RELATIONSHIPS BETWEEN INFORMAL CAREGIVERS’ MARITAL SATISFACTION, BURDEN, AND CAREGIVING STRESS

Abstract Spouses often serve as the primary caregiver of individuals with dementia (Wright, 1991). As caregiving can be a stressful experience, marriage strains may occur. Researchers have found that caregiver spouses reporting low marital cohesion and satisfaction endorsed significant symptoms of depression (Rankin et al., 2001). Lower levels of marital intimacy have been found to be associated with higher levels of depression and strain among caregivers (Morris et al., 1998). The goal of the current study was to better understand the relationships between caregiver (N = 158) marital satisfaction, caregiving stress, and subjective and objective burden. Results indicated that marital satisfaction was a significant negative predictor of subjective burden as measured by the Zarit Burden Interview (F(1,134) = 93.51, p < .001, R2 = .411), subjective burden as measured by the Revised Memory and Behavior Problems Checklist (RMBPC), Reaction Scale (F(1, 146) = 25.65, p < .001, R2 = .149), and role captivity (F(1, 139), P < .001, R2 = .380). Marital satisfaction was a significant positive predictor of caregiver competence (F(1,140) = 32.45, p < .001, R2 = .188). It was also found that marital satisfaction was not a significant predictor of objective burden as measured by the RMBPC Frequency Scale (F(1, 146), p = .065, R2 = .023). The findings have implications for future interventions in that improving marital satisfaction of spouse caregivers may reduce subjective burden, decrease feeling trapped within the caregiving role, and increase caregivers’ sense of competence within the caregiving role.


SUPPORT AND EDUCATION NEED FULFILLMENT IN INFORMAL DEMENTIA CAREGIVERS
Nicholas James, 1 and Daniel Paulson 1 , 1. University of Central Florida, Orlando, Florida, United States Caregivers vary widely in their need for and utilization of support services, and there are many reasons for this (e.g., time or financial cost, distance, perception of need). This study explored the disparity between services that are desired and those that are utilized, and examined the hypothesis that unmet needs are a determinant of caregiver burden. An online sample of informal caregivers (N=151) responded to a questionnaire containing a list of common caregiver support services: sharing duties, professional transportation, respite care, non-profit community organizations, financial counseling, caregiver education programs, support groups.
Participants were presented with a list of support services and information and asked to indicate A) which they desired and B) which they had received while providing care. Respite care and financial counseling were identified as support that caregivers were unable to obtain, while caregiving education and family/friend support were most commonly fulfilled. A linear regression model controlling for demographic variables was constructed. Unfulfilled support needs accounted for 40.6% of variance in caregiver burden, however the final model included only total ratio of unfulfilled services, transportation services, stress management skills, professional treatment for the caregiver, and behavioral management skills. Results highlight the unique contribution of certain support services in burden reduction. These findings imply a need to improve accessibility to caregiver support, especially those which require payment (e.g., transportation aids and mental healthcare). Further implications and actionable changes related to caregiver support services are discussed.

FACTORS ASSOCIATED WITH CAREGIVER REACTIONS TO PROBLEM BEHAVIORS OF PERSONS WITH ALZHEIMER'S DISEASE
Junrong Shi, 1 and Cathy Scott 1 , 1. University of Tennessee at Chattanooga, Chattanooga, Tennessee, United States Problem behaviors among persons with Alzheimer's Disease (AD) can have a major impact on caregivers. However, caregiver's subjective reactions to the problem behaviors have a stronger impact on caregivers than the objective frequency of problem behaviors (Robinson et al., 2001). This study aims to examine the factors associated with caregiver's subjective reactions to problem behaviors. Data were collected from a sample recruited from community agencies served AD caregivers in the southeastern region of the country (N=109). The caregivers' reactions to problem behaviors were measured by the Revised Memory and Behavior Problem Checklist (Teri et al., 1992). Three subscale scores were used to measure the reactions to the behaviors related to memory loss, depression and disruption. Multivariate regression models were conducted including gender, race, employment, living arrangement, knowledge about the disease, resilience for caregivers; and ADL and IADL functioning, and frequency of problem behaviors for care recipients. Race (B=-.162; p<.05) and frequency of care-recipient problem behaviors (B= 0.733; p<.001) were significantly associated with caregiver's reaction to problem behaviors. Caregiver's knowledge about the disease (p<.01) only influence their reactions to memory loss problems but not for disruption and depression problems. African American caregivers had fewer reactions to disruption (p<.01) and more reactions to depression problems (p=0.06) than white caregivers, but no difference between the two groups in their reactions to memory loss problems. Personal resilience was not associated with reactions to any problem behaviors. Intervention should be tailored to the needs of caregivers to deal with behaviors of a person with AD. Spouses often serve as the primary caregiver of individuals with dementia (Wright, 1991). As caregiving can be a stressful experience, marriage strains may occur. Researchers have found that caregiver spouses reporting low marital cohesion and satisfaction endorsed significant symptoms of depression (Rankin et al., 2001). Lower levels of marital intimacy have been found to be associated with higher levels of depression and strain among caregivers (Morris et al., 1998). The goal of the current study was to better understand the relationships between caregiver (N = 158) marital satisfaction, caregiving stress, and subjective and objective burden. Results indicated that marital satisfaction was a significant negative predictor of subjective burden as measured by the Zarit Burden Interview (F(1,134) = 93.51, p < .001, R2 = .411), subjective burden as measured by the Revised Memory and Behavior Problems Checklist (RMBPC), Reaction Scale (F(1, 146) = 25.65, p < .001, R2 = .149), and role captivity (F(1, 139), P < .001, R2 = .380). Marital satisfaction was a significant positive predictor of caregiver competence (F(1,140) = 32.45, p < .001, R2 = .188). It was also found that marital satisfaction was not a significant predictor of objective burden as measured by the RMBPC Frequency Scale (F(1, 146), p = .065, R2 = .023). The findings have implications for future interventions in that improving marital satisfaction of spouse caregivers may reduce subjective burden, decrease feeling trapped within the caregiving role, and increase caregivers' sense of competence within the caregiving role.

