Psychological, marital, and health consequences of caring for a dementia patien : a longitudinal gender study of aging spouse caregivers

Due to their advanced years, older spouse caregivers to dementia patients are at high-risk for experiencing adverse outcomes. For many dementia victims, a spouse may be the only alternative to nursing home placement. Yet, the potential for two patients from this demanding care giving arrangement, instead of one, is very high. It is not clear whether aging males experience the care giving role differently from aging females. Two schools of thought, continued gender-linked behaviors" and "reverse gender-linked behavior," are considered in addressing the question "Are aging men or aging women more stressed caring for a spouse with dementia?" Using longitudinal data from a recent national survey of caregivers to dementia patients, this study selected 98 spouses who at Time 1 data collection were 70 years or older and care giving a partner with dementia at home. Caregivers were compared by gender on outcomes of burden, depression, health status, and closeness of marital relationship at both time periods. Using multiple regression techniques, models for predicting caregiver outcomes at Time 2 using Time 1 data were developed. Aging wives had significantly lower levels of well-being than husbands on all outcome measures at both time periods, and correlation analysis suggested important differences in correlates associated with outcome measures by gender. Multiple regression analysis demonstrated different patterns for husbands and wives on outcome measures, indicating gender differences. For both sexes, high burden level at Time 1 was the best predictor of poor well-being at Time 2, for all outcome measures. The study concludes that for older spouses, predictors of caregiver outcomes are gender-specific. Findings from these data support reverse gender-linked behavior theory. An unexpected finding was discovered on the variable length of time care giving. Forty percent of the samples were unable to report reliably on this measure. It is posited-if this is happening in this data base-it most likely is happening in other data sets as well. Researchers are cautioned on using this variable without adequate countermeasures. Lastly, the Functional Dementia Scale is found to be an invalid instrument. Corrective improvements are suggested.