By Marjorie S. Miller

UNIVERSITY PARK, Pa. – Caregivers who employ adult daycare services to help care for individuals with dementia have fewer emotional ups and downs, and that may protect the caregivers’ health, according to Penn State researchers.

A study that investigated emotional fluctuations in caregivers of individuals with dementia by researchers in the College of Health and Human Development has been published in the journal Health Psychology. Yin Liu, a doctoral candidate, is the first author. Additional authors include Steven H. Zarit, distinguished professor of human development and family studies (HDFS); David M. Almeida, professor of human development and family studies; and Kyungmin Kim, postdoctoral scholar.

The study examined associations between fluctuation in daily negative affect (i.e., depression and anger) and use of adult daycare, daily experiences, and other caregiving characteristics.

“Specifically, it shows that people who use more days of adult day care have fewer day-to-day intrinsic emotional fluctuations,” Zarit said. “These fluctuations represent individual differences in how emotionally reactive people are after controlling for the events of the day. Emotional reactivity has been linked to increased illness in other studies. Reduced emotional liability due to adult day care use may be protective of caregivers’ health.”

The researchers asked 173 family caregivers of individuals with dementia to keep an eight-day diary of their experiences. Statistical models were then used to show associations between daily stressors and changes in affect, and to test hypotheses on associations between daycare use, daily experiences, and emotional fluctuations.

“We know that people who are more emotionally labile -- who have greater fluctuations -- are more at risk of developing health problems when they are in stressful situations,” Liu said. “We examined the magnitude of caregivers’ daily emotional lability in negative affect, and associations with daily experiences, caregiving characteristics, and whether getting relief from caregiving stressors by an ADS program makes a difference in emotional lability.”

The study showed that, when the sum of days of adult daycare use was greater than average, there was a stabilizing effect on fluctuations in caregivers’ emotions, specifically with regard to negative affect. Better sleep quality was associated with less fluctuation in anger; and younger age and more years of education were associated with less fluctuation in daily depression.

“Emotional well-being refers to both the level of affect, and its fluctuation. When emotional well-being is studied, researchers usually focus on the level – how much positive or negative emotion someone experiences. In this study, we considered both aspects. After we take into account daily experiences, such as stressors – people still differed from one another in emotional fluctuations from day to day. The amount of fluctuation, however, was lower when people used more days of adult day services for their relative across the period we observed them (8 days),” Liu said.

Specifically, there was a stabilizing effect on caregivers’ daily depressive symptoms and anger. The results suggest that getting more days of relief from full-time caregiving help people control ups and downs in their emotions.

“In a previous study, we showed that levels of depression and anger were decreased on days the caregiver's relative attended adult day services. Here we show more emotional stability as well,” Liu added. Both dimensions of emotion play a role in health.

“With the unconditional help and support from Dr. Zarit and the lab there will be more exciting and innovative work on family caregivers’ health and well-being,” Liu said. “This study is only a humble start.”

The research was supported by a grant from the National Institute on Aging.

The paper, "Daily Fluctuation in Negative Affect for Family Caregivers of Individuals with Dementia," is available in the November issue of Health Psychology.   back...
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