Personal losses and relationship quality in dementia caregiving

Models of the dementia caregiving stress process specify that the impairments and behavioral problems of the person with Alzheimer's disease or related disorder (ADRD) and primary subjective stressors, such as burden, along with secondary stressors and appraisals, lead to negative outcomes such as depression. This cross-sectional study focused on the affective and relational aspects of this process, examining the associations of personal and relational losses and perceived relationship quality to ADRD caregivers' depressive symptoms, using a series of multiple regressions to specify a path model. This theoretical model specified personal losses and the subjective relationship quality as intervening variables between the care recipient impairments and subsequent subjective stressors, overload and role captivity. Loss of intimate exchange, current quality of relationship, and loss of self each had direct effects or indirect effects on caregiver depression that suggest the important role of personal and relational losses in the stress process.