Review: pathways to morbidity in carers of dementia sufferers

The recent literature on informal carers of dementia patients is reviewed. Families bear the major responsibility for such care. The production of "burden" in carers is a complex process, involving developmental and cultural factors, in addition to the stressors of dementia itself. Also influential are the carer's gender, coping style, social network, and the carer's level of intimacy with the elder. The interpretation of actual morbidity is complicated by methodologic problems. However, carers appear to suffer from at least moderate levels of psychological symptomatology. Carers tend to judge their own health to be poorer than that of controls. Some studies have also found aspects of caregiving to be associated with elder abuse, but this is controversial. Caregiving in dementia appears to be at least as stressful as that in chronic physical illness and depression. Finally, the implications for service provision and future research are considered.