Understanding the Burden: Exploring Key Factors in Dementia Caregiving in Residential Care Homes.

Background: The factors of influence on caregiver burden with regard to dementia care provided in residential care homes are multifaceted. Few studies in the literature have simultaneously investigated the variables related to residential care recipients with dementia and their formal caregivers.

Purpose: This study was designed to assess caregiving burden in formal caregivers of residential care recipients with dementia and to identify significant predictors of this burden associated with these care recipients and their caregivers.

Methods: This prospective cross-sectional study enrolled 206 registered nurses and nursing assistants working as formal caregivers, as well as 256 residents with dementia across 6 residential care homes. Structured questionnaires were used to collect data on the sociodemographic characteristics, attitudes, dementia care knowledge, and caregiver burden of nursing staff, as well as data on the sociodemographic characteristics, daily functional ability, cognitive functioning, and neuropsychiatric symptoms of residential care recipients with dementia.

Results: The formal caregivers in this study reported experiencing mild to moderate care burden. Stepwise linear regression analysis identified prior dementia care training, confidence in care provision, and attitude in the formal caregivers and number of medications and agitation/aggression levels in the residents as significant predictors of caregiving burden, explaining 32% of the variance. Unexpectedly, the basic dementia care knowledge of the caregivers and the physical dependence and other neuropsychiatric symptoms of the residents were not identified as significant predictors of caregiver burden.

Conclusions/implications for practice: The findings of this study underscore the critical importance of caregiver attitude, confidence, and coping skills in determining caregiving burden, noting that not all behavioral and psychological symptoms impact this burden equally. These insights emphasize the need to enhance confidence and positive attitudes in formal caregivers and to effectively manage residents' aggressive behaviors through both pharmacological and nonpharmacological approaches to ameliorate the high caregiver burden associated with dementia care.