Author(s): Mavall, L. and Thorslund, M.

Published In: Arch Gerontol Geriatr, 45 (2): 137-50

Study Aim/Purpose: The authors state that the primary aim of the study was to investigate whether day care programs in Sweden positively impacted caregivers of relatives with dementia, with specific regard to feelings of worry, burden, overload and depression, physical difficulties, and psychological wellbeing. 

Summary of Methods: The study design was a pre/post analysis of change among caregivers. Fifty-one caregivers in 49 day care centers were recruited and met the inclusion criteria for the study (i.e. diagnosis by a physician as suffering from dementia or memory problems associated with dementia, ability to interview the caregiver no later than the client’s fifth visit to day care, and the relative was the dementia sufferer’s main caregiver though not necessarily co-residing). Data were collected at baseline and 4 months post through at-home interviews. Outcome measures were: 1) depression, somatic problems, and psychological well-being (measured by parts of the Center for Epidemiological studies Depression scale questionnaire; 2) self-perceptions of role captivity and worry (measured by level of agreement with items developed for the present study and a 1998 study in America); and 3) caregiver overload (including four items developed by Pearlin, et al (1990) and three developed for this and the 1998 American study mentioned above). 

Summary of Key Results: Feelings of role captivity, worry and overload significantly decreased for all groups of caregivers after 4 months of day care. Within this group, “those who started with a high score for negative and difficulty feelings seemed to be helped less by day care than those who had lower scores from the start.” At the same time, continuation of day care had no significant association with changes in the depression scores for all caregivers; however, among the subgroup of caregivers who did not reside with their family member with dementia, depression levels were reduced among those who continued with day care compared to those who discontinued day care use during the study period. In a regression model, “no significant associations were found between any single feature of caregivers and care recipients and whether they continued day care. “ 

Study Limitations (as cited by authors): Authors cited the small sample size as a limitation in the ability to generalize the study findings. 

Authors’ Discussion/Conclusions: The authors conclude from their findings that day care “seems most appropriate for those who reside with the care recipient” and “of greatest benefit to caregivers who experience less worry, overload and role captivity from the start.” With regard to practice and policy recommendations they state that: “The challenge is for the authorities to identify those caregivers (who benefit most from day care) while providing other caregivers with other forms of support, for example home help services or short-term residential respite care.”