Why does placement of persons with Alzheimer’s disease into long-term care improve caregivers’ well-being? Examination of psychological mediators.

Mausbach, Brent T.; Chattillion, Elizabeth A.; Ho, Jennifer; Flynn, Laura M.; Tiznado, Denisse; von Känel, Roland; Patterson, Thomas L.; Grant, Igor

doi:10.1037/a0037626

Cited by 36Dementia and Cognitive Impairment ResearchGeriatric Care and Nursing HomesNursing care and research

Why does placement of persons with Alzheimer’s disease into long-term care improve caregivers’ well-being? Examination of psychological mediators.

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Mausbach, Brent T., Chattillion, Elizabeth A., Ho, Jennifer, Flynn, Laura M., Tiznado, Denisse, von Känel, Roland, Patterson, Thomas L., Grant, Igor·2014·Psychology and Aging

DOI 10.1037/a0037626PMC PMC4267921

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Abstract

Caregiving for individuals with Alzheimer's disease is associated with chronic stress and elevated symptoms of depression. Placement of the care receiver (CR) into a long-term care setting may be associated with improved caregiver well-being; however, the psychological mechanisms underlying this relationship are unclear. This study evaluated whether decreases in activity restriction and increases in personal mastery mediated placement-related reductions in caregiver depressive symptoms. In a 5-year longitudinal study of 126 spousal Alzheimer's disease caregivers, we used multilevel models to evaluate placement-related changes in depressive symptoms (short form of the Center for Epidemiologic Studies Depression scale), activity restriction (Activity Restriction Scale), and personal mastery (Pearlin Mastery Scale) in 44 caregivers who placed their spouses into long-term care relative to caregivers who never placed their CRs. The Monte Carlo method for assessing mediation was used to evaluate the significance of the indirect effect of activity restriction and personal mastery on postplacement changes in depressive symptoms. Placement of the CR was associated with significant reductions in depressive symptoms and activity restriction and was also associated with increased personal mastery. Lower activity restriction and higher personal mastery were associated with reduced depressive symptoms. Furthermore, both variables significantly mediated the effect of placement on depressive symptoms. Placement-related reductions in activity restriction and increases in personal mastery are important psychological factors that help explain postplacement reductions in depressive symptoms. The implications for clinical care provided to caregivers are discussed.

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Admitting a relative to a residential care facility has mixed effects on family caregivers' emotional and psychological well-being; some studies find distress remains unchanged or increases for some caregivers such as spouses, while others find distress decreases.
“Admitting a relative to a residential care facility has mixed effects on the emotional and psychological well-being of family caregivers.Some studies suggest that distress remains unchanged or even increases for some caregivers (such as spouses), but other studies have found that distress decreases.454,[499][500][501]”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [500]
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Admitting a relative to a residential care facility has mixed effects on the emotional and psychological well-being of dementia family caregivers.
“Admitting a relative to a residential care facility has mixed effects on the emotional and psychological well‐being of dementia family caregivers. Some studies suggest that distress remains unchanged or even increases for some caregivers (such as spouses), but other studies have found that distress decreases. 494 , 545 , 546 , 547”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [546]

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WHY DOES PLACEMENT OF ALZHEIMER'S PATIENTS INTO LONG-TERM CARE IMPROVE CAREGIVERS' WELL-BEING? EXAMINATION OF PSYCHOLOGICAL MEDIATORS
Ho, J. S., Mausbach, B. T., Chattillion, E. A., Flynn, L., Tiznado, D., von Kaenel, R., Patterson, T., & Grant, I. (2014) · eScholarship (California Digital Library)
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Authors: Mausbach, B. T., Chattillion, E. A., Ho, J., Flynn, L. M., Tiznado, D., von Känel, R., Patterson, T. L., & Grant, I.
Affiliations: University of California San Diego (US)
San Diego State University (US)
University of Hawaiʻi at Mānoa (US)
University of Missouri–Kansas City (US)
ORCID: Mausbach, Brent T.
Patterson, Thomas L.
Venue: Psychology and Aging
Publisher: American Psychological Association (APA)
Published: 2014
Volume: 29
Issue: 4
Pages: 776-786
ISSN: 0882-7974 (ISSN-L)
1939-1498
DOI: 10.1037/a0037626
PMC: PMC4267921
OpenAlex: W2319260349
Cited by: 36
References: 76
Citations by year: 2026: 1 · 2025: 4 · 2024: 1 · 2023: 4 · 2022: 4 · 2021: 3 · 2020: 4 · 2019: 4 · 2018: 4 · 2017: 1 · 2016: 4 · 2015: 2
FWCI: 1.78
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Psychology and Aging (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
BORIS (University Library Bern) (submittedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: National Institute on Aging (R01 AG015301, R01 AG031090)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
Health Sciences › Health Professions › Pharmacy › Nursing care and research
Keywords: Alzheimer's disease, spousal caregivers, long-term care placement, caregiver depressive symptoms, caregiver well-being, activity limitation, personal mastery, mediation, chronic stress, psychological mediators
MeSH terms: Adaptation, Psychological, Aged, Alzheimer Disease, Depression, Female, Humans, Long-Term Care, Longitudinal Studies, Male, Mental Health, Middle Aged, Monte Carlo Method, Personal Satisfaction, Stress, Psychological, Negotiating, Caregivers, Spouses

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Why does placement of persons with Alzheimer’s disease into long-term care improve caregivers’ well-being? Examination of psychological mediators.

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