Factors associated with anger and anger expression in caregivers of elderly relatives

Abstract

Objectives: Anger is a common feeling among family caregivers of elderly dependents. However, this feeling has received less attention than other emotional effects of caring. This study measures anger in caregivers and analyzes its predictors.

Method: Trait anger and anger expression (expression-in, expression-out and expression index), caregiver and care recipient features, stressors (e.g. care demands and support), appraisal (e.g. burden) and resources (e.g. coping, self-efficacy) were assessed in 111 caregivers of elderly dependent relatives. Staged stepwise multiple linear regression analyses were carried out for each of the four anger scores.

Results: Caregivers presented mild anger levels and showed expression-in rather than expression-out of anger. Stepwise multiple linear regression analyses showed that a bad relationship between caregiver and care recipient, the presence of disruptive behaviors and caregivers’ low efficacy to handle them, and mostly the use of emotion-focused coping were the significant predictors of trait anger, anger expression index and anger expression-out. Explained variance for each of these regression models was 38%, 33% and 27%, respectively. Burden was the only significant predictor for internal anger expression (8% explained variance).

Conclusion: Results highlight that interventions aimed to improve caregivers’ strategies to address memory and behavior problems and to promote the use of effective coping strategies could be helpful to prevent anger and expression-out of anger. Reducing burden in caregivers might result in reductions of anger expression-in. Data underscore the need to consider anger feeling and both in-expression and out-expression of anger separately in order to understand anger experience in caregivers.

Keywords:

• caregiving
• family caregiver
• anger expression
• anger trait
• coping

Acknowledgements

Our thanks to all the caregivers involved in this study and their institutions: State Reference Care Centre of people with Alzheimer's disease and other dementias – IMSERSO (Salamanca); Pamplona, Leñeros and Carmen Laforet Adult Day Services (Madrid City Council); Maria Wolff Adult Day Services (Madrid); Area 6 Teaching and Research Unit of Nursing (Madrid); Alzheimer Association of Zamora and San Carlos Clinic Hospital (Madrid).

Additional information

Funding

This research was supported by the funding from Complutense University in Madrid (Spain) [grant number 2011/2015] to V. Fernández-Lansac.