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Physical, cognitive, and psychosocial variables from the disablement process model predict patterns of independence and the transition into disability for the oldest-old
- Authors:
- FAUTH Elizabeth Braungart, et al
- Journal article citation:
- Gerontologist, 47(5), October 2007, pp.613-624.
- Publisher:
- Oxford University Press
This study used the Disablement Process Model to predict whether a sample of the oldest-old maintained their disability or disability-free status over a 2- and 4-year follow-up, or whether they transitioned into a state of disability during this time. The study followed a sample of 149 Swedish adults who were 86 years of age or older over a period of 4 years. The sample were grouped by ability in activities of daily living as being functional survivors (nondisabled over time), increasingly disabled (initially nondisabled but later disabled), chronically disabled (disabled at all waves), or deceased. Variables from baseline were used to predict group membership into these four longitudinal outcome groups. Results indicated that demographic factors, physical impairments, physical and cognitive limitations, and psychosocial variables at baseline predicted membership into the functional survivor group after 2 years and most continued to distinguish between functional survivors and other groups after 4 years. These findings indicate key variables that may be useful in predicting shorter term longitudinal changes in disability. By understanding the physical, cognitive, and psychological variables that predict whether a person develops a disability within the next 2 or 4 years, we may be better able to plan for care or implement appropriate interventions.
Resistiveness to care during assistance with activities of daily living in non-institutionalized persons with dementia: associations with informal caregivers’ stress and well-being
- Authors:
- FAUTH Elizabeth Braungart, et al
- Journal article citation:
- Aging and Mental Health, 20(9), 2016, pp.888-898.
- Publisher:
- Taylor and Francis
Objectives: Resistiveness to care (RTC) refers to behaviour problems that co-occur during assistance with activities of daily living (ADL). RTC are considered challenging, but are mostly studied in institutions with implications for patients and formal caregivers. RTC is associated with agitation, but agitation is considered a separate construct. Detection of RTC may be left out of common assessments of persons with dementia in studies of informal caregiving (e.g. global assessments of dementia behavioural symptoms, standard assessments of ADL function). This study examines how RTC (frequency and caregivers’ stress appraisals of RTC) is related to caregivers’ well-being. Method: 234 caregivers of people with dementia reported care receivers’ ADL impairment (eating, bathing, dressing), RTC frequency (of eating, bathing dressing), and their stress appraisals of these behaviours (RTC appraisals). Caregivers also self-reported their role overload, role captivity, and depressive symptoms. Hierarchical linear regression models included independent variables (demographics, ADL impairment, RTC frequency, RTC appraisals) with three separate dependent variables (overload, captivity, depressive symptoms). Results: Two-thirds of informal caregivers reported RTC. Care recipients’ ADL impairment was associated with caregiver outcomes, but only before RTC was entered into the models. RTC frequency significantly predicted caregivers’ overload, captivity, and depression. RTC appraisals predicted overload and captivity. Conclusion: RTC is common in persons with dementia residing at home, and RTC has more negative association with informal caregivers’ well-being than assistance with ADL. Adding RTC frequency and appraisal items to standard ADL measures may better estimate caregivers' needs and risk, and identify modifiable environmental features by assessing behavioral symptoms in context.Resistiveness to care during assistance with activities of daily living in non-institutionalised persons with dementia: associations with informal caregivers’ stress and well-being (Edited publisher abstract)