Journal of Advanced Nursing

The Association Between Caregiving Context and the Health and Well‐Being of Carers and Their Care Recipients Living With Dementia: A Cross‐Sectional Study

ABSTRACT

Aim(s)

To examine the association between caregiving context and the health and well-being of community-dwelling people with dementia (functional ability, physical function, depression, quality of life and health-related quality of life) and their informal carers (health-related quality of life) at the pre-rehabilitation stage and the potential mediating role of caregiving context variables.

Design

Cross-sectional study.

Methods

Secondary analysis of baseline data from a randomised controlled trial of 130 dementia care dyads—the Interdisciplinary Home-based Reablement Programme (2018–2022). Bivariate analyses were applied to identify key caregiving context variables—co-residence, sole carer status, additional caring responsibilities, client-carer relationship and subjective carer burden (carer burden hereafter)—associated with health outcomes. Subsequently, multivariable linear regression models were developed. To examine carer burden, two models were run for each outcome: one with caregiving context variables and covariates, and the other adding carer burden. The mediating effects of the identified caregiving context variable were examined using post hoc mediation analysis.

Results

Spouse/partner carer relationship was significantly associated with better client well-being, including lower depressive symptoms and higher quality of life scores compared to adult child and other relationships. Higher carer burden was strongly associated with lower functional ability, more depressive symptoms, lower quality of life for clients and lower health-related quality of life for both clients and carers. Including carer burden in regression models explained the greatest variance across most models. Carer burden fully mediated the association between additional caring responsibilities and client functional ability, and partially mediated the association between other carers and client depression.

Conclusion

Carer burden needs to be carefully considered in supporting the health and well-being of dementia carer dyads.

Implications

Addressing carer burden and tailoring support to carers are essential for optimising health impacts for dementia carer dyads.

Reporting Method

STROBE checklist.

Patient or Public Contribution

None.

Trial Registration

ClinicalTrials.gov identifier: ACTRN12618000600246