PREDICTORS OF CARE-RELATED EMOTIONAL DISTRESS AMONG CAREGIVERS FOR INDIVIDUALS WITH DEMENTIA

In the United States, 15 million adults serve as informal caregivers for a person with dementia (PWD). While caregiving has many rewards, reports of burden and mental health concerns are common. Pearlin’s Stress Process Model posits both primary stressors relating to the PWD’s impairment and secondary strains resulting from care predict health outcomes for caregivers. Using the National Study of Caregiving (NSOC), we examine contextual factors of the PWD and caregiver as well as caregiver health and intrapsychic strains as predictors of emotional distress related to the caregiving role. We also examine whether PWD level of functional impairment (categorized as low, moderate, or high) moderates the effect of other PWD and caregiver characteristics. Our sample included 1063 caregivers for 717 PWDs. The caregiving role was found to be very emotionally difficult by 17% of the sample. Two-level hierarchical linear models (caregivers nested within PWDs) were run with PWD and caregiver level contextual factors, caregiver health and psychological well-being, and interactions entered consecutively. High PWD functional impairment, being female, higher education, more pain, sleep difficulty, and lower psychological well-being were associated with higher levels of care-related emotional distress. When testing for the moderating effects of PWD level of functional impairment, the association between providing routine (as opposed to as-needed) care and increased emotional difficulty was strongest for caregivers of PWD with moderate impairment. Caregivers with greater feelings of psychological well-being (control/adjustment) were less likely to report care-related distress, even controlling for PWD functional impairment and caregiver health.