Carer burden and positive gain in dementia

Purpose: Behavioural and psychological symptoms of dementia (BPSD) have been well established as factors involved in the development of carer burden. However, it is not clear which symptoms are most burdensome for carers and which caregiver factors may be involved. This study aims to explore symptoms associated with executive functioning deficits and their impact on three dimensions of carer burden and positive gain. It also aims to discover whether behaviour management strategies used by carers, and their level of experiential avoidance, had an independent impact on these factors. Design/methodology/approach: A total of 110 dementia caregivers completed five self-report measures as part of a cross-sectional design: the Dysexecutive Questionnaire (DEX), Zarit Burden Interview, Positive Aspects of Caregiving Questionnaire, Dementia Management Strategies Scale and Experiential Avoidance in Caregiving Questionnaire (EACQ). Findings: Executive functioning deficits (DEX) were found to account for most variance in burden, with DEX subscales impacting differentially on the three dimensions of burden and positive gain. The use of negative management strategies was associated with higher levels of burden, as was Active Avoidant Behaviour (a subscale of the EACQ), whereas positive management strategies were associated with positive gain. Originality/value: In line with previous findings, symptoms associated with executive functioning deficits were the most significant factor in the development of carer burden. The findings relating to behaviour management strategies and experiential avoidance suggest that these could be potential mediating mechanisms in this relationship. Further research is required to explore this in detail, and to consider implications for targeted carer interventions.