Impact of Family Caregiving upon Caregivers of Elders with Dementia in China

Abstract

Caring for an elder with dementia at home is considered a challenging and complex process. The purpose of this study was to describe the impact of family caregiving upon caregivers of elders with dementia on caregiver's health in the context of Chinese family caregiving. The investigation also describes the roles of caregiving appraisal, coping, familism, and perceived social support on the relationship between caregving stressors and caregiver outcomes.A cross-sectional correlational design was used to examine relationships among the variables. Ninety-six family caregivers of elders with dementia in China were recruited. Self-reported questionnaires were utilized to measure the variables.Results from bivariate correlational analysis found that ADL impairments had no any significant relationship with other variables and was not used in model testing.. Path analysis indicated that the proposed Dementia Caregiving Model did not fit the data well. Model modifications were performed based on AMOS 5.0 output and the theoretical rationale for the potential modifications. The modified final model fit the data perfectly. It explained 21.1% and 39.7% of the variance in caregiver physical health and psychological health respectively. In the final models, behavioral problems of care-recipients and perceived social support of caregivers had direct and indirect effects on caregiver physical health and psychological health. Familism and caregiving satisfaction only had indirect effects on caregiver psychological health and no effects on caregiver physical health. Conversely, caregiving subjective burden and coping had direct effects on caregiver health; burden had direct effects on both physical and psychological health of caregivers, whereas coping had a direct effect on caregiver psychological health.The findings enrich knowledge of dementia family caregiving in the context of China and Chinese culture and add the important variables of caregiver appraisal of caregiving satisfaction and familism to existing theories and models of stress and coping on family caregiving cross culturally. This study not only contributes to Chinese nursing research by introducing a conceptual model for family caregiving of elders with dementia, but also can be a basis for formulating interventions to help family caregivers of elders with dementia cope with their caregiving situations.