Mark P. Rubert

Telecommunications technology as an aid to family caregivers of persons with dementia

Objective The aging of the population implies that an increased number of people are going to need some form of care or assistance. Caregiving poses a range of physical, emotional, and financial demands and often causes burden and stress for family members. This article describes how technology can be used to provide support to caregivers and increase the quality of life for both caregivers and care recipients. Preliminary data from an ongoing study of dementia caregivers is provided to demonstrate the feasibility of using technological interventions for this population. Methods The intervention involves a telecommunications system designed to augment a family therapy intervention by enhancing access to formal and informal support services. Specifically the system is intended to facilitate linkages between caregivers and other family members, friends, and other caregivers as well as to facilitate access to information on available resources. A total of 76 caregivers of dementia patients, including Cuban American and white American caregivers, received the telecommunications intervention. Data include real-time usage data and measures of usability at 6 months, 12 months, and 18 months after the initiation of the intervention. Results The data reported in this article are based on responses to the usability questionnaire at 6 months from a sample of 44 caregivers. Overall the results indicate that the system is easy to use and the caregivers find it valuable. The most common reason that the caregivers use the system is to communicate with other caregivers, especially those who are not nearby. The caregivers, especially the Cuban Americans, reported that the system facilitated their ability to communicate with family members and their therapist. The caregivers also indicated that they found participation in the “online discussion” groups to be very valuable and also found the “online resource guide”useful. Conclusions The results demonstrate how current information and communication technologies can be used to help caregivers meet the challenges of caregiving and improve the quality of life for caregivers. The potential benefit of this type of technology for health care providers is also discussed.

Understanding sources of user variability in computer-based data entry performance

The pervasive use of computers in work settings implies that an increased number of workers, with varying levels of skills and abilities, will be performing computerbased tasks. This study investigated the impact of age, cognitive abilities, and computer experience on the performance of a real world data entry task. One hundred and ten subjects, ranging in age from 20 - 75 years, performed the task for nine hours following task training. The results indicated that abilities such as visuo-spatial skills, motor skills and processing speed had a significant impact on performance as did age and prior computer experience. With respect to age, the older participants completed less work than the younger and middle-aged subjects. Age differences in psychomotor skills and processing speed appeared to be important factors underlying age effects. In fact, the data indicated that after controlling for differences in these abilities age was no longer a significant predictor of work output. Further, after controlling f...

Hispanic caregivers of adults with mental retardation: importance of family functioning.

Our aim in this study was to validate a stress-process model for Hispanic caregivers of adults with mental retardation that incorporates family functioning. The model postulates that maladaptive adult behaviors are related to poorer family relationships and higher levels of family burden, which in turn is related to caregiver psychological distress and self-reported health. The 153 Hispanic caregivers were interviewed in their homes with structured interviews and self-report measures. We analyzed cross-sectional data using structural equation modeling. The hypothesized model provided an excellent fit to the data. Also, family relationships mediated the relationship between maladaptive adult behaviors and family burden, and higher levels of family burden were related to greater caregiver distress. Acculturation was negatively related to caregiver distress.

An Evaluation of The NINCDS-ADRDA Neuropsychological Criteria for the Assessment of Alzheimer’s Disease: A Confirmatory Factor Analysis Of Single Versus Multi-Factor Models

Neuropsychological test batteries are frequently used to assess the nature and severity of cognitive deficits among patients with early Alzheimers Disease (AD) and related disorders. The NINCDS-ADRDA criteria are among the most widely used guidelines to diagnose dementia (McKhann et al.,1984). These criteria specify eight distinct areas of neuropsychological function that should be evaluated in patients with suspected cognitive impairment. Recent studies have suggested that neuropsychological deficits observed in AD may be explained by a single general factor related to memory deficits or to executive dysfunction. In contrast, the results of other investigations have indicated that multiple qualitatively different factors underlie cognitive abilities in AD. In the present study, we used confirmatory factor analysis to examine the structure of cognitive abilities in AD and to assess the extent to which single and multiple ability factors accurately represent neuropsychological test data obtained from patients with AD. Results indicated that the NINCDS-ADRDA model fit the data better than a single factor model. However, a more parsimonious model specifying memory, verbal abilities, visuospatial skills, executive function, and higher as well as lower functional activities of daily living fit the data better than the NINCDS-ADRDA model. These results have important theoretical and practical implications for diagnostic evaluation.

Well-Being and Family Role Strains Among Cuban American and Puerto Rican Mothers of Adults with Mental Retardation

Abstract This article examines predictors of depressive symptoms and caregiving burden in a sample of Cuban American and Puerto Rican caregivers of an adult child with mental retardation. Using a stress process model of caregiving, the focus of this analysis was on family role strains that result from the caregiving process, which were hypothesized to be particularly strong predictors of maternal well-being in Latino families. Findings indicate that Cuban American mothers of adults with mental retardation had higher socioeconomic status than Puerto Rican mothers, yet there was a substantial amount of within-group heterogeneity in family socio-demographic characteristics, linked closely with immigration patterns for the Cuban American mothers. However, taking into account socio-demographic diversity and ethnicity, findings demonstrate that mothers whose family had more problems had higher levels of burden and depressive symptoms, supporting the hypothesized importance of family functioning to Latina mothers with a non-normative parenting challenge.

Caregiving for Hispanic Alzheimer's Disease Patients: Understanding the Problem

The authors analyze aspects of caregiving for Hispanic Alzheimers disease (AD) patients. A review of the literature on caregiving and ethnicity and data concerning caregiving for AD patients in different Hispanic groups are presented. The presence of ethnicity-related differences in caregiving for Hispanic AD patients is confirmed. These differences, however, appear to be present largely in certain areas, such as household composition, distribution of caregiving roles, help-seeking behavior, and site of caregiving. The authors consider areas that need to be addressed in future research and specific modifications to current caregiving models for the study of AD patients in the Hispanic community.