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Experiences and Perspectives of Family Caregivers of the Person with Dementia

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Abstract

The concepts of intergenerational equity, relational reciprocity and the dynamics of familial caregiving have long been a source of inquiry for social scientists, health care advocates and wellness experts. Like knowledge of the various dementias themselves, the body of information about the perceived experience of caring for a family member(s), with an Alzheimer’s type dementia, has been amassed over the last 20 years.

This chapter will discuss the profile of the contemporary family caregivers for persons with cognitive impairment. It briefly surveys the diversity that exists, among people who assume, or inherit a caring or care coordination role within a family. Commonalities, shared experiences and normative benchmarks for the likely course of caring for a cognitively impaired family member will be examined from six perspectives using the words of actual families it illustrates the realities of dementia care. These perspectives are physical care, lifestyle changes, emotional and psychological needs of the ill person and their carers, relational changes, pragmatic (legal and financial) dimensions and ethical decision-making dilemmas. The phases families encounter, during a journey with dementia, parallels the progression of illness over time, and has been referred to, in lay person terms, as “First Fear to Last Tear” [Bretcher (Alzheimer’s Association, Saint Louis Chapter; 2013)]. The impact on caregivers, from disease related experiences, across the continuum of long term dementia care, will be examined in terms of their negative or positive influence on well-being.

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References

  1. Gillick MR. The critical role of caregivers in achieving patient-centered care. JAMA. 2013;310(6):575–6.

    Article  CAS  PubMed  Google Scholar 

  2. Alzheimer’s Association. Late stage caregiving: your role as a caregiver. 2014.

    Google Scholar 

  3. Gitlin LN, Schultz R. Family caregiving of older adults. In: Prohaska RT, Anderson LA, Binstock RH, editors. Public health for aging society. Baltimore, MD: The Johns Hopkins University Press; 2014. p. 181–204.

    Google Scholar 

  4. Ory MG, Hoffmann RR, Yee JL, Tennstedt S, Schulz R. Prevalence and impact of caregiving: a detailed comparison between dementia and nondementia caregivers. Gerontologist. 1999;39(2):177–86.

    Article  CAS  PubMed  Google Scholar 

  5. Rava S. Swimming solo: a daughters memoir of her parets, his parents and Alzheimer’s disease. Sewanee, TN: Plateau books; 2011.

    Google Scholar 

  6. Bouldin ED, Anderson E. Caregiving across the United States: caregivers of persons with Alzheimer’s disease or dementia in 8 states and the District of Columbia. Data from 2009 and 2010 Behavioral Risk Factor Surveillance System [Internet]. 2010

    Google Scholar 

  7. Meuser TM, Berg-Weger M, Chibnall JT, Harmon AC, Stowe JN. Assessment of readiness for mobility transition (ARMT): a tool for mobility transition counseling with older adults. J Appl Gerontol. 2013;32(4):484–507. doi:10.1177/0733464811425914.

    Article  PubMed  Google Scholar 

  8. Caregiving NAf, AARP. Caregiving in the U.S. Unpublished data analyzed under contract for the Alzheimer’s Association. 2009.

    Google Scholar 

  9. Fuller-Jonap F, Haley WE. Mental and physical health of male caregivers of a spouse with Alzheimer’s disease. J Aging Health. 1995;7(1):99–118.

    Article  CAS  PubMed  Google Scholar 

  10. Ohio department of aging. Whom does caregiving affect? 2009. Available from: http://aging.ohio.gov/resources/publications/Caregiver_Fact_Sheet_1-866.pdf

  11. Robinson CA, Bottorff JL, Besut B, Oliffe JL, Tomlinson J. The male face of caregiving: a scoping review of men caring for a person with dementia. Am J Mens Health. 2014;8(5):409–26.

    Article  PubMed  Google Scholar 

  12. National Institute on Aging. Alzheimer’s disease and education center: intimacy sexuality and Alzheimer’s disease: a resource list. 2008. Available from: http://www.nia.nih.gov/alzheimers/intimacy-sexuality-and-alzheimers-disease-resource-list

  13. Bookwala J, Schulz R. A comparison of primary stressors, secondary stressors, and depressive symptoms between caregiving husbands and wives: The caregiver health effects study. Psychology and aging. 2000;15:607–616.

