Contributions of Caregiver Management Styles to the Discrepancy Between Reported and Observed Task Performance in People with Dementia

Journal article


Camino, J., Kishita, N, ., Trucco, A.O., Khondoker, M,., Mioshi, E. and Backhouse, T. (2022). Contributions of Caregiver Management Styles to the Discrepancy Between Reported and Observed Task Performance in People with Dementia. Journal of Alzheimer's Disease . 88 (4), pp. 1605-1614. https://doi.org/10.3233/JAD-220155
AuthorsCamino, J., Kishita, N, ., Trucco, A.O., Khondoker, M,., Mioshi, E. and Backhouse, T.
Abstract

Background: The identification and understanding of the discrepancy between caregivers’ reports of people with dementia’s (PwD) performance of activities of daily living (ADLs) and observed performance, could clarify what kind of support a PwD effectively needs when completing tasks. Strategies used by caregivers have not been included in the investigation of this discrepancy.
Objectives: To (1) investigate if caregivers’ report of PwD’s ADL performance are consistent with PwD’s observed performance; (2) explore if caregiver management styles, depression, and anxiety, contribute to this discrepancy.
Methods: PwD (n=64) were assessed with standardised performance-based (AMPS) and informant-based (DAD) ADL assessments. Caregivers completed depression (PHQ-9), anxiety (GAD-7), and dementia management style (DMSS: criticism, active-management, and encouragement) questionnaires.
Cohen’s kappa determined agreement/disagreement in ADL performance. To investigate the potential discrepancy between the DAD and AMPS, a continuous variable was generated: comparative ADL score. Multiple linear regression analysis explored whether caregivers’ management styles, depression or anxiety could explain the ADL discrepancy.

Results: Poor level of agreement between observed and reported ADL performance [k= -0.025 (95%CI -0.123 – 0.073)] was identified, with most caregivers underestimating ADL performance.
The combined model explained 18% (R2=0.18, F(5, 55)=2.52,p=<0.05) of the variance of the comparative ADL score. Active-management (β=-0.037,t(60)=-3.363, p=0.001) and encouragement (β=0.025,t(60)=2.018, p=0.05) styles made the largest and statistically significant contribution to the model.

Conclusions: Encouragement style could be advised for caregivers who underestimate ADL performance, while active management style for those who overestimate it. Findings have scope to increase caregivers’ abilities to support PwD activity engagement in daily life.

KeywordsDementia, discrepancy, ADLs, carer management styles
Year2022
JournalJournal of Alzheimer's Disease
Journal citation88 (4), pp. 1605-1614
PublisherIOS Press
ISSN1875-8908
Digital Object Identifier (DOI)https://doi.org/10.3233/JAD-220155
Publication dates
Print16 Aug 2022
Publication process dates
Accepted06 Jun 2022
Deposited28 Nov 2022
Accepted author manuscript
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File Access Level
Open
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License: CC BY 4.0
File access level: Open

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