ALZHEIMERS-DISEASE AFFLICTED SPOUSES WHO REMAIN AT HOME - CAN HUMAN DIALECTICS EXPLAIN THE FINDINGS

When one spouse has Alzheimer's disease (AD), marital interactions ten d to decline. Findings from this study suggest that level of spousal i nteractions influence longitudinal outcomes for afflicted spouses. Thi rty AD spouses and their spouse caregivers were assessed at baseline ( time 1) and two years later (time 2). Continued in-home care at time 2 is predicted by high levels of positive spousal interactions, high ca regiver commitment, good caregiver health, and shorter time as caregiv er (all assessed at time 1). The same variables but in an inverse rela tionship predict which AD spouses are deceased at time 2. Nursing home placement is predicted by AD spouses' higher educational level, unhap py marital relationships, and low caregiver commitment. Afflicted spou ses' cognitive and functional impairment levels, their physical health and depression do not predict outcomes. A theoretical explanation is developed drawing on Riegel's dialectical theory of human development and Bowlby's attachment theory. It is suggested that interactions betw een spouses are crucial for afflicted spouses' survival.