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Mental health and morbidity of caregivers and co-residents of individuals with dementia: a quasi-experimental design
- Authors:
- MAGUIRE Aideen, ROSATO Michael, O'REILLY Dermot
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(10), 2017, pp.1104-1113.
- Publisher:
- Wiley
Objectives: To determine if providing informal care to a co-resident with dementia symptoms places an additional risk on the likelihood of poor mental health or mortality compared with co-resident non-caregivers. Design: A quasi-experimental design of caregiving and non-caregiving co-residents of individuals with dementia symptoms provides a natural comparator for the additive effects of caregiving on top of living with an individual with dementia symptoms. Methods: Census records, providing information on household structure, intensity of caregiving, presence of dementia symptoms and self-reported mental health were linked to mortality records over the following 33 months. Multi-level regression models were constructed to determine the risk of poor mental health and death in co-resident caregivers of individuals with dementia symptoms compared with co-resident non-caregivers, adjusting for the clustering of individuals within households. Results: The cohort consisted of 10 982 co-residents (55.1% caregivers), with 12.1% of non-caregivers reporting poor mental health compared with 8.4% of intense caregivers (>20 h of care per week). During follow-up, the cohort experienced 560 deaths (245 to caregivers). Overall, caregiving co-residents were at no greater risk of poor mental health but had lower mortality risk than non-caregiving co-residents; this lower mortality risk was also seen amongst the most intensive caregivers. Conclusion: Caregiving poses no additional risk to mental health over and above the risk associated with merely living with someone with dementia and is associated with a lower mortality risk compared with non-caregiving co-residents. (Edited publisher abstract)
Touch, the essence of caring for people with end-stage dementia: a mental health perspective in Namaste care
- Authors:
- NICHOLLS Daniel, et al
- Journal article citation:
- Aging and Mental Health, 17(5), 2013, pp.571-578.
- Publisher:
- Taylor and Francis
This article presents the mental health aspects of ‘touch’ associated with a funded research project: Avoiding ‘high tech’ through ‘high touch’ in end-stage dementia: Protocol for care at the end-of-life. Data explored in this article are derived from focus groups conducted at three residential aged care facilities located in metropolitan and regional areas of NSW, Australia. The exploration of touch vis-a-vis mental health fell under two broad themes: touch by others and touch by the person. Sub-elements of these themes comprised touch towards a physical objective, touch towards an emotional objective, touch of objects and touch of others. The overarching outcome of interconnectedness embraced environmental awareness and human and life awareness. These two broad themes, with their accompanying elements, express the essential nature of mental health as a reciprocal connectedness, with reciprocal impacts on both those people with advanced dementia and their carers. (Edited publisher abstract)
Stress, distress and mucosal immunity in carers of a partner with fronto-temporal dementia
- Authors:
- BRISTOW Matt, et al
- Journal article citation:
- Aging and Mental Health, 12(5), September 2008, pp.595-604.
- Publisher:
- Taylor and Francis
This study investigates the psychological and physiological impact of caring for a partner with fronto-temporal dementia (FTD). Carers were expected to exhibit greater stress and poorer psychological well-being in comparison with non-carers, and suppressed mucosal immunity. Twenty-five carers and 36 non-carers completed standardised psychological assessments of perceived stress, psychological well-being, coping and social support. Levels of mucosal immunity were assessed in saliva samples collected over the 3 days of the study, alongside daily assessments of stress, arousal and mood. Informal carers as a group reported greater stress and poorer psychological well-being, but there was considerable variation, with some carers reporting better psychological functioning than non-carers. Immune levels were not suppressed in carers compared with non-carers; counter to hypothesis, there was a positive correlation between immunity and poorer psychological well-being. This research suggests that caring for a partner with FTD increases distress and carers might benefit from psychological intervention. However, the variation in psychological well-being requires explanation. Furthermore, this first examination of mucosal immunity employing participants experiencing enduring stress suggests that, in contrast to previous research, enduring stress does not lead to suppression of mucosal immunity and may actually enhance it.
