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Alzheimer's dementia in persons with Down's syndrome: predicting time spent on day-to-day caregiving
- Authors:
- McCARRON Mary, et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 4(4), November 2005, pp.521-538.
- Publisher:
- Sage
The aim of this study was to investigate the amount of time formal caregivers spend addressing activities of day-to-day care activities for persons with Down's syndrome (DS) with and without Alzheimer's dementia (AD). Caregivers completed for 63 persons with DS and AD, and 61 persons with DS without AD, the Caregiving Activity Survey-Intellectual Disability (CAS-ID). Data was also gathered on co-morbid conditions. Regression analysis was used to understand predictors of increased time spent on day-to-day caregiving. Significant differences were found in average time spent in day-to-day caregiving for persons with and without AD. Mid-stage and end-stage AD, and co-morbid conditions were all found to predict increased time spent caregiving. Nature and tasks of day-to-day caregiving appeared to change as AD progressed. The study concluded that staff time to address day-to-day caregiving needs appeared to increase with onset of AD and did so most dramatically for persons with moderate intellectual disability. Equally, while the tasks for staff were different, time demands in caring for persons at both mid-and end-stage AD appeared similar.
Frailty: a costly phenomenon in caring for elders with cognitive impairment
- Authors:
- BUTLER Aine, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(2), 2016, pp.161-168.
- Publisher:
- Wiley
Objectives: Dementia draws on a variety of public and private resources. There is increasing pressure to define the cost components in this area to improve resource allocation and accountability. The aim of this study was to characterize frailty in a group of cognitively impaired community-dwelling elders and evaluate its relationship with cost and resource utilization. Methods: The study assessed a cross-sectional, convenient sample of 115 cognitively impaired patients of age >55 years who attended the National Memory Clinic in St James' University Hospital, a Trinity College-affiliated hospital in Dublin, Ireland. Participants had a clinical diagnosis of possible Alzheimer's disease or mild cognitive impairment. Frailty was measured using the biological syndrome model. Formal health and social care costs and daily informal caregiving costs were collected and the total costs of care estimated by applying the appropriate unit cost estimate for each resource activity. Stepwise regression models were constructed to establish the factors associated with increased care costs. Results: Patient dependence, frailty and number of co-morbid illnesses explained 43.3% of the variance in observed daily informal care costs in dementia and cognitively impaired patients. Dependence was the sole factor retained in an optimal model explaining 19% of the variance in formal health and social care costs. Conclusion: Frailty retained a strong association with daily informal care costs even in the context of other known risk factors for increasing care costs. Interventions that reduce frailty as well as patient dependence on others may be associated with cost savings. (Edited publisher abstract)
Self-efficacy for managing dementia may protect against burden and depression in Alzheimer's caregivers
- Authors:
- GALLAGHER Damien, et al
- Journal article citation:
- Aging and Mental Health, 15(6), August 2011, pp.663-670.
- Publisher:
- Taylor and Francis
Self-efficacy can be described as an individual's assessment of his or her ability to perform a specific task successfully; it is a modifiable attribute which has been shown to influence health behaviours, and can be learned and enhanced. This study aimed to determine whether self-efficacy for different domains of dementia care could be considered independent predictors of symptoms of burden and depression. The study used 84 pairs of patients with Alzheimer's disease and their carers, recruited at the memory clinic of a university teaching hospital in Dublin in the course of the Enhancing Care in Alzheimer's Disease study conducted in 2009. Patient function, cognition and symptoms were assessed, together with caregiver burden, personality, depressive symptoms, coping strategies and self-efficacy for completing tasks related to dementia care. 33% of the caregivers reported significant depressive symptoms. The study findings indicated that self-efficacy for tasks related to dementia care had an important role to play among other predictors of burden and depression in caregivers, and that self-efficacy for symptom management had a direct beneficial impact on the psychological health of caregivers.