Wives, husbands, and daughters caring for institutionalized and noninstitutionalized dementia patients: toward a model of caregiver burden.

The primary purposes of this article are to clarify some of the inconsistencies in the previous research studies done on factors associated with caregiver burden; to identify specific sets of variables that best explain the differential burden levels among caregivers; and to provide a substantial foundation for developing a model of caregiver burden useful for both research and clinical interventions. The caregiver's gender, relationship to the patient, and the residential location of the patient (same house, community, or institution) are major considerations in our analyses. This study is also unique, because it uses a relatively large national sample of caregivers, which is necessary to accomplish the study's objectives. Mailed questionnaires were completed by 409 caregivers identified by fifty local support groups in sixteen different states in the United States. Generally, the primary correlates of burden were factors related to the levels and types of impairment in patient functioning, caregiver life satisfaction, and social support. Each category of caregiver circumstances had a unique set of three to five correlates with the total amount of variance explained in burden ranging from 25 percent (husbands living with the patients) to 68 percent (husbands with spouses in nursing homes). Implications for future research and interventions are discussed.