Abstract
We assessed which coping strategies (problem-focused, emotion-focused, dysfunctional) mediate the association between caregivers’ understanding of dementia as terminal and their distress. A total of 215 caregivers of community-dwelling persons with severe dementia were surveyed every 4 months over 3 years. A generalized structural equation model was used to test mediation. Caregivers who correctly understood dementia as terminal and those unsure (vs incorrect), experienced more distress (correct: β [95% confidence interval (CI)]: 0.80 [0.00 to 1.60]; unsure: 0.95 [0.04 to 1.87]). Caregivers with correct understanding of dementia as terminal (vs incorrect) employed more dysfunctional (2.01 [0.60 to 3.42]) and problem-focused coping strategies (2.56 [0.08 to 5.05]). Although dysfunctional and problem-focused coping (associated with higher distress) mediated the positive association between caregivers’ understanding that dementia is terminal and their distress, emotion-focused coping (associated with lower distress) did not offset this relationship. Results suggest that terminal illness disclosure to caregivers should be accompanied by interventions to promote emotion-focused coping strategies.
Highlights
Caregivers who understood dementia as terminal experienced more distress.
Dysfunctional and problem-focused coping mediated the positive relationship between terminal illness understanding and caregiver distress.
Emotion-focused coping did not offset this relationship.
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This post is Copyright: Ishwarya Balasubramanian,
Louisa Camille Poco,
Ellie Bostwick Andres,
Isha Chaudhry,
Truls Østbye,
Chetna Malhotra,
PISCES study group | July 7, 2024