Family Caregivers: Disability, Illness, and Ageing

By Hilary Schofield; Sidney Bloch et al. | Go to book overview

6
THE RELATIVE BURDEN OF
PHYSICAL AND MENTAL
DISABILITIES

With the increasing need to understand the stressors of family caregiving, and thereby develop and provide appropriate supports, various studies have attempted to identify the aspects of disability that are most emotionally burdensome to carers. Some argue that dealing with cognitive impairment and behavioural disturbance is more stressful than dealing with physical or functional disability. 1 In studies of dementia carers, behavioural and mood disturbance have been found to be closely associated with carer burden and distress 2 and predictive of depression. 3 Moreover, behaviour and mood disturbance in dementia patients is more highly correlated to carer burden than is physical disability in stroke patients; 4 indeed one study found no significant relationship between carer burden and level of physical disability in stroke patients. 5

Comparing carers from distinct disability groups has been less conclusive. It was found that carers of those with physical disability, but not carers of the elderly with behavioural disability, had greater anxiety and depression and worse self-rated health. 6 A comparable study found no differences in carer burden. 7 Dementia carers have been found to have similar levels of burden or distress to those caring for physically-impaired stroke, 8 cardiac, 9 and cancer patients. 10

Whether or not cognitive disability has been diagnosed as Alzheimer's disease or other dementia may also affect carer burden. Carers are less likely to interpret behaviour problems as 'misbehaviour or a result of some failure on their own part' when they have knowledge of dementia symptoms ( Rabins 1985:81). As Alzheimer's

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