Cognitive-Behavioral Dementia Caregiving Styles: Associations With Care Stress and Well-Being. (17th December 2021)

• Record Type: Journal Article
• Authors: Leggett, Amanda; Connell, Cathleen; Gitlin, Laura; Kales, Helen
• Is Part Of: Innovation in aging. Volume 5(2021)Supplement 1
• Page Start: 810
• Page End: 810
• Publication Date: 2021-12-17
• Subjects: Aging -- Periodicals; Gerontology -- Periodicals; 612.67
• DOI: 10.1093/geroni/igab046.2980
• Languages: English
• ISSNs: 2399-5300

Abstract

Abstract: While Stress Process Models of family caregiving have been examined extensively, little focus has been placed on caregiver's actual management of care. We consider whether caregiving style classified previously through k-modes machine learning models and based on cognitive-behavioral approaches to care impact caregivers' experiences of care-related stress and well-being. The three previously identified styles include: Adapters- strong dementia understanding and adaptability, encouraging behavioral approach; Managers- poor dementia understanding and adaptability, critical behavioral approach; and Avoiders- moderate dementia understanding and adaptability, passive behavioral approach. Participants included 100 primary family caregivers for PWDs who were on average 64 years old, 74% female, and 18% non-White. Utilizing linear regressions, each caregiving style was considered a key predictor (reference: Adapters) of the Zarit Burden Interview (ZBI), Caregiver Assessment of Function and Upset (CAFU) upset score, Neuropsychiatric Inventory (NPI-C) distress scale, and Positive and Negative Affect scale (PANAS) controlling for dementia severity, care duration, co-residency, and demographics. Relative to Adapters, Managers had more CAFU upset (β=0.4, p<.001), more NPI-C distress (β=0.4, p<.001), and greater burden (ZBI) (β=0.3, p<.001). Avoiders showed significantly greater CAFU upset than Adapters (β=0.2, p<.05). Positive affect was not associated with caregiving style. Caregiving styles associated with less understanding and adaptability and a more critical behavioral approach showed worse caregiving outcomes accounting for dementia severity. Results can inform a nuanced approach to tailoring and targeting interventions based on caregiver styles with the goal of reaching caregivers at risk for poor outcomes and ultimately leading to significant public health impact.