title: The effects of duration of caregiving on institutionalization.
abstract: 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.
authors.affiliation: Department of Behavioral Science, University of Kentucky, 110 College of Medicine Office Building, Lexington, KY 40536, USA. jgaugle@uky.edu
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Gaugler
authors.forename: Robert L
authors.initials: RL
authors.lastname: Kane
authors.forename: Rosalie A
authors.initials: RA
authors.lastname: Kane
authors.forename: Ted
authors.initials: T
authors.lastname: Clay
authors.forename: Robert C
authors.initials: RC
authors.lastname: Newcomer
mesh_terms: D003704:Dementia / Q000451:nursing; D006801:Humans; D007326:Institutionalization; D014481:United States