title: Experience of burden in carers of people with dementia on the margins of long-term care.
abstract: OBJECTIVE
  This study aimed to identify the factors determining carer burden in a group of carers supporting people with dementia (PwD) deemed to be at high risk of moving to long-term residential or nursing home care.
  
  
  METHODS
  National data collected as part of the European RightTimePlaceCare project were analysed. This included 81 dyads of community-dwelling people with dementia and their informal carers.
  
  
  METHODS
  Structured face-to-face interviews were conducted in North West England between June 2011 and April 2012. Interviews collected data relating to the person with dementia (cognitive functioning, activities of daily living, neuropsychiatric symptoms and formal and informal dementia care resource use) and carers' level of burden (22-item Zarit Burden Index), hours spent caring and availability of additional informal support.
  
  
  RESULTS
  Logistic regression analysis identified five factors associated with high carer burden: neuropsychiatric symptomatology in the PwD, intensive supervision of the PwD by the carer, being a female carer, being an adult-child carer and absence of informal carer support. Use of home care or day care services was unrelated to burden.
  
  
  CONCLUSIONS
  Support programmes focusing on challenging behaviours and risk management may be of benefit to carers. More individually tailored interventions for specific carer groups including female or younger carers may be warranted. The implementation of peer support networks could be beneficial to carers who lack additional family support.
authors.affiliation: Personal Social Services Research Unit, University of Manchester, Manchester, UK.
authors.forename: Caroline L
authors.initials: CL
authors.lastname: Sutcliffe
authors.affiliation: Personal Social Services Research Unit, University of Manchester, Manchester, UK.
authors.forename: Clarissa M
authors.initials: CM
authors.lastname: Giebel
authors.affiliation: Personal Social Services Research Unit, University of Manchester, Manchester, UK.
authors.forename: David
authors.initials: D
authors.lastname: Jolley
authors.affiliation: Personal Social Services Research Unit, University of Manchester, Manchester, UK.
authors.forename: David J
authors.initials: DJ
authors.lastname: Challis
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003704:Dementia / Q000451:nursing* / Q000523:psychology; D004739:England; D005260:Female; D006801:Humans; D016015:Logistic Models; D008134:Long-Term Care / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013315:Stress, Psychological / Q000209:etiology* / Q000523:psychology
keywords: care support; carer burden; dementia; neuropsychiatric symptoms