Dementia caregiving in spousal relationships: a dyadic perspective

The number of couples facing a dementia diagnosis for one partner of the spousal dyad increases. Spousal caregiving can be a highly stressful experience associated with negative caregiver outcomes such as depression and poorer immune function. However, surprisingly little is known about how the illness and the required care effects patient's well-being and relational changes experienced by afflicted couples. The aim of this study was to provide a literature review on how the dyadic perspective is taken into account and on how dementia effects both parts of the dyad.

In order to outline findings about individual and dyadic well-being of affected couples, we conducted a literature search to review the three types of studies. First, studies focusing on one partner's perspective, usually the perspective of the caregiver; second, studies including the caregiver's and partially the care receiver's view; third, studies directly referring to both partners' perspectives.

The majority of studies neglect the individual with dementia by exclusively assessing caregiver variables or only indirectly including patients' characteristics. Very few studies embrace dyadic and relational variables to execute how both partners experience the illness, spousal caregiving, and changes in the relationship. Despite the arguable validity of self reports of individuals with dementia, some studies demonstrated the usefulness of including both partners' perspectives.

Results indicate the urgent need of integrating the perspective of the individual with dementia to improve the understanding of the effects of dementia caregiving. Directly assessing the dyadic perspective of affected couples provides essential information for interventions.