SOCIAL SUPPORT AND PSYCHOLOGICAL DISTRESS AMONG SPOUSE CAREGIVERS OF DEMENTIA PATIENTS (ALZHEIMER'S DISEASE).

Abstract

This study is an examination of the informal support systems of 40 spouse caregivers of dementia patients in relation to two variables associated with maintaining their patient at home: (1) the caregiver's experience of psychological distress, and (2) the caregiver's need for formal support. There now exists evidence to suggest that informal supports act to mediate the stress associated with caring for a dementia patient; however, research in the area of social supports has generally lacked careful definitions of the variables at work. To remedy that deficiency, distinctions were made in this study between the quantitative and qualitative dimensions of informal supports and the expressive and instrumental functions of informal supports. Initial analyses did not support the hypotheses that informal supports operate independently to buffer caregivers' experience of psychological distress and the need for formal support. However, when formal support was redefined in terms of two types of services--professional counseling services and community services--significant findings did emerge. Level of caregiver anxiety was found to be significantly related to perceived need for counseling services. Perceived need for community services was predicted by the combination of the patient's level of cognitive impairment, and the caregiver's experience of higher levels of anxiety and lower levels of informal expressive support. These results suggest that interventions directed toward the provision of services should be based on a thorough evaluation which includes the patient's level of functioning as well as the caregiver's emotional and instrumental resources. Professionals working with dementia patients and their families must be alerted to those caregivers who are at risk of severe emotional distress, and services should be provided to them before families collapse under the strain of caregiving.