The affective correlates of the desire to institutionalize in caregivers to relatives with dementia

The aim of the present study was to examine the emotional correlates of the desire to institutionalize in family caregivers of elderly persons diagnosed with dementia. Subjects were 75 female caregivers and their elderly relatives who were referred, within the last two years, to the Division of Geriatric Medicine in Camp Hill Hospital. All care recipients had a diagnosis of dementia made by a neuropsychologist or geriatrician according to the DSM III-R criteria. It was hypothesized that caregiver burnout would predict institutionalization over and above patient disability variables. It was predicted that caregiver burden would be correlated with the desire to institutionalize but would not predict desire to institutionalize over and above patient disability variables. Results indicated that severity of patient disability accounted for 23 per cent of the variance in caregivers' desire to institutionalize. As expected, caregiver burnout was a significant predictor accounting for an additional 9 per cent of the variance above and beyond that accounted for by patient disability. While burden was correlated with desire to institutionalize, when patient disability was statistically controlled, burden was not a significant predictor of desire to institutionalize. Discussion focuses on the need to include comprehensive measures of patient disability in studies addressing the role of psychological variables in caregiver stress. It is argued that resource depletion models of caregiver stress may provide a viable account of the processes involved in caregivers' decisions concerning the institutionalization of a care recipient.