    Google Scholar 

  14. Fisher GG, Franks MM, Plassman BL, Brown SL, Potter GG, Llewellyn D, et al. Caring for individuals with dementia and cognitive impairment, not dementia: findings from the aging, demographics, and memory study. JAM Geriatr Soc. 2011;59(3):488–94.

    Article  Google Scholar 

  15. Schumacher LAP, MacNeil R, Mobily K, Teague M, Butcher H. The leisure journey for sandwich generation caregivers. Ther Recreat J. 2012;46(1):42–60.

    Google Scholar 

  16. Hammer LB, Neal MB. Working sandwiched-generation caregivers: prevalence, characteristics, and outcomes. Psychol-Manag J. 2008;11(1):93–112.

    Google Scholar 

  17. Riley LD, Bowen CP. The sandwich generation: challenges and coping strategies of multigenerational families. Fam J. 2005;13(1):52–8.

    Article  Google Scholar 

  18. Loomis LS, Booth A. Multigenerational caregiving and well-being. J Fam Issues. 1995;16(2):131–48.

    Article  Google Scholar 

  19. Rubin R, White-Means S. Informal caregiving: dilemmas of sandwiched caregivers. J Fam Econ Iss. 2009;30(3):252–67.

    Article  Google Scholar 

  20. National down syndrome society. 2014. Available at: http://www.ndss.org/

  21. Chen H. Down syndrome: prognosis. Updated 8.2014. Medscape [Internet]. 2014.

    Google Scholar 

  22. Lancet Neurology (The). Strengthening connections between Down syndrome and AD. Lancet Neurol 2013;12(10):931.

    Google Scholar 

  23. Institute MMM. The Metlife study of caregiving costs to working caregivers: double jeopardy for baby boomers caring for their parents. 2011.

    Google Scholar 

  24. Alzheimer’s Association. Alzheimer’s disease facts and figures. 2014. pp. 30–58.

    Google Scholar 

  25. Hargrave R. Caregivers of African-American elderly with dementia: a review and analysis. Annals Long-term Care. 2006;14(10).

    Google Scholar 

  26. Haley WE, Gitlin LN, Wisniewwski SR, Mahoney DF, Coons DW, Winter L, et al. Well-being, appraisal, and coping in African-American and Caucasian dementia caregivers: findings from the REACH study. Aging Ment Health. 2004;8(4):316–29.

    Article  CAS  PubMed  Google Scholar 

  27. Institue MLMM. Still out, still aging: the MetLife study of lesbian, gay, bisexual and transgender baby boomers. 2010.

    Google Scholar 

  28. Achenbaum WA. How boomers turned conventional wisdom on its head a historian’s view on how the future may judge a transitional generation. Metlife mature market institute. 2012.

    Google Scholar 

  29. Ganguli M, Dodge HH, Shen C, Panday RS, DeKosky ST. Alzheimer’s disease and mortality: a—year epidemiological study. Arch Neurol. 2005;62(5):779–84.

    Article  PubMed  Google Scholar 

  30. Caregiving NAf, Schulz R, Cook T, Pittsburgh UCfSURDoPUo. Caregiving costs: declining health in the Alzheimer’s caregiver as dementia increases in the care recipient. 2011.

    Google Scholar 

  31. AgingCare.com. Thirty percent of caregivers die. 2014. Available from: http://www.agingcare.com/Discussions/Thirty-Percent-of-Caregivers-Die-Before-The-People-They-Care-For-Do-97626.htm

  32. Mavarid M, Paola M, Spazzaumo L, Mastriforti R, Rinaldi P, Polidori C, et al. The caregiver burden inventory in evaluating the burden of caregivers of elderly demented patients: results from a multicenter study. Aging Clin Exp Res. 2013;17(1):46–53.

    Google Scholar 

  33. Carr D, Duchek JM, Meuser TM, Morris JC. Older adult drivers with cognitive impairment. Am Fam Physician. 2006;73(6):680–7.

