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Journal of Aging and Health, Vol. 17, No. 2, 172-189 (2005)
DOI: 10.1177/0898264304274252
© 2005 SAGE Publications

Caregiver Psychological Adjustment and Institutionalization of Persons With Alzheimer’s Disease

David W. Gilley

Rush Institute for Healthy Aging

Judith J. McCann

Rush Institute for Healthy Aging

Julia L. Bienias

Rush Institute for Healthy Aging

Denis A. Evans

Rush Institute for Healthy Aging

This prospective study examines the relationship between caregiver psychological adjustment and institutionalization of persons with Alzheimer’s disease (AD). Method: A 3-year longitudinal study was conducted with a clinic-based cohort of 396 persons with AD and their respective family caregivers. Caregiver adjustment was sequentially measured in 3-month intervals using standard scales of appraisal (perceived burden and satisfaction) and emotion (depressive symptoms and positive affect). Results: In multivariable proportional hazards regression models predicting time to institutionalization controlling for AD severity, hazard ratios were significant for appraisal measures of caregiver adjustment, perceived burden (1.053; 95% confidence interval [CI], 1.014, 1.093), and satisfaction (.929; 95% CI, .883, .977). In contrast, levels of caregivers’ positive and negative emotion did not reliably predict institutionalization. Discussion: The findings highlight the importance of caregiver appraisals in decisions to institutionalize persons with a dementia syndrome, but the limited impact of caregiver emotion was unexpected and requires further study.

Key Words: long-term care • dementia • depression • family caregivers


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