Why does placement of persons with Alzheimer's disease into long-term care improve caregivers' well-being? Examination of psychological mediators.

Mausbach, Brent T; Chattillion, Elizabeth A; Ho, Jennifer; Flynn, Laura M; Tiznado, Denisse; von Känel, Roland; Patterson, Thomas L; Grant, Igor (2014). Why does placement of persons with Alzheimer's disease into long-term care improve caregivers' well-being? Examination of psychological mediators. Psychology and aging, 29(4), pp. 776-786. American Psychological Association 10.1037/a0037626

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Caregiving for individuals with Alzheimer's disease is associated with chronic stress and elevated symptoms of depression. Placement of the care receiver (CR) into a long-term care setting may be associated with improved caregiver well-being; however, the psychological mechanisms underlying this relationship are unclear. This study evaluated whether decreases in activity restriction and increases in personal mastery mediated placement-related reductions in caregiver depressive symptoms. In a 5-year longitudinal study of 126 spousal Alzheimer's disease caregivers, we used multilevel models to evaluate placement-related changes in depressive symptoms (short form of the Center for Epidemiologic Studies Depression scale), activity restriction (Activity Restriction Scale), and personal mastery (Pearlin Mastery Scale) in 44 caregivers who placed their spouses into long-term care relative to caregivers who never placed their CRs. The Monte Carlo method for assessing mediation was used to evaluate the significance of the indirect effect of activity restriction and personal mastery on postplacement changes in depressive symptoms. Placement of the CR was associated with significant reductions in depressive symptoms and activity restriction and was also associated with increased personal mastery. Lower activity restriction and higher personal mastery were associated with reduced depressive symptoms. Furthermore, both variables significantly mediated the effect of placement on depressive symptoms. Placement-related reductions in activity restriction and increases in personal mastery are important psychological factors that help explain postplacement reductions in depressive symptoms. The implications for clinical care provided to caregivers are discussed.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology > Centre of Competence for Psychosomatic Medicine

UniBE Contributor:

von Känel, Roland

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0882-7974

Publisher:

American Psychological Association

Language:

English

Submitter:

Annette Barbara Kocher

Date Deposited:

26 Mar 2015 11:01

Last Modified:

26 Oct 2015 11:19

Publisher DOI:

10.1037/a0037626

PubMed ID:

25133414

BORIS DOI:

10.7892/boris.66472

URI:

https://boris.unibe.ch/id/eprint/66472

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