1
|
Sideman AB, Merrilees J, Dulaney S, Kiekhofer R, Braley T, Lee K, Chiong W, Miller B, Bonasera SJ, Possin KL. "Out of the clear blue sky she tells me she loves me": Connection experiences between caregivers and people with dementia. J Am Geriatr Soc 2023; 71:2172-2183. [PMID: 36917135 PMCID: PMC10500033 DOI: 10.1111/jgs.18297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/17/2023] [Accepted: 02/02/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Dementia can impede the relationship and connection between the person with dementia (PWD) and their caregiver. Yet, caregiving in dementia also offers opportunities for connection, which has implications for caregiver and PWD well-being. In this qualitative study, we describe and characterize ways caregivers felt connected to the person with dementia they care for. METHODS We conducted a telephone-based survey with caregivers of people with dementia. For this paper, we analyzed responses to an open-ended question focused on when caregivers feel most connected to the person they are caring for. Responses were analyzed and coded and themes were identified through an iterative process involving a multidisciplinary team of researchers and clinicians. RESULTS 437 caregivers participated in this study. We identified two domains of connection: activity-based and emotion-based connections. Within activity-based connections, the following themes emerged: everyday activities; reminiscing; activities of caregiving; novel experiences; and time with family and friends. Within emotional connections, the following themes emerged: expressions of love, appreciation, and gratitude; physical affection; sharing an emotion or emotional experience; and times when the PWD seems like "themself" again. CONCLUSIONS Findings provide insights into ways caregivers experience a sense of connection with the person they care for. There is a call to shift away from focusing on reducing stress and toward optimizing positive experiences as a way to better support caregivers' health and well-being. Interventions that leverage these insights to foster caregiver - PWD connection could lead to better health and well-being for both members of the dyad. The amplification of a positive experience may be particularly important for caregivers who are struggling with limited support or respite. Clinicians may be interested in using a question about connection as a way to more fully understand a caregiver's current experience.
Collapse
Affiliation(s)
- Alissa Bernstein Sideman
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, USA
- Global Brain Health Institute, Department of Neurology, University of California, San Francisco, California, USA
- Department of Humanities and Social Sciences, University of California, San Francisco, California, USA
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California, USA
| | - Jennifer Merrilees
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California, USA
| | - Sarah Dulaney
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California, USA
| | - Rachel Kiekhofer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California, USA
| | - Tamara Braley
- Division of Geriatrics, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Kirby Lee
- Department of Clinical Pharmacy, University of California, San Francisco, California, USA
| | - Winston Chiong
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California, USA
| | - Bruce Miller
- Global Brain Health Institute, Department of Neurology, University of California, San Francisco, California, USA
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California, USA
| | - Stephen J. Bonasera
- Division of Geriatrics, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
- Department of Medicine, Division of Geriatrics and Palliative Care, Baystate Health, Springfield, Massachusetts, USA
| | - Katherine L. Possin
- Global Brain Health Institute, Department of Neurology, University of California, San Francisco, California, USA
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California, USA
| |
Collapse
|
2
|
Colclough C, Miles E, Rusted J, Perach R, Hicks B, Dixon J, Dangoor M, Gridley K, Birks Y, Donaghy P, Mcardle R, Moseley E, Sondh HK, Banerjee S. Emotion-focused dyadic coping styles used by family carers of people with dementia during the COVID-19 pandemic. DEMENTIA 2023:14713012231173812. [PMID: 37147119 PMCID: PMC10164090 DOI: 10.1177/14713012231173812] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Emotional wellbeing of family carers and people with dementia is associated with not only how each individual copes with stress and conflict, but also by how they cope together. Finding ways to positively cope together was particularly important during COVID-19 lockdown restrictions, when other avenues of emotional support were less available. We explored how carers experienced and used emotion-focused dyadic coping styles during the COVID-19 pandemic. In-depth qualitative interviews were conducted during the pandemic with 42 family carers, supplemented by quality of life scores collected both pre- and during the pandemic and household status. Abductive thematic analysis identified five styles of emotion-focused dyadic coping: common, supportive, hostile, disengaged avoidance and protective. The COVID-19 pandemic left many dyads unsupported. While many carers adapted, reporting increases in quality of life and enjoying the extra time with the person with dementia, others experienced dyadic conflict and reductions in quality of life. This variation was associated with dyadic coping styles, including challenges in using 'positive' styles and the protective use of 'negative' disengaged avoidance in the right situations. Dyadic coping styles also differed as a function of whether the dyad lived together. As many people with dementia are supported by an informal carer, considering how they cope together could help us to better support them. We make suggestions for dyadic interventions tailored by co-residency status that could help dyads identify and communicate coping needs, reconnect following avoidance coping, and replenish their coping resources through social support.
