spouse caregiver reactions in such areas as anger and aggressive response to patients, the impact of feelings of social deprivation and personal sacrifice, as well as the implications of caregiving stresses for patient care and maintenance of family cohesion and quality of life.

Acknowledgments

This research was supported in part by a grant from the Bristol-Myers Squibb Pharmaceutical Research Institute, Princeton, New Jersey, USA. The authors thank the following clinical investigators and centers for their contributions to this study: S. H. Appel, MD, Baylor College of Medicine, Texas Medical Center, Houston, TX; J. B. Cohn, MD, Psychopharmacology Research Institute, Van Nuys, CA; T. H. Crook, PhD., Memory Assessment Clinics, Inc., Bethesda, MD; S. H. Ferris, PhD., and B. Reisberg, MD., NYU Medical Center, NY, NY; J. H. Fox, MD., and J. Schoenberger, MD., Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL; J. Hartford, MD., Cincinnati Medical Research Institute, Cincinnati, OH; L Jarvik, MD., PhD., Neuropsychiatric Institute-UCLA, Los Angeles, CA; M. Lakin, MD., Memory Assessment Clinics, Inc., Scottsdale, AZ; G. Larrabee, PhD., Memory Assessment Clinics, Inc., St. Petersburg, FL; J. Mendels, MD., Philadelphia Medical Institute, Philadelphia, PA; W. Petrie, MD., Psychiatric Consultants, Inc., Nashville, TN; and P. Tariot, MD., University of Rochester, Rochester, NY.