    Google Scholar 

  34. Carr DB, Ott BR. The older adult driver with cognitive impairment “it’s a very frustrating life”. JAMA. 2010;303(16):1632–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Kohm R, Surti GM. Management of behavioral problems in dementia. J Med Health. 2008;91(11):335–8.

    Google Scholar 

  36. Levy ML, Miller BL, Cummings JL, Fairbanks LA, Craig A. Alzheimer disease and frontotemporal dementias behavioral distinctions. Arch Neurol. 1996;53(7):687–90.

    Article  CAS  PubMed  Google Scholar 

  37. Lyons KS, Zarit SH, Sayer AG, Whitlatch CJ. Caregiving as a dyadic process: perspectives from caregiver and receiver. J Gerontol Psychol Sci. 2002;57B(3):195–204.

    Article  Google Scholar 

  38. Morris SE, Cuthbert BN. Research domain criteria: cognitive systems, neural circuits, and dimensions of behavior. Dialogues Clin Neurosci. 2012;14(2):29–37.

    PubMed  PubMed Central  Google Scholar 

  39. Boss P. Ambiguous loss: Harvard University Press. Cambridge, MA.

    Google Scholar 

  40. Kind V. The caregiver’s path to compassionate decision making: making choices for those who can’t (Home Nursing Caring). Austin, TX: Greenleaf book group; 2010.

    Google Scholar 

  41. Beauchamp TL, Childress JF. Principles of biomedical ethics. 5th ed. New York: Oxford University Press; 2001.

    Google Scholar 

  42. Kolcaba KY, Fisher EM. A holistic perspective on comfort care as an advance directive. Crit Care Nurs Q. 1996;18(4):66–76.

    Article  CAS  PubMed  Google Scholar 

  43. Alzheimer’s Association. Alzheimer news: new statement to medical community demands a dignified diagnosis of dementia. 2009.

    Google Scholar 

  44. Robinson KM, Buchwalter KC, Reed D. Predictors of use of services among dementia caregivers. West J Nurs Res. 2005;27(2):126–40.

    Article  PubMed  Google Scholar 

  45. Pew Research Center. The return of the multi-generational family household. A social and demographic trends report. 2010.

    Google Scholar 

  46. Mollica RF. Coordinating services across the continuum of health, housing, and supportive services. J Aging Health. 2003;15:165–88.

    Article  PubMed  Google Scholar 

  47. Zarit SH, Kim K, Femia EE, Almeida DM, Savla J, Molenaar PCM. Effects of adult day care on daily stress of caregivers: a within-person approach. J Gerontol Ser B Psychologic Sci Soc Sci. 2011.

    Google Scholar 

  48. Kane RL, West JC. It shouldn’t be this way—the failure of long term care. Nashville, TN: Press V; 2005.

    Google Scholar 

  49. Zimmerman S, Sloane PD, Fletcher S. The measurement and importance of quality in tomorrow’s assisted living. In: Golant S, Hyde J, editors. The assisted living residence: a vision for the future. Baltimore: Johns Hopkins University Press; 2008.

    Google Scholar 

  50. Span P. The new old age: caring and coping. Avoiding the call to hospice. 2009.

    Google Scholar 

  51. Silverstein NM, Maslow K. Improving hospital care for persons with dementia. New York: Springer; 2006.

    Google Scholar 

  52. Schulz R, Mendelsohn AB, Haley WE, Mahoney D, Allen RS, Zhang S, et al. End-of-life care and the effects of bereavement on family caregivers of persons with dementia. N Engl J Med. 2003;349(20):1936–42.

    Article  CAS  PubMed  Google Scholar 

  53. Conversationproject.org. 2014.

    Google Scholar 

  54. Wilder HM, Oliver DP, Demiris G, Washington K. Informal hospice caregiving: the toll on quality of life. J Soc Work End Life Palliat Care. 2008;4(4):312–32.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Raleigh H, Robinson ED, Hoey J, Marol K, Jamison TM. Family care perceptions of hospice support. J Hosp Palliat Care Nurs. 2006;8(1):25–33.

