ISSUES AND INNOVATIONS IN NURSING PRACTICE Problem behaviour, caregiver reactions, and impact among caregivers of persons with Alzheimer's disease

Correspondence: Karen Robinson, Room 3057, HSC K Building, School of Nursing, University of Louisville, Louisville, KY 40292, USA. E-mail: [email protected] B INSON K.M. ADKISSON P . & WEINRICH S . ( 2001 ) journal of Advanced RO , Nursing 36(4), 573-582 Problem behaviour, caregiver reactions, and impact among caregivers of persons with Alzheimer's disease Background. Problem behaviours that occur during Alzheimer's disease (AD) can have major impact on caregivers. How caregivers react to these behaviours may determine the total impact experienced from caregiving. Purpose. This study examined the relationships between problematic behaviours and caregiving impact in 30 primary caregivers of persons with AD. The frst question explored the relationship between frequency of problem behaviour and impact; the second explored the relationship between caregiver reactions to problem behaviours and impact from caregiving. Methods. The frequency of problem behaviour and the caregiver reaction was measured using The Revised Memory and Behaviour Problem Checklist (Teri et al. 1992). The impact from caregiving was operationalized using the Cost of Care Index developed by Kosberg and Cairl (1986). Results. Signifcant associations were found for 11 of the 20 subscales that measured the association between the frequency of problem behaviour in the client and the impact from caregiving experienced by the caregiver. In comparison, the association between caregiver's reaction to problem behaviours and impact from caregiving was even more signifcant in value with 15 subscales of 20 being signifcant. Female caregivers experienced a greater reaction to disruptive and depressive behaviour when compared with male caregivers even though both genders reported similar frequencies of problem behaviours. In regard to fndings about the impact from caregiving, four of the six indicators were higher for women than for men. Conclusions. Caregiver reaction to problem behaviours was more highly associ­ ated with impact from caregiving than the actual frequency of the behaviours. These fndings have great implications for intervention programs. Caregivers, especially females, need to receive individualized, specifc education/training on how to understand and manage disruptive and depressive behaviour in persons with AD.