IMPACT OF ELDER ABUSE ON SUBSEQUENT COGNITIVE DETERIORATION IN OLDER ADULTS WITH COGNITIVE IMPAIRMENT
Boye FANG, 1 and Elsie Yan 2 , 1. Hong Kong Polytechnic University,Hong Kong Polytechnic University,Hong Kong,2. The Hong Kong Polytechnic University,Hong Kong,Hong Kong Objectives: Considering the rapidly increasing older population, elder abuse has become a major public health problem. Using longitudinal data, this study examines the impact of elder abuse on subsequent cognitive deterioration. Methods: At baseline, one-thousand-and-two older adults (aged≥55 years) with a clinically valid diagnosis of mildto-moderate cognitive impairment were consecutively recruited from the geriatric and neurological departments of three Grade-A hospitals in Guangdong Province of People's Republic of China from 2015 to 2016 and 958 of them have completed the present follow-up study after two years. The major independent variables were psychological abuse, physical abuse, caregiver neglect, and financial exploitation experienced at baseline. The outcome variable was cognitive deterioration defined by repeated measures using the Mini-Mental State Examination. Covariates included demographic characteristics, neuropsychiatric symptoms, depression, and IADL impairment. Results: According to the mixed-effect model, elder abuse at baseline did not have significant association with baseline cognitive impairment. However, experience of physical abuse (coefficient 0.11; 95% CI 0.06-0.15), psychological abuse (coefficient 0.28; 95% CI 0.09-0.47), and caregiver neglect (coefficient 0.03; 95% CI 0.01-0.05) at baseline predicted greater cognitive deterioration over the two-year observation period. Other contributing factors for greater cognitive deterioration included neuropsychiatric symptoms and depression. Discussion: Although no significant cross-sectional association between elder abuse and cognitive impairment was observed, physical abuse, psychological abuse, and caregiver neglect at baseline was found to have a long-term prominent effect on subsequent cognitive deterioration over the two-year observation period. The present results su

FUTURE PLANNING AMONG OLDER CAREGIVERS OF FAMILY MEMBERS WITH INTELLECTUAL DISABILITY OR MENTAL ILLNESS
Fei Wang, 1 and Yangdi Han 2 , 1. Jack, Joseph and Morton Mandel School of Applied Social Sciences,Case Western Reserve University,Cleveland,Ohio,United States,2. School of Social Development and Public Policy,Fudan University,Shanghai,Shanghai,China Objectives: This study aims to examine future planning among older caregivers for family members with intellectual disability or mental illness, focusing on preferences, predictors and barriers. Method: Data were drawn from 260 caregivers (aged 50 or older) to a family member with intellectual disability or mental illness in Shanghai, China. Caregivers rated six types of future care arrangement under three circumstances: (1) the ideal situation, (2) unable to provide care due to age-related illnesses, and (3) caregivers are deceased. Socio-demographic factors associated with future planning were examined using multinomial logistic regression. Caregivers also rated twelve barriers to future planning. Results: Government-subsidized care facility is the most preferable care arrangement across the three circumstances. While continuing family care was still preferred if caregivers were to become sick or deceased, it was a less preferred option in the ideal situation. Common barriers were the cost of institutional care and the inadequate skills of the staff. Regarding the predictors of future planning, the older the caregivers were, the less likely they had no future plans. Caregivers were more likely to prefer family care over institutional care if their family members had mild impairment. Caregivers of a family member with mental illness were more likely to have no future planning than caregivers of a family member with intellectual disability. Conclusion: This study identified the needs of older caregivers for future planning specific to different circumstances. It also identified demographic profiles of future planning and the caregiver population at risk of no future planning.