    Article  Google Scholar 

  56. Robinson J, Fortinsky R, Kleppinger A, Shugrue N, Porter M. A broader view of family caregiving: effects of caregiving and caregiver conditions on depressive symptoms, health, work, and social isolation. J Gerontol: Soc Sci. 2009;64B(6):788–98.

    Article  Google Scholar 

  57. Alzheimer’s Association. Nearly 60 percent of people worldwide incorrectly believe that Alzheimer’s disease is a typical part of aging. Alzheimer’s News 2014 [Internet]. 2014.

    Google Scholar 

  58. SAGE. The issues—disability [cited 2014]. Available from: http://www.sageusa.org/issues/disability.cfm#sthash.veWCfUpO.dpufthere

  59. Association NAPS. Policy and advocacy: elder financial exploitation.

    Google Scholar 

  60. Bookman A, Kimbrel D. Families and elder care in the twenty-first century. Future Child. 2011;21(2):117–40.

    Article  PubMed  Google Scholar 

  61. Bretcher C. Alzheimer’s Association, Saint Louis Chapter. Train the trainer manual. 2013.

    Google Scholar 

  62. Brookmeyer R, Corrada MM, Curriero FC, Kawas C. Survival following a diagnosis of Alzheimer disease. Arch Neurol. 2005;59(11):1764–7.

    Article  Google Scholar 

  63. Curry LA, Wetle T. Ethical considerations. In: Evashwick CJ, editor. The continuum of long term care. 3rd ed. Clinton Park, NY: Thomson Delmar Learning; 2005. p. 279–92.

    Google Scholar 

  64. Evashwick CJ. The continuum of long term care. Clifton Park, NY: Thomson Delmar Learning; 2005.

    Google Scholar 

  65. Gaugler JE, Mittelman MS, Hepburn K, Newcome R. Clinically significant changes in burden and depression among dementia caregivers following nursing home admission. BMC Med. 2010;8:85.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Gentry M. Challenges of elderly immigrants. Hum Serv Today. 2010;6(2):1–4.

    Google Scholar 

  67. Gorospe E. Elderly immigrants: emerging challenge for the U.S. healthcare system. Internet J Healthc Adm. 2005;4(1).

    Google Scholar 

  68. Greenlee K. Leaving the farm. Generations. 2013;37(3):6–7.

    Google Scholar 

  69. Morris LW, Mobily RG, Britton PG. The relationship between marital intimacy, perceived strain and depression in spouse caregivers of dementia sufferers. Br J Med Psychol. 1988;61(3):231–6.

    Article  PubMed  Google Scholar 

  70. Noelker LS, Whitlatch CJ. Informal caregiving. In: Evashwick CJ, editor. The continuum of long-term care. 3rd ed. Clifton Park, NY: Thomson Delmar Learning; 2005. p. 29–48.

    Google Scholar 

  71. Roth DL, Haley WE, Hovarter M, Perkins M, Wadley VG, Suzanne J. Family caregiving and all-cause mortality: findings from a population-based propensity-matched analysis. Am J Epidemiol. 2013;178(10):1571–8.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Schulz R. Research priorities in geriatric palliative care: informal caregiving. J Palliat Med. 2013;16(9):1008–12.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Services USDoHaH. Frontotemporal disorders: information for patients, families and caregivers: national institutes of health. 2014.

    Google Scholar 

  74. Tay L, Chua KC, Chan M, Lim WS, Ang YY, Koh E, et al. Differential perceptions of quality of life (QoL) in community-dwelling persons with mild-to-moderate dementia. Int Psychogeriatr. 2014;26(8):1273–82.

    Article  PubMed  Google Scholar 

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Correspondence to Janis McGillick .

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McGillick, J., Murphy-White, M. (2016). Experiences and Perspectives of Family Caregivers of the Person with Dementia. In: Boltz, M., Galvin, J. (eds) Dementia Care. Springer, Cham. https://doi.org/10.1007/978-3-319-18377-0_12

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  • DOI: https://doi.org/10.1007/978-3-319-18377-0_12

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