Abstract
In recent studies of dementia caregivers, researchers suggested that physical and psychological symptoms incurred during caregiving did not always improve or resolve when caregiving ended. The purpose of this cross-sectional, correlational study was to explore the relationships between psychological outcomes and caregiver personal variables (personality traits, coping strategies, pre-loss depression), environmental variables (length of nursing home placement and length of post-caregiving), and guilt informer family caregivers of people with dementia. Using Facebook and word of mouth, a convenience sample of former caregivers of individuals with dementia (N=171) was recruited and participants completed a 147-item online survey comprised of 6 instruments and a demographic questionnaire. The data were analyzed using frequency percentiles, Pearson product-moment correlation coefficients, and hierarchical regression models. The sample reported high rates of depression (41.5%), anxiety (42.1%), and poor sleep quality (74.3%). Significant positive relationships between dysfunctional coping strategies and both guilt (p < 0.01) and neuroticism (p < 0.01) were found. There were large positive correlations between depression, anxiety, and sleep quality, and dysfunctional coping and neuroticism, and medium positive correlations between guilt and both depression and anxiety (p < 0.01). Pre-loss depression was moderately correlated with depression, anxiety, and sleep quality (p < 0.01). After controlling for demographic variables and covariates, dysfunctional coping and neuroticism explained32% of the variance in depression (R2= .52, ΔR2 = .32, F(5, 165) = 36.24, p < .001) and24% of the variance in anxiety (R2= .41, ΔR2 = .24, F(5, 165) = 22.65, p < .001). After controlling for demographic variables and covariates, dysfunctional coping, pre-loss depression, and extraversion accounted for 17% of the variance in sleep quality (R2 = .30,ΔR2 = .16, F(6, 164) = 11.44, p < .001). The study findings provided a foundation for future research and theory development in the population of former caregivers of people with dementia. Implications for clinical practice and education include increasing awareness among nurses and other health care providers about the high prevalence of poor psychological outcomes in this population, so that former caregivers with depression, anxiety, or sleep disturbances may be identified and referred to the appropriate resources.