Purpose: Our objective in this analysis was to determine how the duration of caregiving interacts with key care demands (i.e., severity of problem behaviors) to influence the institutionalization of individuals suffering from dementia. Methods: We utilized multiregional data from 4,761 caregivers of individuals with dementia over a 3-year period. We conducted multinomial logistic and Cox proportional hazards analyses to determine the moderating effects of duration on behavior problems when institutionalization was predicted. Baseline covariates included the context of care, primary objective stressors, primary subjective stressors, resources, and global outcomes. Results: The Duration of care X Behavior problems interaction term was not significant in the multinomial regression or Cox hazards models. However, main effects models demonstrated that more recent caregivers were more likely to institutionalize individuals with dementia than respondents in different stages of the caregiving career. Implications: The results emphasize the need to (a) broaden scientific conceptualizations to consider duration of care as integral; (b) refine targeting when interventions are administered early in the dementia caregiving process; and (c) understand patterns of attrition when caregiver adaptation is modeled over time.
Bibliographical noteFunding Information:
The Enabling Autonomy, Participation, and Well-Being in Old Age: The Home Environment as a Determinant for Healthy Ageing (ENABLE–AGE) Project was funded by the European Commission from 2002 to 2004 (under Grant QLRT-2001-00334). The Swedish ENABLE– AGE team is grateful for additional funding from the Swedish Research Council on Social Science and Working Life, the Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning, and the Swedish Research Council. We thank all study participants, consortium and national team members, and subcontractors for their contributions.
- Alzheimer's disease
- Family caregiving
- Informal care
- Nursing home placement