title: Predictors of change in caregiver burden and depressive symptoms following nursing home admission.
abstract: Prior research has yielded discrepant findings regarding change in caregiver burden or depressive symptoms after institutionalization of persons with dementia. However, earlier studies often included small postplacement samples. In samples of 1,610 and 1,116 dementia caregivers with up to 6 months' and 12 months' postplacement data, respectively, this study identified predictors of change in caregiver burden and depressive symptoms following nursing home admission. Descriptive analyses found that caregivers reported significant and considerable decreases in burden in the 6- and 12-month postplacement panels. A number of variables predicted increased burden and depressive symptoms in the 6- and 12-month postplacement panels. Preplacement measures of burden and depressive symptoms, site (Florida), overnight hospital use, and spousal relationship appear to result in impaired caregiver well-being following nursing home admission. Incorporating more specific measures of stress, considering the influence of health-related transitions, and coordinating clinical strategies that balance caregivers' needs for placement with sustainability of at-home care are important challenges for future research.
authors.affiliation: Center on Aging, School of Nursing, University of Minnesota, Minneapolis, MN 55455, USA. gaug0015@umn.edu
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Gaugler
authors.forename: Mary S
authors.initials: MS
authors.lastname: Mittelman
authors.forename: Kenneth
authors.initials: K
authors.lastname: Hepburn
authors.forename: Robert
authors.initials: R
authors.lastname: Newcomer
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology / Q000628:therapy*; D017028:Caregivers / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007326:Institutionalization; D008134:Long-Term Care; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009735:Nursing Homes; D017063:Outcome Assessment, Health Care; D010343:Patient Admission; D011336:Probability; D012307:Risk Factors; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*