Care partner responses to the onset of mild cognitive impairment

Abstract

Purpose: We examined characteristics, responses, and psychological well-being of care partners who support and assist older adults recently diagnosed with mild cognitive impairment (MCI).

Design and methods: Based on a sample of 106 care partners of community residents diagnosed with MCI at memory clinics, we conducted face-to-face interviews including scales and open-ended questions. Measures tapped elements of the caregiver stress process model advanced by Pearlin and associates (1990, Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30, 583-594), including background characteristics, knowledge and attitude resources, stressors, strains, and protective conditions. The outcome was psychological well-being as indexed by depressive symptoms.

Results: Care partners' depressive symptoms were higher in the context of poorer health, lower perceived importance of religion, less knowledge about dementia, being more bothered by the older adult's MCI symptoms, having a lower sense of environmental mastery, more perceived burden, more frequent use of coping strategies, and more social support. Narratives revealed multiple dimensions of stress, strain, and frustration, regardless of the level of depressive symptoms.

Implications: Assisting a relative with MCI presents new and complex challenges, even though it is an early caregiving role. Care partners likely would benefit from strategies aimed at reducing self-blame, enhancing coping skills, sustaining their sense of mastery, managing their health, seeking and accepting respite, and communicating effectively with the person with MCI and significant others.