Family caregivers of persons with dementia rely on a range of resources to provide care and cope with caregiving stressors. Informal (unpaid) and formal (paid) instrumental support contribute to diverse caregiver outcomes. Previous research of caregiver support has focused on subjective measures of help or has compared caregivers receiving formal services to those who do not. We focused instead on the effects of change in the amount of formal and informal instrumental assistance on caregivers' distress. We expected that greater gains in assistance would be associated with greater reduction of caregivers' distress. Increases in formal but not informal levels of assistance were associated with improvement in each measure of distress. Additional measures may be needed to fully understand the effects of informal and formal assistance.
Aneshensel CS, Pearlin LI, Mullan JT, et al.: Profiles in Caregiving. San Diego: Academic Press, 1995.
2.
Cantor M: Strain among caregivers: A study of experience in the United States. Gerontologist. 1983; 23: 597-604.
3.
Pearlin LI: The sociological study of stress. J Health Soc Behav. 1983; 30: 241-256.
4.
Wisniewski SR, Belle SH, Coon DW, et al.: The resources for enhancing Alzheimer's caregiver health (REACH): Project design and baseline characteristics. Psychology Aging. 2003; 18: 375-384.
5.
Ory M, Hoffman RR, Yee JL, et al.: Prevalence and impact of caregiving: A detailed comparison between dementia and nondementia caregiving subjects. Gerontologist. 1999; 39: 177-185.
6.
Gottlieb BH, Johnson J: Impact of day programs on family caregivers of persons with dementia. Guelph, Ontario: Gerontology Research Center, University of Guelph, 1995.
7.
Otswald SK, Hepburn KW, Caron W, et al.: Reducing caregiver burden: A randomized psychoeducational intervention for caregivers. Gerontologist. 1999; 39: 299-309.
8.
Zarit SH, Stephens MAP, Townsend A, et al.: Stress reduction for family caregivers: Effects of adult day care use. J Gerontol Soc Sci. 1998; 54B: S267-S277.
9.
Majerovitz SD: Formal versus informal support: Stress buffering among dementia caregivers. J Mental Health Aging. 2001; 7: 413-423.
10.
Franks M, Stephens MAP: Social support in the context of caregiving: Husbands' provision of support to wives involved in parent care. J Gerontol. 1996; 51B: 43-52.
11.
Haley WE, Levine EG, Brown SL, et al.: Stress, appraisal, coping, and social support as predictors of adaptational outcome among dementia caregivers. Psychology Aging. 1987; 2: 323-330.
12.
Ho B, Friedland J, Rappolt S, et al.: Caregiving for relatives with Alzheimer's disease: Feelings of Chinese-Canadian women. J Aging Studies. 2003; 17: 301-321.
13.
Pearlin LI, Mullan JT, Semple SJ, et al.: Caregiving and the stress process: An overview of concepts and their measures. Gerontologist. 1990; 30: 583-594.
14.
Lechner VM: Support systems and stress reduction among workers caring for dependent parents. Social Work. 1993; 38: 461-469.
15.
Chappell NL, Reid RC: Burden and well-being among caregivers: Examining the distinction. Gerontologist. 2002; 42: 772-780.
16.
Lawton MP, Brody EM, Saperstein AR: A controlled study of respite service for caregivers of Alzheimer's patients. Gerontologist. 1989; 29: 8-16.
17.
Baumgarten M, Lebel P, Laprise H, et al.: Adult day care for the frail elderly: Outcomes, satisfaction, and cost. J Aging Health. 2002; 14: 237-259.
18.
Ritchie L: Adult day care: Northern perspectives. Public Health Nursing. 2003; 20(2): 120-131.
19.
Ensel WM, Lin N: The life stress paradigm and psychological distress. J Health Social Behav. 1991; 32: 321-341.
20.
Lawton MP, Brody EM: Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist. 1969; 9: 179-186.
21.
Teri L, Truax P, Longsdon R, et al.: Assessment of behavior problems in dementia: The Revised Memory and Behavior Problems Checklist. Unpublished manuscript, 1990.
22.
Radloff L: The CES-D Scale: A self-report depression scale for research in the general population. Appl Psychol Meas. 1977; 1: 385-401.
23.
Derogatis LR, Spencer PM: The Brief Symptom Inventory (BSI): Administration and Procedures Manual-1. Baltimore, MD: Johns Hopkins University School of Medicine, Clinical Psychometric Research Unit, 1982.
24.
Linn RL, Slinde JA: The determination of the significance of change between pre and posttesting periods. Rev Educat Res. 1977; 47: 121-150.
25.
Rogosa DR: Myths about longitudinal research. In Schaie KW, Campbell RT, Meredith W, et al. (eds.): Methodological Issues in Aging Research. New York: Springer, 1988: 171-209.
26.
Willet JB: Measuring change more effectively by modeling individual growth over time. In Husen T, Postlethwaite TN (eds.): The International Encyclopedia of Education, 2nd ed.Oxford: Pergamon Press, 1994.
27.
Stoolmiller M, Duncan T, Bank L, et al.: Some problems and solutions in the study of change: Significant patterns in client resistance. J Consult Clin Psychol. 1993; 61: 920-928.
28.
Gaugler JE, Jarrott SE, Zarit SH, et al.: Respite for dementia caregivers: The effects of adult day service use on caregiving hours and care demands. Int Psychogeriatr. 2003; 15: 37-58.
29.
Malone Beach EE, Zarit SH: Dimensions of social support and social conflict as predictors of caregiver depression. Int Psychogeriatr. 1995; 7: 25-37.
30.
Kosloski K, Montgomery RJV: The effects of respite on caregivers of Alzheimer's patients: One-year evaluation of the Michigan model respite programs. J Appl Gerontol. 1993; 12: 4-17.
31.
Jarrott SE, Zarit SH, Stephens MAP, et al.: Effects of adult day service programs on time usage by employed and non-employed caregivers. J Appl Gerontol. 2000; 19: 371-388.
32.
Gaugler JE, Zarit SH, Townsend A, et al.: Evaluating communitybased programs for dementia caregivers: The cost implications of adult day services. J Appl Gerontol. 2003; 22: 118-133.
33.
Bass DM, Noelker LS, Rechlin LR: The moderating influence of service use on negative caregiver consequences. J Gerontol Soc Sci. 1996; 51B: S121-S131.
34.
Yates ME, Tennstedt S, Chang B: Contributors to and mediators of psychological well-being for informal caregivers. J Gerontol Psychol Sci Soc Sci. 1999; 54B: 12-22.
35.
Bass DM, Noelker LS, McCarthy CA: The influence of formal and informal helpers on primary caregivers' perceptions of quality of care. J Appl Gerontol. 1999; 18: 177-200.
36.
Kiecolt-Glaser JK, Dyer CS, Shuttleworth EC: Upsetting social interactions and distress among Alzheimer's Disease family caregivers: A replication and extension. Am J Commun Psychol. 1988; 16: 825-837.
