Identifying at-risk, ethnically diverse stroke caregivers for counseling: a longitudinal study of mental health

This study examined (1) causality in the relationship between stroke caregiver mental health and care-recipient functioning, and (2) the prediction from stroke caregiver and care-recipient variables 5 months and 11 months later.

Questionnaire, interview, and observational data were collected from 124 ethnically diverse stroke caregiver/care-recipient dyads in the homes of care recipients at 1, 6, and 12 months after discharge.

The magnitudes of the causal pathways between stroke caregiver mental health and care-recipient functioning were not significantly different. At 1 month after discharge, the best predictors of poor caregiver mental health 11 months later were care-recipient low daily functioning and caregiver low sense of coherence, high burden, and high depression.

Caregiver mental health and care-recipient functioning may have reciprocal causal influence on each other, so one of the first steps in stroke rehabilitation may be providing counseling to the primary caregiver. Caregivers with high burden, a low sense of coherence, and a low-functioning care recipient are those most at risk for poor mental health outcomes.