By Pamela D. Wilson, The Care Navigator, CSA, MS, BS/BA, CG

A study recently released in the Journal of the American Geriatrics Society (1) indicates that caregiver-patient interpersonal interactions contribute to the presence of neuropsychiatric disorders in individuals with dementia. In simple terms, lack of caregiving knowledge often results in caregiver stress and anxiety that is projected on the person needing care increasing negative behavioral reactions. In this study, the neuropsychiatric disorders studied were: restlessness, constant talking, hallucinations, paranoia, uncontrolled anger, combativeness, danger to self, danger to others, destructive behavior, repetitive questions, wandering and waking the caregiver.

It's well known that caregivers are depressed. This depression (and degree of) is considered bi-directional in its effect on the person receiving care. This means that caregiver depression contributes to challenging behaviors in the care recipient and challenging behaviors contribute back into increased depression in the caregiver. More depressed caregivers report more behavioral issues in the persons for whom they provide care than those who manage the situation well.

Other factors such as age, relationship to the person receiving care, education level, and hours per week spent caregiving contribute to the level and frequency of neuropsychiatric disorders. Because older caregivers and spouse caregivers are likely to have known the individual before the dementia diagnosis, they may be better able to interact and cope to prevent behavioral disturbances. However in circumstances where denial exists can complicate care matters.

Caregivers with less education may have a lower level of understanding of dementia and less well developed coping skills than more educated caregivers. Characteristics such as sex and education are related to different styles of caregiving such as being nurturing, supporting, non-adapting. These caregiving styles contribute to the activity level and overall demeanor of the care recipient.

In managing behaviors of loved ones with dementia, it's important to take various components into consideration. There is no single right approach. Opportunities to increase caregiver education level about dementia and subsequently to reduce depression levels serve as a basis for eliminating or reducing common neuropsychiatric disorders.

(1) Sink, K.M. and others. Caregiver Characteristics Are Associated with Neuropsychiatric Symptoms of Dementia. JAGS 54:796-803, 2006.

Copyright 2011 Pamela D. Wilson, All Rights Reserved.

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