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Caregiver's Burden with the Alzheimer Patient

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Laura Claypool

on 22 November 2013

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Transcript of Caregiver's Burden with the Alzheimer Patient

Caring for a Loved one with Alzheimer's Disease

Review of Literature
Nursing Research Questions
- Does gender play a role in how caregiver's reacted or cope with the burden of caring for a spouse with Alzheimer's disease?
- Does culture play a role in the caregiver's health behavior when caring for a spouse?
- Are caregiver's physical and psychosocial health being overlooked?

Implications for Future Nursing Research
- Should focus on health care disparities in the home health care setting regarding the treatment for those with AD.
- The older adult (65yo +) population is rapidly growing and expected to exceed 70 million by 2030.
- Daycares for individuals with AD, Home Health Aides, Alternative Therapies
- Are therapies specific to the care of AD patients being catered the caregivers who implement them?
- Understanding the motives behind caregiving
- Can allow for greater insight into the psychosocial health of the caregiver and a direction on how to improve a caregiver's psychosocial health.
- Identifying sleep patterns, physical activity engagement and eating patterns of caregivers
- Coping Mechanisms
- Akpinar, B., Kucukguclu, O., & Yener, G. (2011). Effects of gender on burden among caregivers of alzheimer's patients. (Master's thesis, Dokuz Eylul University School of Nursing, Izmir, Turkey).
- Alberca, J., Castilla, C., Cruz, B., Garrido, V., Gris, E., Lara, A., & Lara, J. (2012).
Disengagement coping partially mediates the relationship between caregiver burden and anxiety and depression in caregivers of people with alzheimer's disease. Journal of Affective Disorders, 136, 848-856.
- Allison, M., Anconi, S., Dimsdale, J., Grant, I., Harmell, A., Mills, P., … Ziegler, M. (2011). The relationship between self-efficacy and resting blood pressure in spousal alzheimer's caregivers. British Journal of Health Psychology, 16, 317-328.
- Anders, C., Han, G., & Hayslip, B. (2008). Predictors of alzheimer's disease caregiver depression and burden: What noncaregiving adults can learn from active caregivers. Educational Gerontology , 34, 945-969. doi: 10.1080/03601270802016481
- Callone, P. R. (2006). A Caregiver's Guide to Alzheimer's Disease : 300 Tips for Making Life Easier. New York: Demos Medical Pub.
-Canonici, A., Andrade, L., Gobbi, S., Santos-Galduroz, R., Gobbi, L., & Stella, F. (2012). Functional dependence and caregiver burden in Alzheimer's disease: a controlled trial on the benefits of motor intervention. Psychogeriatrics, 12(3), 186-192. doi:10.1111/j.1479-8301.2012.00407.x

References (Cont.)
- Chin, A., Negash, S., & Hamilton, R. (2011). Diversity and disaprity in dementia: the impact of ethnoracial differences in Alzheimer disease. Retrieved from
- Coakley, D., Coen, R., Crosby, L., Cunningham, C., Gallagher, D., Lacey, L., … Walsh, J. (2011). Self-efficacy for managing dementia may protect against burden and depression in alzheimer’s caregivers. Aging & Mental Health, 15(6), 663-670.
- Del-Pino-Casado, R., Frías-Osuna, A., Palomino-Moral, P. A., & Ramón Martínez-Riera, J.
(2012). Gender Differences Regarding Informal Caregivers of Older People. Journal Of Nursing Scholarship, 44(4), 349-357. doi:10.1111/j.1547-5069.2012.01477.x
- Del-Pino-Casado, Rafael, PhD, RN, Frias-Osuna, A., & Palomino-Moral, P. (2011). Subjective
burden and cultural motives for caregiving in informal caregivers of older people. Journal of Nursing Scholarship, 43(3), 282-91. Retrieved from
- Gallagher, D., Ni Mhaolain, A., Crosby, L., Ryan, D., Lacey, L., Coen, R. F., & ... Lawlor, B. A.
(2011). Self-efficacy for managing dementia may protect against burden and depression in Alzheimer's caregivers. Aging & Mental Health, 15(6), 663-670. doi:10.1080/13607863.2011.562179
- Garity, J. (2006). Caring for a family member with Alzheimer's disease: coping with caregiver
burden post-nursing home placement. Journal Of Gerontological Nursing, 32(6), 39-48.

