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Patients with dementia

Appraising stress levels for home visited caregivers of patients with dementia

            Caregivers of dementia patients experience numerous challenges while trying to balance other demands such as relationships, career, and child rearing with caregiving. Caregivers are at an escalated risk for depression, stress, burden, and other health complications (McDaniel & Allen, 2012). There are complex and diverse impacts on caregivers. Additionally, there are a variety of factors that can ameliorate or exacerbate how caregivers feel or react to their role. Many studies report that care involving dementia patients is more stressful compared to physical disability patients (Reckrey et al., 2013).

There are two common models that elaborate the factors that lead to caregiver stress. According to Poulshock and Deimling model, the disease results to a care burdem that manifests in several ways that may be ameliorated (by mature coping mechanisms or support) or exacerbated (by psychological or physical caregiver ill health, or behavioral disturbance) (Caregiving in the U.S., 2011).  Pearlin and colleagues caregiver stress model elaborates four areas that facilitate caregiver stress; background context, illness’ primary stressors, secondary role strains, and intrapsychic strains (Thies & Bleiler, 2011). In Campbell and colleagues model, caregiver burden has role captivity, caregiver overload, and adverse life events as the strongest predictor (Bialon & Coke, 2012).

Caregivers can be supported through informational, emotional, and instrumental support. There is a positive relationship between psychological well-being and social support. Support acts as a buffer against stress and burden for caregivers through increasing the notion that there are resources for handling stress (Alzheimer’s Disease Facts and Figures, 2013). Unwelcome support is actually more stressful. There are variations between emotional and instrumental support, informal and formal stress, and perceived and actual support. Culture, neuroticism levels, individual preference, race, and gender influence how support is perceived and used (Unwin & Tatum, 2011). This paper aims at finding out if engaging Nurse Practitioners in House-Calls can reduce caregivers stress.


Alzheimer’s Disease Facts and Figures (2013). Retrieved on 8th February, 2014 from

Bialon, L. N., & Coke, S. (2012). A study on caregiver burden: Stressors, challenges, and possible solutions. American Journal of Hospice & Palliative Medicine, 29(3), 210-218. doi:10.1177/1049909111416494

Caregiving in the U.S. (2011). National Alliance for Caregiving. Administration on Aging.

            homebound elders: Does caregiver burden play a role? Journal of Aging Health, 9(25), 1036-1049 

McDaniel, K., R., & Allen, D. G. (2012). Working and care-giving: The impact on caregiver stress, family-work conflict, and burnout. Journal of Life Care Planning, 10(4), 21-32.

Reckrey, J.M., DeCherrie, L.V., Kelley, A.S., & Ornstein, K. (2013). Health care utilization         among homebound elders: Does caregiver burden play a role? Journal of Aging Health,    9(25): 1036-1049.

Thies, W., & Bleiler, L. (2011). Alzheimer’s disease facts and figures, Alzheimer’s and dementia. Alzheimer’s Association, 7(2), 208-244.

Unwin, B. K., & Tatum, P. E. (2011).  House calls. American Family Physician, 83(8), 925-938.

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