Do caregiver management strategies influence patient behaviour in dementia?
OBJECTIVE
Little is known about the effectiveness of caregiver management strategies on the functioning of the demented patient. However, identification of specific caregiver strategies may provide useful information on the management and manifestation of behavioural problems in dementia.


METHODS
Ninety-nine patients with dementia and their informal caregivers were followed up for one year. Interviews were used to assess differences in caregiver management strategies. Behavioural disturbances in the patient were measured with the Neuropsychiatric Inventory (NPI). Repeated measures analysis were carried out to investigate the relationship between caregiver management strategies and patient behaviour.


RESULTS
Three caregiver management strategies were identified, based on whether caregivers accepted, or not, the caregiving situation and dementia related problems. Caregivers characterized by non-acceptance were typified as 'Non-adapters'; caregivers characterized by acceptance were further subdivided into two groups typified as 'Nurturers' and 'Supporters'. Caregiver characteristics such as sex, education and personality were important determinants of management strategies. MANOVA showed that non-adapters reported significantly more hyperactivity symptoms in patients and felt less competent than did supporters.


CONCLUSIONS
Caregiver management strategies would appear to be associated with behavioural problems in dementia, and are important in predicting patient behaviour and caregiver burden. Intervention programmes should aim at teaching caregivers adequate management strategies.
de Vugt
Marjolein E
ME
Department of Psychiatry and Neuropsychology, University of Maastricht, The Netherlands.
Stevens
Fred
F
Aalten
Pauline
P
Lousberg
Richel
R
Jaspers
Niek
N
Winkens
Ieke
I
Jolles
Jellemer
J
Verhey
Frans R J
FR
D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003704:Dementia / Q000451:nursing* / Q000523:psychology; D004522:Educational Status; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010551:Personality; D011595:Psychomotor Agitation / Q000209:etiology; D012737:Sex Factors