What causes problems in Alzheimer's disease: attributions by caregivers. A qualitative study.
OBJECTIVE
To gain insight into caregivers' understanding of the causes of behaviours they find problematic in people with Alzheimer's disease in order to inform the development of educational strategies.


METHODS
A qualitative, semi-structured interview was used. Participants were 205 caregivers for a person with Alzheimer's disease, all of whom were aware of the diagnosis and who had been recruited as part of a larger longitudinal study. Participants were from inner-city and suburban London/semi-rural Essex. The main outcome measures were caregivers' understanding of: the cause of problematic behaviour; the ability of the person with dementia to control this behaviour; the prognosis of the illness.


RESULTS
Most carers attribute the cognitive, behavioural and psychological symptoms of dementia to causes other than dementia; many believe that the person with dementia has control over their behaviour and substantial numbers believe the person with dementia will return to normal.


CONCLUSIONS
This study suggests that providing facts about the illness to caregivers is not enough, as caregivers may not understand that the symptoms they observe are related to the diagnosis. Education by clinicians should focus on the understanding of caregivers and in particular explore the caregivers' attributions of the symptoms which are present in the person for whom they care.
Paton
Joni
J
Department of Mental Health Sciences/Camden and Islington Mental Health and Social Care Trust, University College London, London, UK.
Johnston
Kate
K
Katona
Cornelius
C
Livingston
Gill
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000451:nursing / Q000523:psychology*; D017028:Caregivers / Q000193:education / Q000523:psychology*; D005260:Female; D006266:Health Education / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007389:Internal-External Control; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012803:Sick Role; D012920:Social Behavior Disorders / Q000209:etiology / Q000523:psychology