Differences in caregiving dynamics: A comparative analysis of family caregivers of patients with Alzheimer's disease and spinal cord injured survivors.

摘要

In the United States the elderly population is expected to dramatically increase in the next 20 years. As Americans grow older their level of functional impairment and the risk of developing multiple chronic illnesses will also increase, thus placing a greater burden on the family unit for long-term personal care. Two decades of caregiving research has firmly established the negative health consequences to caregivers who provide the highest level of personal care. Because the caregiving experience is a dynamic process unique to each caregiver, experts in the field of adult care are stressing the importance of conducting research studies within the context of specific diseases and disabilities that reflect the individual experiences of different subgroups of caregivers. This study examined the differences in care dynamics between caregivers of Alzheimer's disease and spinal cord injured persons. Two large secondary data sets from federally funded University of Miami studies, the REACH II study and the Spinal Cord Injury study were analyzed. A total of 289 caregiver/care recipient baseline interviews were used to address five areas of analyses: (1) Differences in caregiver demographic characteristics; (2) Differences in care experiences; (3) Differences in psychological, physical and social functioning; (4) Differences in frequency of use of religious/spiritual coping strategies; and (5) Predictors of caregivers' psychological, physical and social functioning. Seven hypothesis were tested by conducting a series oft-tests and Chi-square analyses to compare group differences, and multiple regression analyses to determine significant predictors of caregivers' psychological (depression and burden), physical, and social functioning. The findings from this study established that caregiving dynamics were different for these two groups of caregivers as evidenced by distinct differences in their demographic profiles, care experiences, psychological, physical and social functioning and religious/spiritual coping. Caregivers of Alzheimer's disease persons were older, faced greater care challenges, had less social support, and were at greater risk of experiencing symptoms of depression and burden, health problems and being socially isolated than caregivers of spinal cord injured survivors. Lack of social support was the strongest predictor of poor psychological and social functioning for both caregiver groups.