The effects of duration of caregiving on institutionalization

Purpose: Our objective in this analysis was to de-termine how the duration of caregiving interacts with key care demands (i.e., severity of problem behaviors) to influence the institutionalization of individuals suffering from dementia. Methods: We utilized mul-tiregional data from 4,761 caregivers of individuals with dementia over a 3-year period. We conducted multinomial logistic and Cox proportional hazards analyses to determine the moderating effects of duration on behavior problems when institutionaliza-tion was predicted. Baseline covariates included the context of care, primary objective stressors, primary subjective stressors, resources, and global outcomes. Results: The Duration of care 3 Behavior problems interaction term was not significant in the multinomial regression or Cox hazards models. However, main effects models demonstrated that more recent care-givers were more likely to institutionalize individuals with dementia than respondents in different stages of the caregiving career. Implications: The results em-phasize the need to (a) broaden scientific conceptu-alizations to consider duration of care as integral; (b) refine targeting when interventions are administered early in the dementia caregiving process; and (c) understand patterns of attrition when caregiver adap-tation is modeled over time