The stress process of family caregiving in institutional settings

Purpose: This study adapts the Stress Process Model (SPM) of family caregiv ing to examine the predictors of depression in a sample of caregivers (n = 133) with demented relatives residing in suburban skilled nursing facilitie s. Design and Methods: We interviewed family caregivers. of family members residing in skilled nursing homes using a variety of measures to assess pri mary stressors, secondary strain, nursing home stressors, and caregiver dep ression. We used block-wise regression analyses to determine the predictors of caregiver depression. Results: Results indicated that positive resident adjustment to placement was best predicted by the closeness of the residen t-caregiver relationship and nursing home stressors. Caregiver strain, resi dent adjustment, and nursing home stressors best predicted caregiver adjust ment. In turn, the best predictors of caregiver depression included caregiv er age, caregiver adjustment to the nursing. home, and nursing home stresso rs. Implications. These results suggest that caregiver depression is closel y linked to how well both the resident and caregiver adjust to the nursing home environment. Results also indicate that by broadening the SPM to inclu de stressors common to the nursing home experience, researchers, will be ab le to understand more clearly the specific components of the stress process that may lead to depression in family caregivers of persons living in nurs ing homes.