The psychological health implications of social support for the Alzheimer caregiver

Abstract

Apart from the personal and socioeconomic burdens of dementia, the immense, intangible emotional and psychological suffering endured by dementia patients, their carers and families are difficult to quantify. Alzheimer’s dementia (AD) accounts for over 50% of all dementias and is responsible for a large percentage of morbidity and mortality in older adults. It is also recognised as a disease qualitatively distinct from the normal ageing process. Identified almost 95 years ago by Alois Alzheimer, it poses a seminal problem, which in the twenty-first century is compounded by the predicted extension in human longevity. Caregivers thus bear a considerable financial, social and emotional burden due to the progressive debilitating nature of the disease. It is hypothesised that social support buffers the individual from the negative emotional effects of stressful circumstances associated with the caregiving process; and although the inevitable course of the disease cannot be stopped, improving support to caregivers may decrease feelings of isolation and improve psychological health. Caregivers of AD patients often report experiencing a lack of social support due to the nature and progression of this disease. This study thus aims to investigate the relationship between real and/or perceived social support and psychological health (depression, loneliness, and perceived burden of care) amongst a cohort of Alzheimer’s caregivers. The following standardised measuring instruments were used to elicit data: the Zarit Burden Interview (ZBI), the Beck Depression Inventory (BDI-II), UCLA Loneliness Scale, Personal Resource Questionnaire (PRQ85) and a biographical questionnaire. Data were analysed using correlation and regression statistical techniques. The main findings of this study were that there is a significant positive correlation between loneliness and depression; loneliness and personal strain (burden) as well as both role and personal strain (burden) with depression. A significant negative correlation was also found between perceived social support and loneliness. Additional findings were that participants with higher educational qualifications experienced more personal strain and role strain (burden); caregivers with patients in the two younger age groups scored higher on the BDI-II; and the cognitive status of the patient correlated with the burden experienced by the caregiver. A significant negative correlation between summaries of reactions (burden) and duration of caregiving was also reported.