References (Cont)
- Gaugler, J. E., Roth, D. L., Haley, W. E., & Mittelman, M. S. (2008). Can Counseling and
Support Reduce Burden and Depressive Symptoms in Caregivers of People with Alzheimer's Disease During the Transition to Institutionalization? Results from the New York University Caregiver Intervention Study. Journal Of The American Geriatrics Society, 56(3), 421-428. doi:10.1111/j.1532-5415.2007.01593.x
- Gonzalez, E. W., Polansky, M., Lippa, C., Walker, D., & Feng, D. (2011). Family Caregivers At
Risk: Who Are They??. Issues In Mental Health Nursing, 32(8), 528-536. doi:10.3109/01612840.2011.573123
- Hilgeman, M. M., M.A., Durkin, D. W., M.S.W., Sun, F., PhD., DeCoster, J., PhD., Allen, R. S.,
PhD., Gallagher-Thompson, D., & Burgio, L. D., PhD. (2009). Testing a theoretical model of the stress process in alzheimer's caregivers with race as a moderator. The Gerontologist, 49(2), 248-261. Retrieved from
- Kim, H., Chang, M., Rose, K., & Kim, S. (2012). Predictors of caregiver burden in caregivers of
individuals with dementia. Journal Of Advanced Nursing, 68(4), 846-855. doi:10.1111/j.1365-2648.2011.05787.x
- Levy, K., Lanctôt, K. L., Farber, S. B., Li, A., & Herrmann, N. (2012). Does Pharmacological
Treatment of Neuropsychiatric Symptoms in Alzheimer's Disease Relieve Caregiver Burden?. Drugs & Aging, 29(3), 167-179. doi:10.2165/11599140-000000000-00000
- Martín-Carrasco, M., Martín, M., Valero, C., Millán, P., García, C., Montalbán, S., & ...
Vilanova, M. (2009). Effectiveness of a psychoeducational intervention program in the reduction of caregiver burden in alzheimer's disease patients' caregivers.International Journal Of Geriatric Psychiatry, 24(5), 489-499. doi:10.1002/gps.2142
- Omoto, M. (2009). Distress and Burden Among Caregivers of Patients with Alzheimer's Disease.
Kentucky Newsletter For Health, Physical Education, Recreation & Dance, 45(1), 18-21.
- Oremus, M., Cosby, J. L., Wolfson, C., Oremus, M. M., Cosby, J. L., & Wolfson, C. C. (2005).
Questionnaire to Caregivers of Alzheimer Disease Patients. Research In Nursing & Health, 28419-430.
- Sanders, S., Ott, C., Kelber, S., & Noonan, P. (2008). The experience of high levels of grief in
caregivers of persons with Alzheimer's disease and related dementia. Death Studies, 32(6), 495-523.
- 65 years and older
- 5.3 Americans are currently suffering from AD
- By 2050, 16 million Americans will be diagnosed with AD.
- 70% of individuals with AD are cared for in home by family or friend caregivers
- Informal caregivers are many times "referred to as the 'hidden patients', and stressed caregivers face an increased risk of mortality compared to non-caregiving counterparts." (Gonzalez, et al, 2011)
- 3.2 million full-time caregiving jobs are achieved by informal caregiving (Shayl, et al, 2012)
Strengths & Weaknesses
- Strengths
- Individual characteristics associated with resilient caregivers
- Importance of external support systems for caregivers
- Community Based Services
- Focused studies related to the demographics of the participants
- Age
- Gender
- Ethnicity and Race
- Education Level
- Household Incomes

- Weakness
- Sample Populations
- Generality
- Small
- Social Service Agencies vs. Voluntary Participation
- Informed consent
- Comprehensive Evaluation
Similarities & Differences
- Relationship between resiliency and the caregiver burden
- A study found that "as resilience increased, caregiver burden decreased." (Scott, C., 2013)
- Focus on religion and spiritual aspects
- Caregiver/patient interactions and relationships.
- Lack of social support linked to increased occurrence of depression.
- Caregiving for individuals with AD consumes a lot of time
- Informal caregivers devote approximately 205.8 hours per week per 100 people over the age of 50. (Shayl, et al, 2012)

Gaps in Literature
- Mental health of caregivers prior to the studies were not defined or identified.
- Specific coping strategies of the different caregivers.
- Population
- Diverse sample
- Articles related to culture, some of the most prevalent cultures were not even addressed.
- Smaller/Larger
- Caregiver's perception of their own health status.
- Possible bias with some of the surveys as people with severely ill care recipients were less likely to want to answer. Therefore, the sample studied consisted of individuals in a slightly more stable situation.
Caregiver's Burden:
Ashley Albro
Alexandra Barikian
Laura Claypool
Leah DiEgidio
Elizabeth Nihen
Created By:
- Nurses need to educate themselves on the disease and how it progresses, how it affects the patient, and its affect on the family and caregiver.

- Family members need to be informed on what is to be expected with the illness.
- Stages of AD
- Coping Mechanisms
- Community Resources

- The impact of culture in relation to early dx of AD.
Background & Significance to Nursing
- Alzheimer's Disease (AD) is a degenerative disease that involves memory, attention, and cognitive impairment paired with functional and intellectual deterioration.
- Gradual process that occurs over the span of 3 to 20 years
- The individual suffering from AD will experience changes in behavior emotionally, mentally, and physically (Gonzalez, Polansky, Lippa, Walker, & Feng, 2011)
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