The effects of duration of caregiving on institutionalization.
OBJECTIVE
Our objective in this analysis was to determine how the duration of caregiving interacts with key care demands (i.e., severity of problem behaviors) to influence the institutionalization of individuals suffering from dementia.


METHODS
We utilized multiregional data from 4,761 caregivers of individuals with dementia over a 3-year period. We conducted multinomial logistic and Cox proportional hazards analyses to determine the moderating effects of duration on behavior problems when institutionalization was predicted. Baseline covariates included the context of care, primary objective stressors, primary subjective stressors, resources, and global outcomes.


RESULTS
The Duration of care x Behavior problems interaction term was not significant in the multinomial regression or Cox hazards models. However, main effects models demonstrated that more recent caregivers were more likely to institutionalize individuals with dementia than respondents in different stages of the caregiving career.


CONCLUSIONS
The results emphasize the need to (a) broaden scientific conceptualizations to consider duration of care as integral; (b) refine targeting when interventions are administered early in the dementia caregiving process; and (c) understand patterns of attrition when caregiver adaptation is modeled over time.
Gaugler
Joseph E
JE
Department of Behavioral Science, University of Kentucky, 110 College of Medicine Office Building, Lexington, KY 40536, USA. jgaugle@uky.edu
Kane
Robert L
RL
Kane
Rosalie A
RA
Clay
Ted
T
Newcomer
Robert C
RC
D003704:Dementia / Q000451:nursing; D006801:Humans; D007326:Institutionalization; D014481:United States