Date of Award:
Doctor of Philosophy (PhD)
JoAnn T. Tschanz
Dementia is a progressive syndrome with declines in cognitive and functional abilities. As the world’s population becomes increasingly older, prevalence rates are expected to increase exponentially to over 80 million affected by the year 2040. Individuals with dementia and their caregivers experience various difficulties associated with progression that increases stress for both parties. Caregiving can be burdensome and caregivers may employ a number of strategies to manage problems as they arise. Renewed interest has been focused on the care environment as one way to modify dementia progression as caregivers can be an influential person in the care recipient’s life. Two hundred sixty-six dyads consisting of persons with dementia and their caregivers were examined to investigate whether caregiving coping strategies influenced the care recipient’s time to severe dementia, institutionalization, and death. Using the Ways of Coping Checklist (WCCL-R), latent profile analysis was used to examine whether caregivers could be categorized based on their use of coping strategies.
Results indicated that caregivers could be profiled based on their use of coping strategies on the WCCL-R, as follows: problem-focused, acceptance-based, emotionfocused, and low coping classes. While there was good assignment for the latent classes, caregiver characteristics were not predictive of these groups per multinomial logistic regression. Cox regression was used to analyze survival times to the clinical outcomes of severe dementia, institutionalization, and mortality. While the latent profiles did not predict survival time to the three outcomes, the emotion-focused class (n =12) showed a trend in predicting hazard of death (HR = .522, p = .066, 95% CI = .261-1.045). Longer duration of dementia was associated with higher hazard of severe dementia (HR = 1.181, p = .003, 95% CI = 1.057-1.319), while older age of dementia onset was associated with higher hazard of death (HR = 1.085, p
Although caregiver coping profiles did not predict survival times for clinical outcomes, the successful classification of caregivers based on utilization of coping strategies may provide a useful way to study both caregiver and care recipient outcomes.
Wanzek, Joseph S., "Examining the Effects of Caregiver Coping Strategies on Care Recipient Outcomes" (2016). All Graduate Theses and Dissertations. 5009.