Aging and Mental Health
- Publisher:
- Taylor and Francis
Aging and Mental Health covers the biological, psychological and social aspects of ageing as they relate to mental health. In particular it concentrates on forming an integrated approach between the various biopsychosocial processes and aetiological factors associated with psychological changes in the elderly. It highlights the various strategies, therapies and services which may be directed at improving the mental health of the elderly. Articles from this journal are indexed and abstracted selectively on Social Care Online.
Mental health in old age: a collection of projects
- Author:
- AGE CONCERN
- Publisher:
- Age Concern
- Publication year:
- 1983
- Pagination:
- 87p.
- Place of publication:
- Mitcham
Risk and resiliency factors related to dementia caregiver mental health
- Authors:
- ALTAMIRANO Olivia, DE MAMANI Amy Weisman
- Journal article citation:
- Family Process, 60(3), 2021, pp.904-919.
- Publisher:
- Wiley
Prevalence rates for dementia are expected to rise exponentially as the elderly population rises. With this comes a corresponding increase in the number of family members who will become dementia caregivers. Caregivers of people with dementia often experience a deterioration in mental health. Identifying factors that relate to caregiver mental health is necessary to develop appropriate interventions. The current study explored how family functioning (measured with a latent variable that includes family cohesion, family balance, and family communication), caregiver expressed emotion (EE), and patient symptom severity related to caregiver mental health (measured with a latent variable that includes depression, anxiety, and stress). Participants included 107 dementia caregivers. The following specific hypotheses were tested: lower levels of both (1) EE and (2) patient symptom severity, and (3) higher levels of family functioning would be related to better caregiver mental health. Results produced a well-fitting model: X2(18) = 14.858, p = .672; CFI = 1.00; RMSEA = .00; SRMR = .037. Moreover, results indicated that better family functioning (Ɣ = −3.54, SE = 1.34, p = .008), lower levels of caregiver EE (β = .36, SE = 0.07, p < .01), and higher patient symptom severity (β = −3.03, SE = 0.88, p = .001) were related to better caregiver mental health. Results from this study suggest that efforts to bolster family functioning (i.e., enhance communication, promote cohesion, encourage flexibility) could help improve caregiver mental health. (Edited publisher abstract)
A longitudinal exploration of mental health resilience, cognitive impairment and loneliness
- Authors:
- WINDLE Gill, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 36(7), 2021, pp.1020-1028.
- Publisher:
- Wiley
Objective: There is a growing interest in how people living with dementia may achieve good outcomes and be resilient despite their health challenges. Understanding what might be important for resilience in this population is largely untested theory. Methods: The analysis draws a subsample with cognitive impairment (N = 579) from two waves of the Cognitive Function and Ageing Studies Wales study, a nationally representative study of community-dwelling people aged 65+ in Wales. We constructed a measure of mental health resilience (MHR) defined as no depression, no anxiety and high well-being. Drawing on a resilience framework, we tested univariate and cumulative effects models of the factors that enable MHR, and then examined whether MHR is important for reducing loneliness over time. Results: Across both waves of data 22% (n = 121) met the criteria for MHR. The cumulative effects model found the odds of MHR were greater for male gender, higher self-esteem, greater social resources and no subjective memory complaints. Controlling for these significant predictors, MHR significantly predicted lower total and sub-scale scores for loneliness at wave 2. Sensitivity analysis shows these effects held at lower levels of cognitive function when the Mini-Mental State Examination score was <25, but not at <23. Conclusions: This paper addresses a gap in research regarding the conceptualisation and measurement of resilience when facing cognitive impairment. Understanding what aspects of a person's life might enable good mental health despite cognitive impairment—to be resilient—could inform effective strategies for friends and families, along with health, and social policy and practice. (Edited publisher abstract)
Positive and negative experiences of caregiving in dementia: the role of sense of coherence
- Authors:
- GONÇALVES‐PEREIRA Manuel, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 36(2), 2021, pp.360-367.
