Caregiver Burden and Desire for Institutional Placement –the Role of Positive Aspect of Caregiving and Religiosity Coping

Background and Purpose: Family caregivers provide the majority of care and support at home for persons with dementia (Gitlin, 2012). Caregiving related burden or bother might produce stress for family caregivers, which is a predictor of institutionalization such as nursing home placement (Gaugler et al., 2009). There is limited research that has focused on the resource of CGs, such as positive aspects of caregiving, the religiosity coping of caregivers (CG), and the concomitant CG desire to institutionalize care recipients (CR). In this study, we intended to answer the following research questions: 1) Whether caregiver burden, daily care bother, and RMBPC bother are positively associated with higher desire for institutional placement?; 2) Are positive aspect of caregiving or religiosity coping associated with lower level of desire for institutional placement?; and 3) How do positive aspect of caregiving or religiosity coping moderate the relationship between caregiver burden, daily care bother, RMBPC bother, and desire for institutional placement?

Methods: Secondary data (N = 670) were drawn from the baseline assessment of the Resources for Enhancing Alzheimer’s Caregiver Health II (REACH II) project. Descriptive analysis, bivariate correlation, as well as multiple linear regression were conducted using SPSS 22.0. Multiple linear regressions were conducted with 3 models. In the first model, demographic variables and three major independent variables of caregiver burden, daily care bother, and RMBPC bother were put in the model to answer research question 1. Then, positive aspect of caregiving and religiosity coping were added into the 2^ndmodel to answer research question 2. In the third model, six interactions between positive aspect of caregiving and religiosity coping with caregiver burden, daily care bother, and RMBPC bother were added to answer research question 3.

Results: The results indicated that higher levels of caregiver burden (β = 0.247, p <. 001), daily care bother (β = 0.102, p < .05), and RMBPC bother (β = 0.087, p < .05) were significantly associated with higher level of desire for institutional placement. Both positive aspect of caregiving and religiosity coping were negatively associated with desire for institutional placement, however, only positive aspect of caregiving was a significant factor of desire for institutional placement (β = -0.208, p < .001). Only the interaction between daily care bother and religiosity coping was significant (β = -0.064, p< .05), which indicated that the harmful effect of daily care bother on desire for institutional placement were significantly buffered among those who have religiosity coping.

Conclusions and Implications: Given the projected growth in the number of dementia caregivers, the findings have important implications for social work. CGs who perceive the caregiving experience to be positive are better able to provide care to family members with dementia in the community (versus institutional placement). Furthermore, the findings underscore the importance of supporting the CGs religiosity coping and programs that encourage CGs to use religious coping resources. Finally, social workers should work toward developing services and supports that build on the positive aspects of caregiving and religiosity among diverse groups of dementia caregivers.