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Methods: The data were extracted from the Caregiver Survey of the 2004 National Long-Term Care Survey (NLTCS). A total of 310 informal caregivers were selected based upon three inclusion criteria: 1) completion of the questionnaire, 2) non-paid caregivers, and 3) 3 or more errors on a Short Portable Mental Health Status Questionnaire (SPMSQ) as indicative of the cognitive impairment of older adults. A dependent variable, caregiver burden was measured using four items asking caregivers about the impact of caregiving on their privacy, physical strain and social lives. Objective stressors examined were cognitive impairment and disruptive behaviors of older adults. Two supporting resources were FC and SS. Demographic variables (i.e., gender, marital status, education, and ethnicity) were also included. A hierarchical multiple-regression analysis was conducted using SPSS 22.0.
Results: The majority of caregivers were female (68.4%), white (82.3%) and married (67.7%). Consistent with prior research, greater disruptive behaviors (B= .120, β= .548, p< .001) and lower social support (B= -.028, β= -.101, p = .040) were significantly associated with higher caregiver burden. Interestingly, higher FC was related to higher burden (B= .080, β= .307, p< .001). The results also showed a significant moderating effect of FC on the relationships between disruptive behaviors and caregiver burden (= -.005, β= -.138, p= .022), making the main effect of FC on burden non-interpretable; among caregivers with low FC, greater disruptive behaviors were related to higher burden, but among caregivers with high FC, greater disruptive behaviors were related to lower burden. The results showed no moderating effect of SS on the relationships between neither of objective stressors and caregiver burden in this sample. The final regression model was significant (F =21.117, p< .001), accounting for 48.4% of the variance in caregiver burden.
Implications: The findings of this study underscore the important role of family cooperation in protecting caregivers from caregiver burden. Programs for caregivers of older adults with cognitive impairment can benefit from use of psych-educational approach that includes a component to promote family cooperation. Further research is needed to better understand how family cooperation and its impact on caregiver burden changes as disruptive behaviors of older adults advance.