Collapse
Affiliation(s)
| | - Eleanor Miles
- School of Psychology, University of Sussex, Brighton, UK
| | | | - Rotem Perach
- School of Social Sciences, University of Westminster, London, UK
| | - Ben Hicks
- Brighton and Sussex Medical School, Brighton, UK
- University of Sussex, Brighton, UK
| | - Josie Dixon
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Margaret Dangoor
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Kate Gridley
- Social Policy Research Unit, University of York, York, UK
| | - Yvonne Birks
- Social Policy Research Unit, University of York, York, UK
| | - Paul Donaghy
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Riona Mcardle
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Elen Moseley
- South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Sube Banerjee
- Faculty of Health, University of Plymouth, Plymouth, UK
| |
Collapse
|
3
|
Qin B, Li X, Zhang H, Zhang C, Zhao L. Mental health condition of caregivers affected metal health of burn injury patients. Int Wound J 2023; 20:1448-1458. [PMID: 36718494 PMCID: PMC10088817 DOI: 10.1111/iwj.14000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 02/01/2023] Open
Abstract
The present study aimed to explore the association between mental health condition of caregivers and mental health of burn injury patients. Totally 300 burn injury patients and 300 caregivers were enrolled. These two cohorts of patients were randomly allocated to study group and control group (150 patients and 150 caregivers in each group). The mental health condition of patients and caregivers was evaluated both before and after psychological interventions. There was a significant reduction of the self-rating depression scale (SDS) and self-rating anxiety scale (SAS) of patients in the study group and control group after intervention (28.23 ± 4.98 vs 32.21 ± 5.01, P < 0.001; 28.18 ± 5.01 vs 31.18 ± 5.04, P < 0.001). The corresponding indexes of caregivers showed similar results before (SDS: 47.03 ± 4.41 vs 46.98 ± 4.39, P = 0.922; SAS: 47.01 ± 4.31 vs 46.93 ± 4.35, P = 0.873) and after intervention (21.76 ± 4.23 vs 38.98 ± 4.09, P < 0.001; SAS: 21.02 ± 4.09 vs 38.65 ± 4.04, P < 0.001). The SDS score of patients in study group was positively correlated with the SDS and SAS score of caregivers (r = 0.418 and 0.218, P = 0.003 and 0.012). The SAS score of patients in the study group was also positively correlated with the SDS and SAS scores of caregivers (r = 0.107 and 0.761, P = 0.029 and 0.018). Multiple linear regression showed that age, education and time of care per day were the independent variables associated with mental health condition of caregivers in the study group (P < 0.05). Mental health condition of caregivers was closely related to the mental health of patients. Age, education and time of care per day were the independent variables associated with mental health condition of caregivers.
Collapse
Affiliation(s)
- Beibei Qin
- Department of Burn and Plastic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xi Li
- Department of Burn and Plastic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Han Zhang
- Department of Burn and Plastic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Cuina Zhang
- Department of Burn and Plastic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Linru Zhao
- Department of Burn and Plastic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, China
| |
Collapse
|
4
|
Antoniou R, Toli DG, Lerner H, Callahan P, Coble R, Ortiz B, Sideman AB, Shdo SM, Levenson RW, Ferreira N, Moskowitz JT, Rankin KP. A mindfulness-based intervention adapted to dementia caregivers: A study protocol for a randomized clinical control trial. Front Psychol 2022; 13:1062452. [PMID: 36605275 PMCID: PMC9808397 DOI: 10.3389/fpsyg.2022.1062452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Dementia caregiving, besides encompassing various challenges in tandem to the diagnosis of the care recipient, is associated with decreased psychological well-being and mental health. Accordingly, caregivers' wellbeing has an impact on the quality of care they provide and on the relationship quality with the person in their care. The aim of the present study is to examine the effectiveness of a mindfulness-based intervention on relational and psychological wellbeing, tailored to the needs of dementia caregivers. This clinical trial (NCT04977245) will apply a randomized controlled mixed method design. Caregivers will be randomly allocated to either the mindfulness intervention or the active control group. The intervention arm is based on experiential learning and is targeted to promote caregivers' well-being and empowerment. Assessments will include, standardized self-report questionnaires, task performance measures, and qualitative measures. All assessments will be held at three time points (baseline; t0, 0 months, post-intervention; t1, 2 months, and after maintenance; t2, 3 months) focused on three core domains (1. relational well-being, 2. psychological well-being, and 3. dementia patient's lifestyle/activities). The primary outcome will be relational well-being, and data will be analyzed using linear mixed modelling.
