Quality of in-home care, long-term care placement, and the survival of persons with dementia. McClendon, M., J. and Smyth, K., A. Aging & mental health, 19(12):1093-1102, 2015.
abstract   bibtex   
PURPOSE OF THE STUDY: Caregivers of persons with dementia living at home adopt a variety of caregiving styles that vary in quality. Three styles of high-quality care and poor-quality care have been identified. The outcomes, however, of varying styles of caregiving are unknown. Our purpose was to investigate the linkage of quality of care to long-term care placement and survival. DESIGN AND METHODS: We used a sample of 148 primary caregivers of a relative living at home and needing assistance due to memory or thinking problems. We used items from four existing scales and five new items to construct measures of high-quality and poor-quality care. Long-term care and survival were determined from two follow-ups. Cox proportional hazards regression was used to estimate the relationship of quality of care to long-term care placement and survival. RESULTS: Poor quality of care increased the risk of long-term care placement, as expected, but high-quality care was not related to placement. Surprisingly, high-quality care increased the risk of death while poor-quality care decreased the risk. Secondary results were: wishful/intrapsychic coping (a dysfunctional type of emotion-focused coping) and long-term care placement shortened the survival; and caregiver personality traits of neuroticism and agreeableness lengthened the survival. IMPLICATIONS: It is premature to recommend caregiver interventions based on our unexpected findings. Further studies are vital and should include care-recipient impairments and the quality of life of the person with dementia as additional outcomes.
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 title = {Quality of in-home care, long-term care placement, and the survival of persons with dementia},
 type = {article},
 year = {2015},
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 keywords = {Activities of Daily Living,Adaptation, Psychological,Adult,Aged,Aged, 80 and over,Caregivers/psychology/standards,Dementia/mortality/nursing,Female,Home Nursing/standards,Humans,Long-Term Care,Male,Nursing Homes,Proportional Hazards Models,Quality Assurance, Health Care,Quality of Life,Stress, Psychological,Survival Analysis,Time Factors,coping,dementia caregiving,quality of caregiving,survival},
 pages = {1093-1102},
 volume = {19},
 city = {a Department of Neurology, School of Medicine , Case Western Reserve University , Cleveland , OH , USA.},
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 notes = {JID: 9705773; OTO: NOTNLM; 2015/01/29 [aheadofprint]; ppublish},
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 abstract = {PURPOSE OF THE STUDY: Caregivers of persons with dementia living at home adopt a variety of caregiving styles that vary in quality. Three styles of high-quality care and poor-quality care have been identified. The outcomes, however, of varying styles of caregiving are unknown. Our purpose was to investigate the linkage of quality of care to long-term care placement and survival. DESIGN AND METHODS: We used a sample of 148 primary caregivers of a relative living at home and needing assistance due to memory or thinking problems. We used items from four existing scales and five new items to construct measures of high-quality and poor-quality care. Long-term care and survival were determined from two follow-ups. Cox proportional hazards regression was used to estimate the relationship of quality of care to long-term care placement and survival. RESULTS: Poor quality of care increased the risk of long-term care placement, as expected, but high-quality care was not related to placement. Surprisingly, high-quality care increased the risk of death while poor-quality care decreased the risk. Secondary results were: wishful/intrapsychic coping (a dysfunctional type of emotion-focused coping) and long-term care placement shortened the survival; and caregiver personality traits of neuroticism and agreeableness lengthened the survival. IMPLICATIONS: It is premature to recommend caregiver interventions based on our unexpected findings. Further studies are vital and should include care-recipient impairments and the quality of life of the person with dementia as additional outcomes.},
 bibtype = {article},
 author = {McClendon, M J and Smyth, K A},
 journal = {Aging & mental health},
 number = {12}
}
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