CLINICAL DIAGNOSES AND DISABILITY OF COGNITIVELY IMPAIRED OLDER PERSONS AS PREDICTORS OF STRESS IN THEIR CARERS

Background. Aspects of the caring relationship are often promoted as m ore important than the clinical features of the care recipient in pred icting caregiver wellbeing. However, studies of consequences of caring for cognitively impaired people seldom include detailed measures of t he diagnostic profile and disability of the care recipient. Methods. N inety community-living elderly persons with cognitive impairment were clinically assessed for severity on a range of illnesses. Their disabi lity was examined via informant reports. Informants (88% of whom were primary carers) provided information on the behaviour and personality of the subject and reports of their own (informant) wellbeing. Using m ultiple regression, features of the subjects' clinical profile (severi ty of diseases, disability, behavioural problems and personality chang e) were examined as predictors of informant wellbeing. After controlli ng for subject clinical profile, we explored the additional associatio ns between informant stress measures and other descriptors of the subj ect, caregiver and their relationship. Results. The subjects' clinical characteristics, in particular disability and disturbed behaviour, we re strong predictors of caregiver wellbeing, accounting for most of th e explained variance. After control for the subjects' clinical profile , few of the sociodemographic, caregiver or relationship variables exa mined had any influence on caregiver outcome measures. The exceptions were caregiver time demands, older subject age and self-identification as primary carer. Coresidence was not associated with caregiver distr ess. Conclusion. Clinical characteristics of the care recipient are de terminants of caregiver wellbeing, while sociodemographic, caregiver a nd relationship characteristics are less influential. (C) 1997 John Wi ley & Sons, Ltd.