Summary
Little is known about the effectiveness of caregiver management strategies on the functioning of the demented patient. However, identification of specific caregiver strategies may provide useful information on the management and manifestation of behavioural problems in dementia.
In the MAAstricht Study of BEhaviour in Dementia (MAASBED) ninety-nine patients with dementia and their informal caregivers were followed up for one year. Interviews were used to assess differences in caregiver management strategies. Behavioural disturbances in the patient were measured with the Neuropsychiatric Inventory (NPI). Repeated measures analysis was carried out to investigate the relationship between caregiver management strategies and patient behaviour.
Results showed that three caregiver management strategies were identified, based on whether caregivers accepted, or not, the caregiving situation and dementia related problems. Caregivers characterized by non-acceptance were typified as ‘Nonadapters’; caregivers characterized by acceptance were further subdivided into two groups typified as ‘Nurturers’ and ‘Supporters’. Caregiver characteristics such as sex, education and personality were important determinants of management strategies. Furthermore, non-adapters reported significantly more hyperactivity symptoms in patients and felt less competent than did supporters. Supporters felt most competent and reported the least hyperactivity symptoms in the patient.
In conclusion, caregiver management strategies appear to be associated with behavioural problems in dementia and feelings of caregiver competence. Intervention programmes, aimed at teaching caregivers adequate management strategies, may reduce problem behaviours in the patient en caregiver burden.