Institutionalization of demented elderly: the role of caregiver characteristics

Abstract

Background Three sets of caregiver characteristics were examined withrespect to their explanatory value for institutionalization of dementedelderly people: commitment to the caregiving relationship, psychologicaldistress, and personality traits.Method Logistic regression was used to test whether these caregivercharacteristics were risk factors for institutionalization of dementedelderly people in the first year after baseline measurement (N=138).Control variables were caregivers' sex, age and education.Results The results showed the importance of commitment to thecaregiving relationship, indicated by type of relationship betweencaregiver and care recipient. Demented people cared for by non-spouseswere more likely to be institutionalized as compared to those cared forby spouses. For non-spouse care-givers, being more extravert increasedthe likelihood of institutional placement, whereas for spouse caregiversperceiving more pressure from informal increased this likelihood.Conclusions These findings are in agreement with the assumption thatnon-spouses are less strongly committed to the caregiving relationshipas compared to spouses. Results were independent from elders' impairmentin cognitive functioning and (Instrumental) Activities of Daily Living.Caregivers' psychopathology was not a risk factor at all, which is amatter of concern, regarding the consequences for caregivers' own healthand health-care utilization, but also for their treatment of thedemented elder. Copyright (C) 2001 John Wiley & Sons, Ltd.