Yes / Objectives: Longitudinal evidence documenting health conditions in spousal caregivers of people with dementia and whether these influence caregivers’ outcomes is scarce. This study explores type and number of health conditions over two years in caregivers of people with dementia and subgroups based on age, sex, education, hours of care, informant-rated functional ability, neuropsychiatric symptoms, cognition of the person with dementia, and length of diagnosis in the person with dementia. It also explores whether over time the number of health conditions is associated with caregivers’ stress, positive experiences of caregiving, and social networks Methods: Longitudinal data from the IDEAL (Improving the experience of Dementia and Enhancing Active Life) cohort were used. Participants comprised spousal caregivers (n = 977) of people with dementia. Self-reported health conditions using the Charlson Comorbidity Index, stress, positive experiences of caregiving, and social network were assessed over two years. Mixed effect models were used Results: On average participants had 1.5 health conditions at baseline; increasing to 2.1 conditions over two years. More health conditions were reported by caregivers who were older, had no formal education, provided 10 + hours of care per day, and/or cared for a person with more neuropsychiatric symptoms at baseline. More baseline health conditions were associated with greater stress at baseline but not with stress over time. Over two years, when caregivers’ health conditions increased, their stress increased whereas their social network diminished Discussion: Findings highlight that most caregivers have their own health problems which require management to avoid increased stress and shrinking of social networks / Economic and Social Research Council (ESRC) and the National Institute for Health and Care Research (NIHR) - grant ES/L001853/2. Alzheimer’s Society, grant number 348, AS-PR2-16-001. Sabatini was supported by an ESRC Postdoctoral fellowship (ES/X007766/1).

The thesis focuses on care of clients with Alzheimer's, including the burden of family members and possible options of using services of a day care and a week care centre. The theoretical part of the thesis deals with Alzheimer's disease together with nursing care, health care system in the Czech Republic and possibility to use services of day care and week care centres. In the empirical part of the thesis the method of qualitative research was used. A non standardized interview was applied as a method of questioning. The results of the qualitative research clearly show that the care for clients with Alzheimer's dementia represents a major burden for family members who care for the ill and in connection with the care provided they have to tackle following problems. They have to cope with the gradual deterioration of memory of the ill, which is associated with occasional forgetfulness, disorientation, wandering around. Another problem is to handle in an acceptable way the change of behaviour of their loved ones who often attack them both verbally and physically. Family members help patients with feeding, emptying, hygiene and grooming. They must solve the difficulties with activation of patients including memory exercises, they watch whether the patients swallow the medication. The conclusions of the thesis show that family members have to deal with many above mentioned problems when providing care for their loved ones. They themselves are tired and exhausted due to the care they provide, which is related to the incidents of their own health problems. They neglect themselves and their families, it is difficult for them to coordinate the care with their job and often come to work sleepy. For these reasons they would like to use services of day care and week care centres. It eases them of the burden of care, which they see as a benefit. The research revealed the expected services of the day care centre including expected nursing care. The research results were presented to the management of the Aftercare Hospital in Humpolec as it had planned to open a day care centre for patients with Alzheimer's dementia. Furthermore, the results served as a basis for the seminar for potential applicants, who would like to work in the centre. Based on information obtained in the course of writing of the thesis, a draft of the brochure was created which would serve as information material for family members of clients with Alzheimer's including the patients themselves.