Ementia caregiving in spousal relationships

a critique or reaction of Dementia disorder as per article and DSM5(Dementia + one variable)about dementia and the spouses who are caregivers to spouses with Dementia. 3 pages. Use one article plus the DSM5 diagnosis of Dementia Disorder. Article:Aging & Mental Health
Vol. 13, No. 3, May 2009, 426a 436
Dementia caregiving in spousal relationships: A dyadic perspective.
(American Psychological Assoc.)
Braun, M., Scholz, U., Bailey, B., Perren, S., Hornung, R., & Martin, M. (2009). Dementia caregiving in spousal relationships: A dyadic perspective. Aging & Mental Health, 13(3), 426-436. doi:10.1080/13607860902879441
Article Content: Objectives:
The number of couples facing a dementia diagnosis for one partner of the spousal dyad increases.
Spousal caregiving can be a highly stressful experience associated with negative caregiver outcomes such as
depression and poorer immune function. However, surprisingly little is known about how the illness and the
required care effects patientas well-being and relational changes experienced by afflicted couples. The aim of this
study was to provide a literature review on how the dyadic perspective is taken into account and on how dementia
effects both parts of the dyad.
In order to outline findings about individual and dyadic well-being of affected couples, we conducted a
literature search to review the three types of studies. First, studies focusing on one partneras perspective, usually
the perspective of the caregiver; second, studies including the caregiveras and partially the care receiveras view;
third, studies directly referring to both partnersa perspectives.
The majority of studies neglect the individual with dementia by exclusively assessing caregiver variables
or only indirectly including patientsa characteristics. Very few studies embrace dyadic and relational variables to
execute how both partners experience the illness, spousal caregiving, and changes in the relationship. Despite the
arguable validity of self reports of individuals with dementia, some studies demonstrated the usefulness of
including both partnersa perspectives.
Results indicate the urgent need of integrating the perspective of the individual with dementia to
improve the understanding of the effects of dementia caregiving. Directly assessing the dyadic perspective of
affected couples provides essential information for interventions.
dementia care; spousal caregiving; dyadic perspective
Due to increased life expectancy, a growing number of
older couples have to face the transition to a caregiving
relationship when one spouse becomes physically ill,
frail, or develops dementia. Following this societal
development, scientific dementia literature reveals
growing interest in afflicted partners. However,
research on dyadic variables and developments is
rarely found. Thus, we consider it timely and necessary
to review the existing caregiving literature with regard
to what can currently be said about the impact of
dementia on relationship dynamics, as well as on
individual and dyadic well-being of afflicted couples.
Furthermore, we aim to outline the main deficits of
past research and demonstrate potential gains of
dyadic studies indicating both partnersa perspectives.
Dementia is a syndrome indicating brain and
cognitive dysfunction causing significant impairment
in social functioning (Bondi & Lange, 1998). Since this
article concentrates on the impact of dementia on
dyadic processes, we do not discriminate in the
following between different dementia forms when
using the term dementia.
Due to growing impairments in the course of the
illness, personal relationships of people who suffer
from dementia, such as the relationship between the
caregiver and the care recipient, may be negatively
impacted. The provision of care for a spouse with
dementia can be physically and mentally demanding
and stressful. Consequently, many studies have
demonstrated increased stress levels and other negative
consequences for spousal caregiversa health and quality
of life (e.g., Pinquart & Soerensen, 2003; Vitaliano,
Zhang, & Scanlan, 2003). There are, however, also
contrary results indicating differences between care-
givers with respect to their adaptability to the
caregiving situation (Alspaugh, Stephens, Townsend,
Zarit, & Greene, 1999; Danhauer et al., 2004; Gaugler,
Davey, Pearlin, & Zarit, 2000; Schulz & Williamson,
1991). Nonetheless, the overall knowledge on the
caregiveras mental and physical well-being is broad.
In contrast, relatively little is known about how
caregiver and care receiver variables interact. Taking
both perspectives into account might not only help to
explain some of the ambiguous findings on the
caregiver side but also to get a better understanding
*Corresponding author. Email: Melanie.Braunpsychologie.uzh.ch
ISSN 1360a 7863 print/ISSN 1364a 6915 online
2009 Taylor & Francis
DOI: 10.1080/13607860902879441
care*a, a?dyad* dementiaa was performed using the data
bases PsycINFO and pubmed. Focusing on a dyadic
perspective, studies on dementia caregiving can be
categorized by the amount to which they take dyadic
processes into account. Here, three data collection
methods can be distinguished, as follows.
First, data about the caregiving situation are
gathered from one person only, usually from the
caregiver. This type of study design focuses only on
variables from one individual indicating no dyadic
perspective per se. The only data concerning the
partner are typically the diagnosis, age, and gender.
Although these factors are relevant, they do not
include aspects of dyadic interactions.
Second, data are collected from both partners of
the caregiving dyad, whereas one individualas perspec-
tive is directly and the partneras perspective is indirectly
measured (e.g., by using caregiver information to
assess care receiver variables or dyadic constructs).
Third, some studies include directly measured data
from both partners. In this case, the dyadic perspective
is adequately integrated in the analyses. Each of these
data collection designs offers its advantages and
disadvantages, which we will describe in the following
Studies focusing on one part of the dyad:
The caregiveras perspective a Overview
The literature search revealed a high number of studies
on spousal dementia caregiving by analyzing the
perspective of the caregiver. For instance, the term
a?dementia care* spous*a led to more than 270 items.
Due to the high number of studies and our main focus
on dyadic variables, we only describe some example
studies exclusively assessing caregiver variables.
Furthermore, comprehensive meta-analytic data
giving a broad overview of the caregiveras situation
(e.g., Pinquart & Soerensen, 2003; Vitaliano et al.,
2003) are recommended for interested readers.
Studies solely referring to caregiver features
provide information on the impact of caregiving on
the dementia caregiveras health and well-being.
Negative outcomes associated with spousal caregiving
are well documented in the research literature
(Kiecolt-Glaser, Dura, Speicher, Trask, & Glaser,
1991; Pinquart & Soerensen, 2003; Schulz, OaBrien,
Bookwala, & Fleissner, 1995). Although carers
averagely report hig