Collapse
Affiliation(s)
- Rea Antoniou
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, United States,*Correspondence: Rea Antoniou,
| | - Despoina Georgakopoulou Toli
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, United States
| | - Hannah Lerner
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, United States
| | - Patrick Callahan
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, United States
| | - Roger Coble
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, United States
| | - Bailey Ortiz
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, United States
| | - Alissa Bernstein Sideman
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, United States,Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, United States,Department of Humanities & Social Sciences, University of California San Francisco, San Francisco, CA, United States,Global Brain Health Institute, University of California San Francisco, San Francisco, CA, United States
| | - Suzanne M. Shdo
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, United States,Department of Psychology, University of California Berkeley, Berkeley, CA, United States
| | - Robert W. Levenson
- Department of Psychology, University of California Berkeley, Berkeley, CA, United States
| | - Nuno Ferreira
- Department of Social Sciences, School of Humanities and Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Katherine P. Rankin
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, United States
| |
Collapse
|
5
|
Zajdel M, Davidson H, Lea D, Koehly LM. Links of we-talk to caregiver social network systems and health. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2022; 36:1386-1396. [PMID: 35925717 PMCID: PMC9832756 DOI: 10.1037/fam0001013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Caring for a child, particularly one with a rare disease, presents a challenging set of stressors that can impact entire family networks. Given this shared impact, caregivers can engage in communal coping to address the caregiving process, defined as the perception of caregiving as shared and collaborative behaviors to address it. In this study, we examined one common measure of communal coping-first person plural pronouns or "we-talk"-in caregivers of either (a) children with rare or undiagnosed diseases or (b) typically developing children. We sought to examine how we-talk is linked to (a) caregiver health and well-being and (b) social network involvement in caregiving. Caregivers (n = 311) participated in (a) survey questionnaires (b) a network enumeration interview and (c) a semistructured interview of caregiving. Results indicated we-talk was unrelated to stress or self-rated health, but was linked to more benefit-finding; greater individual-focused language (I-talk) was also linked to worse self-rated health. Additionally, we-talk was unrelated to malfeasant behavior (e.g., overly critical), but was linked to less nonfeasant behavior (e.g., underinvolvement), more uplift behavior (e.g., helping with caregiving), and more health-related communication with network members. Further, these findings did not differ across caregiving context. This work highlights the role of communal coping for caregivers managing general parenting stress as well as the stress associated with caring for a child with complex medical needs. Future research should continue to examine how interpersonal coping processes operate within social networks to impact health and well-being for all involved. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Collapse
|
6
|
Chen KH, Casey JJ, Connelly DE, Merrilees J, Yang CM, Miller BL, Levenson RW. Lower activity linkage between caregivers and persons with neurodegenerative diseases is associated with greater caregiver anxiety. Psychophysiology 2022; 59:e14040. [PMID: 35315937 DOI: 10.1111/psyp.14040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 10/24/2021] [Accepted: 12/01/2021] [Indexed: 11/28/2022]
Abstract
Physiological linkage refers to the degree to which two individuals' central/peripheral physiological activities change in coordinated ways. Previous research has focused primarily on linkage in the autonomic nervous system in laboratory settings, particularly examining how linkage is associated with social behavior and relationship quality. In this study, we examined how linkage in couples' daily somatic activity (e.g., synchronized movement measured from wrist sensors)-another important aspect of peripheral physiology-was associated with relationship quality and mental health. We focused on persons with neurodegenerative diseases (PWNDs) and their spousal caregivers, whose linkage might have direct implications for the PWND-caregiver relationship and caregiver's health. Twenty-two PWNDs and their caregivers wore wristwatch actigraphy devices that provided continuous measurement of activity over 7 days at home. PWND-caregiver activity linkage was quantified by the degree to which activity was "in-phase" or "anti-phase" linked (i.e., coordinated changes in the same or opposite direction) during waking hours, computed by correlating minute-by-minute activity levels averaged using a 10-min rolling window. Caregivers completed well-validated surveys that assessed their mental health (including anxiety and depression) and relationship quality with the PWND. We found that lower in-phase activity linkage, but not anti-phase linkage, was associated with higher caregiver anxiety. These dyad-level effects were robust, remaining significant after adjusting for somatic activity at the individual level. No effects were found for caregiver depression or relationship quality. These findings suggest activity linkage and wearables may be useful for day-by-day monitoring of vulnerable populations such as family caregivers. We offered several possible explanations for our findings.
Collapse
Affiliation(s)
- Kuan-Hua Chen
- Department of Psychology, University of California, Berkeley, Berkeley, California, USA
| | - James J Casey
- Department of Psychology, University of California, Berkeley, Berkeley, California, USA
| | - Dyan E Connelly
- Department of Psychology, University of California, Berkeley, Berkeley, California, USA
| | - Jennifer Merrilees
- Memory and Aging Center, University of California, San Francisco, San Francisco, California, USA
| | - Chien-Ming Yang
- Department of Psychology/The Research Center for Mind, Brain & Leaning, National Chengchi University, Taipei, Taiwan
| | - Bruce L Miller
- Memory and Aging Center, University of California, San Francisco, San Francisco, California, USA
| | - Robert W Levenson
- Department of Psychology, University of California, Berkeley, Berkeley, California, USA
| |
Collapse
|