Positive aspects of caregiving as a moderator of treatment outcome over 12 months

Abstract

The authors examined the influence of positive aspects of caregiving (PAC) as a moderator of treatment outcome across 12 months in 1 of the original sites of the Resources for Enhancing Alzheimer's Caregiver Health I project. They used multilevel random coefficients regression analysis to predict time-varying PAC, depression, behavioral bother, and daily care burden in Alzheimer's caregivers (N = 243; mean age = 60.89, SD = 14.19). They found that time-varying PAC was predicted by time-varying daily care burden. They also found significant effects of time-varying PAC for depression, behavioral bother, and daily care burden. Notably, a PAC x Phase x Treatment effect was found for daily care burden, such that individuals who endorsed less PAC benefited most from the intervention across 12 months. The tendency to positively appraise the caregiving experience (i.e., PAC) in response to chronic stressors such as Alzheimer's caregiving may affect individuals' responsiveness to, and benefit from, interventions, whereas only daily care burden affected the tendency to find enjoyment in caregiving across 12 months. Future intervention research should assess individual PAC in order to better tailor interventions to caregiving needs.

Figure 1

Model depicting the relation between baseline control variables, predictor variables, and time-varying emotional outcomes. Asterisks indicate time-varying variables (i.e., values at baseline, 6 months, and 12 months are in the model); variables without an asterisk are baseline values only. CR = care recipient; MMSE = Mini-Mental State Examination; CG = caregiver; SES = socioeconomic status; PAC = positive aspects of caregiving.

Figure 2

White and African American caregivers’ ratings of behavioral bother over 12 months.

Figure 3

Three-way interaction of positive aspects of caregiving (PAC), treatment condition, and phase on daily care burden across 12 months.