- Publisher:
- Wiley
Objectives: Sense of coherence (SOC) is increasingly recognized as an important health determinant, particularly for mental health. Part of the evidence comes from informal caregivers in diverse clinical conditions. The extent to which SOC influences caregiving outcomes, however, is relatively under‐researched in dementia, particularly regarding positive experiences. We analysed the association of SOC with dementia caregivers' subjective burden, psychological distress and positive aspects of care. Methods/Design: This is a secondary analysis of cross‐sectional data from the Lisbon study of Families of Persons with Dementia, involving a convenience sample of 99 primary caregivers of community‐dwelling patients of neurology and psychiatry services. SOC was assessed with the Orientation for Life Scale. Measures of caregivers' outcomes were: the Zarit Burden Interview, the General Health Questionnaire for psychological distress and the Positive Aspects of Caregiving scale. Analyses controlled for demographics, caregiving arrangements, objective burden, social support, patients' neuropsychiatric symptoms and dementia stage. Results: Lower SOC was associated with higher psychological distress (p = 0.001). No significant associations were found for subjective burden (p = 0.081) or positive aspects of caregiving (p = 0.688). Additional analyses showed that lower SOC was associated with less emotional support (p < 0.001) and past psychiatric illness (p = 0.044). Conclusions: These findings support previous research suggesting that SOC is protective for psychological distress, and extend evidence to the positive aspects of care in dementia. The cross‐sectional design and small‐scale convenience sampling preclude both causality presumptions and generalizability. SOC assessments may be useful to define subgroups of dementia caregivers at risk for anxiety and depression. (Edited publisher abstract)
Psychological well‐being and risk of dementia
- Authors:
- SUTIN Angelina R., STEPHAN Yannick, TERRACCIANO Antonio
- Journal article citation:
- International Journal of Geriatric Psychiatry, 33(5), 2018, pp.743-747.
- Publisher:
- Wiley
Objective: Well-being is a psychological resource that buffers against age-related disease. This study tests whether this protective effect extends to dementia and whether it is independent of distress. Methods: Participants (N = 10,099) were from the Health and Retirement Study. Five aspects of positive psychological functioning (life satisfaction, optimism, mastery, purpose in life, and positive affect) were tested as predictors of incident dementia over 6 to 8 years. Results: Purpose in life was associated with a 30% decreased risk of dementia, independent of psychological distress, other clinical and behavioural risk factors, income/wealth, and genetic risk. After controlling for distress and other risk factors, the other aspects of well-being were not associated with dementia risk. Conclusions: After considering psychological distress, we found that measures of well-being were generally not protective against risk of dementia. An exception is purpose in life, which suggests that a meaningful and goal-driven life reduces risk of dementia. (Edited publisher abstract)
Suicidal ideation in family carers of people with dementia: a pilot study
- Authors:
- O'DWYER Siobhan T., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 28(11), 2013, pp.1182-1188.
- Publisher:
- Wiley
An online, cross-sectional survey was conducted with 120 family carers of people with dementa, the majority of whom were located in Australia and USA. The survey included measures of suicidality, self-efficacy, physical health, depression, hopelessness, anxiety, optimism, caregiver burden, coping strategies and social support. Twenty-six percent of carers had contemplated suicide more than once in the previous year. Only half of these had ever told someone they might commit suicide and almost 30% said they were likely to attempt suicide in the future. Carers who had contemplated suicide had poorer mental health, lower self-efficacy for community support service use and greater use of dysfunctional coping strategies than those who had not. In a logistic regression, only depression predicted the presence of suicidal thoughts. The implications for policy and clinical practice in terms of identifying and supporting carers who are already contemplating suicide should be considered. (Edited publisher abstract)