This study seeks to identify a range of stressors and strains experienced by Alzheimer's caregivers, the coping strategies they adopt to deal with the strains, their access to and uses of formal and informal supports, and the consequences of this stress process for symptoms of depression and physical illness. It conceives of the strains encountered within the caregiver role proper as central among the stressors. These strains result from multiple sources: the need to provide help to the patient to compensate for his/her functional disabilities; the overload of demands on the time and energy of the caregiver; the need to exercise vigilant control of aberrant behavior; and the losses experienced around previously shared social and recreational activities, the exchange of affection, and the personality transformation of the patient. Connected to the strains in caregiving are associated strains in other areas of life, particularly family conflict, economic hardship and the cross-pressure of occupational and caregiving demands. In general, we expect that the more intense the various strains in the caregiver role and the more extensively they are diffused into other areas of life, the more the mental and physical health of the caregiver will suffer. However, we also expect that the impact of stressful conditions will be minimized and buffered both by appropriate coping behavior and uses of formal and informal social supports. To observe the intricate relationships and their change, three scheduled interviews will be conducted with a panel of 750 caregivers at intervals of 12 months. The participants will be recruited from the rolls of several agencies dealing with the cognitively impaired and their families. The development of the scheduled interviews has benefited from a qualitative pilot study that has been conducted.
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