Social Support and Self-Rated Health Among Caregivers of Dementia: The Mediating Role of Caregiving Burden

Abstract

Background/Purpose: Background/Purpose: Taking care of beloved ones with dementia is a heavily workload and exhausting job, and substantially affects caregivers’ physical health. Empirical studies have shown social support as an external resource can help caregivers improve their physical health. However, the health benefits of social support using a multidimensional measurement among dementia caregiviers have remained unknown. In addition, this benefit may be affected by caregiving burden because less social support caused by caregiving may result in higher burden, which eventual may influence the physical health. This study examined the relationship between social support and self-rated health of dementia caregivers, and whether caregiving burden mediates such an association and how the mediating effects were.

Methods: This study used data from the baseline assessment of the Resources for Enhancing Alzheimer’s Caregiver Health (REACH II) (N=670), which was a unique multisite clinical trial that implemented and evaluated a multicomponent psychosocial intervention in five areas and lasted for 6 months. Data for 642 caregivers/care recipients dyads were collected in the randomized clinical trial at Birmingham, Memphis, Miami, Palo Alto, and Philadelphia. Self-rated health (i.e. overall health) was measured by a single item asking respondents how they rated their general health. Answers ranged from 0=excellent to 4=poor. Social support was measured by four dimensions: social network (Krause, 1995; Barrera et al., 1981), received support (Lubben, 1988), negative interaction (Krause, 1995) and satisfaction with support (Krause, 1995). Caregiver burden was measured by a 12-item Zarit caregiving burden scale (Teri et al., 1992). Age, gender, education, marital status, race, activity of daily living (ADL) and instrumental activity of daily living (IADL) were controlled in the analysis. Process for SPSS 22.0 was used to conduct the analysis.

Results: Results showed that negative interaction of social support (B=-.043, p<.05) was negatively associated with self-rated health, and levels of satisfaction with support (B=.034, p<.05) was positively related to self-rated health among caregivers after controlling all the socio-demographic variables. Burden was also significantly associated with self-rated health (B=.021, p<.001 ). After adding caregiving burden, the original relationship between negative interaction ((B=-.585, p <.001) or satisfaction with support (B=.464, p<.05) and self-rated health were statistically reduced to -.0172 and .0242 respectively. The results of the Sobel test indicated a significant effect of caregiving burden on negative interaction and self-rated health (b=-.017, z= -4.57, p =.000) as well as interaction with support and self-rated health (b=.024, z= 4.38, p =.000).

Conclusions and Implications: This finding suggests the need for programs and practice on educating caregivers regarding how to identify, approach, and gain their social supports and improve their satisfaction with social support when caring for their loved ones with dementia. Findings also highlight the importance of minimizing the interpersonal conflicts with others between when caregivers provide care for people with dementia. Reducing caregiving burden, keeping balance in health and caregiving burden are also essential for caregiver’s overall health. By providing more programs aimed at reducing caregiving burden, social workers may help primary caregivers enjoy more leisure time and improve healthy conditions.