Symptoms of Mental Impairment Among Elderly Adults and Their Effects on Family Caregivers

Research that has examined the relationship between caregiving stress and elders ' symptoms of mental impairment has focused primarily on cognitive incapacity. This research expands the symptoms of mental impairment to include caregivers ' reports of problems in elders ' social functioning and the presence of disruptive behavior, in addition to the traditional measure of cognitive incapacity. Results from a study of 614 families living with and caring for an impaired elder show cognitive incapacity to have a less important direct effect on caregiving stress than disruptive behavior and impaired social functioning. Cognitive incapacity does have an important indirect effect through its influence on disruptive behavior and social functioning. Key Words: Stress effects, Caregiver strain, Burden, Family caregiving RESEARCH shows that family members provid-ing high levels of care to an impaired elder often experience burden and stress (Johnson & Catalano, 1983; Thompson & Doll, 1982; Zarit et al., 1980). This research has focused primarily on stress that results from caring for an elder who is unable to perform activities of daily living (ADL) or from the level of physical care needed by the elder (Mindel & Wright, 1982). Although these studies point to an important source of strain for caregivers, other aspects of the elder's impairment may be salient as well. Many elders who are receiving care in the home demonstrate some level of mental impairment along with their physical incapacity. Providing a high level of care to a physically impaired individual may be stress pro-ducing, but if, in addition, that individual exhibits symptoms of mental impairment, the difficulties faced by the caregiver may be compounded. Research that does include symptoms of mental impairment commonly assesses only the elder'