Impacts from Dementia-Related Stigma and Direct Support Seeking on Family Caregiver Processes of Stress and Coping

This research investigated how stigma associated with Alzheimer’s disease and related dementias (ADRD) functions within stress and coping processes for family caregivers. Stigma was hypothesized to mediate an association between ADRD behavioral symptoms and family caregiver burden. Caregiver direct social network support seeking was also predicted to mitigate a negative impact of burden on their well-being. ADRD family caregivers (n=411) completed a Qualtrics survey having measures adapted from previously validated scales. Path
analysis conducted in AMOS using maximum likelihood estimation and bootstrapping (95%CI) indicated good model fit: χ2(4) = 12.098, p < .02, CFI = .99, TLI = .94, RMSEA = .07, SRMR = .02. As hypothesized, ADRD behavioral symptoms were associated with stigma (B = .45, = .56, p < .001), with stigma also predicting burden (B = .23, = .27, p < .001). Behavioral symptoms also directly (B = .16, = .23, p = .01), and indirectly (B = .13, = .19, p = .01)
predicted caregiver burden, indicating stigma as partially mediating this association. Direct support seeking was also found to mediate a link between caregiver burden and well-being, although the indirect relationship between the later variables was small (B = .09, = .09, p = .01). Findings underscore the theoretical utility in including stigma within ADRD caregiver stress and coping models and studying caregiving health impacts from a network perspective.
Practical implications point to benefits from educational interventions addressing strategies to assist caregivers in communicating support needs explicitly within personal network.