The concept of resilience, which indicates people's capability of using resources in difficult circumstances in order to reduce or prevent negative effects and achieve positive outcomes, has given a new perspective to the scientific literature on the experience of late-life memory loss and the experience of caring for persons with memory loss. The current research was guided by incorporation of resilience into the stress process model for assessing personal and caregiver burden associated with mild and more severe memory loss. I conducted two studies to investigate the association of protective factors with the well-being of people with dementia or mild cognitive impairment and their caregivers. The first study focused on the well-being of older persons with dementia (PwDs). I employed data from a large national sample of older adults to examine how the perceived social cohesion of neighborhoods affects quality of life among people with and without cognitive impairment in conjunction with their engagement in valued leisure activities. Findings revealed that, regardless of cognitive health status, all participants who perceived high neighborhood social cohesion reported better quality of life along with more participation in valued activities. However, PwDs reported significantly lower perceived neighborhood social cohesion, less involvement in valued activities, and poorer quality of life than persons without cognitive impairment. The second study focused on the well-being of caregivers for older persons with mild cognitive impairment (PwMCIs). I used dyadic data from families dealing with mild cognitive impairment to examine how well-being of caregivers for PwMCIs differed according to whether PwMCI-caregiver dyads had similar or different perceptions of the PwMCIs' cognitive impairment severity. Caregivers reported lower caregiving burden when they and PwMCIs had a similar cognitive impairment representation, or when caregivers rated the PwMCIs’ cognitive functioning more positively than the PwMCIs rated themselves. Also, PwMCIs’ and caregivers' perceptions, and their concordance or discrepancy in those perceptions, varied across the multiple domains related to MCI symptoms. These findings demonstrate that care dyads' perception of MCI-related deficits is not a unitary construct, and that the context of PwMCIs’ and caregivers’ dyadic illness appraisals is significantly associated with the caregivers' well-being. Taken together, the results of these two studies illustrate the value of considering resilience processes in people with cognitive impairment and their caregivers. Examining dimensions of resilience, in association with assessment of the intersecting effects of personal, interpersonal, and environmental factors, provides additional information about the effects of cognitive impairment on older adults’ well-being and the effects of assisting someone with cognitive impairment on caregiver well-being. / Ph. D. / Resilience indicates people's ability to successfully adapt to or bounce back from life adversity by using personal, social, and environmental resources. Resilience helps explain what makes some people with dementia and their caregivers tolerant of changes in memory functioning and able to adapt to difficulties associated with dementia. I conducted two studies to investigate the role of protective resources in buffering negative effects of memory loss on people with dementia and their caregivers. The first study compared people with and without dementia to find out how their sense of belonging to the community and their participation in valued leisure activities influenced their quality of life. Regardless of whether they had memory loss or not, all the people with a stronger sense of belonging in the community participated in more leisure and valued activities and, in turn, had better quality of life. However, compared to cognitively healthy people, those with dementia had lower sense of belonging, less participation in leisure activities, and poorer quality of life. These findings indicate that people with dementia may feel excluded from their community and experience barriers to participation in valued activities. Nevertheless, feeling that one belongs in the neighborhood and participating in valued leisure activities is important for well-being of older adults both with and without cognitive impairment. The second study examined how the well-being of caregivers for persons with mild cognitive impairment (MCI) differed according to whether caregivers and their care recipients had similar or different views on the care recipients’ memory problems. When they both had similar views or the caregivers had a more positive view than their care recipients did, the caregivers reported higher well-being. This finding suggests that some caregivers for people with MCI understand how the person with MCI views their own memory loss, and others either are not aware of all the memory loss symptoms or choose to ignore some of them. In either case, these caregivers feel less burdened than those who think their loved one’s symptoms are worse than the person with memory loss believes. Support for these caregivers is needed to help them cope better with the memory loss in their loved one. The results from these two studies provided valuable evidence about resilience in older adults facing memory loss and their caregivers. Being resilient can help people with dementia and their caregivers manage or overcome the difficulties associated with dementia.
| Identifer | oai:union.ndltd.org:VTETD/oai:vtechworks.lib.vt.edu:10919/86190 |
| Date | 07 June 2017 |
| Creators | Kim, Sujee |
| Contributors | Human Development, Blieszner, Rosemary, Sands, Laura P., Savla, Jyoti S., Roberto, Karen A. |
| Publisher | Virginia Tech |
| Source Sets | Virginia Tech Theses and Dissertation |
| Detected Language | English |
| Type | Dissertation |
| Format | ETD, application/pdf |
| Rights | In Copyright, http://rightsstatements.org/vocab/InC/1.0/ |
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