Caregiving Intensity and Psychological Well-Being for Dementia Caregivers: The Roles of Social Support and Religiosity

Background and Purpose: In recent years dementia has become a growing concern as it is affecting increasing numbers of older adults. According to the Alzheimer’s Association (2015), caregivers have provided an estimated 17.9 billion hours of care to maintain the demand for their loved ones with dementia. With the onset of increasing numbers of dementia patients, caregivers’ psychological well-being is decreasing as demand increases (Heo & Koesk, 2011). However, few studies have showed how caregiving intensity or the number of hours of care has affected psychological well-being of dementia caregivers. Research has shown that social support and religiosity are very important for psychological well-being among dementia caregivers (Hebert, Dang, & Scbulz, 2007). However, few studies have investigated their moderating roles on the association between caregiving intensity and psychological well-being. Using stress coping theory, the purpose of the present study was to test whether and how social support and religiosity played roles in the association between caregiving intensity and psychological well-being among dementia caregivers using a large dataset.

Methods: Data for this study were drawn from the baseline assessment of the Resources for Enhancing Alzheimer’s Caregiver Health (REACH II) (N=566). The dependent variables were depression symptoms and caregiver burden which were measured by CESD-10 and 12-item Zarit caregiving burden scale respectively. The main independent variables were caregiving intensity, social support, and religiosity coping. Caregiving intensity was measured by one question regarding how many hours caregivers actually spend on taking care of family members with dementia. Social support was measured using Lubben social network, received support and satisfaction with support, and negative interaction, all of which were measured using standard scales. Religiosity coping was measured by short form of the Brief Religious Coping scale (six items). Multivariate regression models were conducted while controlling social-demographic variables of age, gender, education, income, ethnicity, and physical health.

Results: The regressions showed that more caregiving hours were positively associated with more caregiving burden and higher levels of depressive symptoms after controlling all the socio-demographic variables. Receiving more support and perceiving higher levels of satisfaction with support, less negative social interaction, and more religiosity utilization were also significantly related to fewer caregiving burden and depressive symptoms. Results further indicated that social network was a significant moderator for the relationships between caregiving intensity and caregiving burden and depressive symptoms among these dementia caregivers.

Conclusion and implication: Our finding reveals a significant negative association of caregiving intensity and psychological well being of dementia caregivers as well as the important roles of social support and religiosity. This finding suggests the need for programs and practice on educating caregivers regarding how to identify, approach, and gain their social supports, especially how to enlarge social network when caring for their loved ones with dementia. There is also a need to help dementia caregivers to utilize religiosity to cope with stress and depression.