Kin relationship of caregivers and people with dementia: stress and response to intervention.

Objective: This study examined the effects of kin relationship on response to use of adult day services (ADS) on feelings of overload, depressive symptoms, and positive affect for family caregivers of people with dementia.

Methods: The sample consisted of 341 participants drawn from two studies of ADS. The studies used a quasi-experimental design, comparing family caregivers enrolling their care receiver with dementia in an ADS program to a control group not using ADS. Using multilevel model analysis, we examined the main and interaction effects of kin relationship (wife vs. daughters/daughters-in-law), intervention (ADS vs. non-ADS users), and time (baseline, 3 months, and 12 months) on overload, depressive symptoms, and positive affect.

Results: Kin relationship affected the response to intervention but in a somewhat different way for each outcome measure. For depressive symptoms, both wives and daughters using ADS had lower scores over time compared to controls. Both wives and daughters using ADS had lower feelings of overload over time, but daughters had a greater decline and wives' scores on this measure dropped only to the level found among controls. For positive affect, wives using ADS showed a considerable decline over time.

Conclusions: These findings suggest that kin relationship is an important moderator of caregivers' response to intervention and warrant more attention both in the design and evaluation of interventions with family caregivers.