Robert M. Baume

Spouse caregivers of Alzheimer patients: problem responses to caregiver burden.

This paper reports on comparisons of patterns of responses by 199 spouses of Alzheimer disease patients to stresses of functioning as caregivers. Focusing on gender and age of spouses, we examine effects of the total burden of caregiving and perceived patient problems on a set of emotional and social responses of caregivers. We also examine ways in which depressive symptoms and anxiety of spouse caregivers were associated with patterns of their responses to caregiving stresses. Total patient problem burden was most strongly associated positively with caregiver anger-resentment toward the patient, followed by caregiver concerns about personal time restriction and limitation of social life. Among individual areas of patient problems, emotional lability of the patient rather than cognitive impairment appeared strongest by far in affecting caregiver response measures. Negative impact of caregiving on their social life and associations appeared to have particularly marked effects on effects on caregiver depressive symptoms and anxiety scores. Spouse caregivers did not differ by age in clinically significant ways in their patterns of reaction to stresses of caregiving. The study suggests the importance of considering potential spouse caregiver reactions in such areas as anger and aggressive response to patients, the impact of feelings of social deprivation and personal sacrifice, as well as the implications of caregiving stresses for patient care and maintenance of family cohesion and quality of life.

Vulnerability of husband and wife caregivers of Alzheimer disease patients to caregiving stressors

This study assessed relationships between problem behaviors in 199 Alzheimer Disease patients and vulnerability factors in the well being and emotional health of their spouse caregivers. Among caregiver wives and the younger caregiver husbands (64 years old and under) the volume of patient problem behavior was significantly negatively associated with total scores on a summary well being measure. The association was not found within the older husband caregiver group. Considering five subdimensions of the summary well being scale (Anxiety, Depressive Symptoms, Positive Well Being, Vitality and General Health), correlational analyses showed that the total patient problems measure appeared to have impact primarily among wife caregivers, particularly those 64 years old and under. Multiple regression analyses showed that one patient problem behavior category, Emotional Lability, was the single strongest predictor of impaired well being of the caregiver among all five subdimensions of the caregiver well being measure. Although Destructive Behavior of the patient was not significant by itself, an Age by Destructive Behavior interaction showed that high levels of patient Destructive Behavior predicted high levels of Depression, Anxiety, and low levels of Positive Well Being more among younger caregivers. Husband caregivers had significantly higher Anxiety scores than wife caregivers. These findings document how particular patient problem behaviors can affect caregivers. They point up as well how both gender and age may help target which caregivers are most vulnerable to the stress of specific Alzheimer patient behavior problems. They also suggest the utility of examining specific dimensions of well being rather than a total score alone for purposes of understanding the relationship of particular patient behavior problems to caregiver emotional and physical health.

Pre-surgery psychological characteristics, pain response, and activities impairment in female patients with repeated periodontal surgery.

This study assessed relationships between pre-surgery psychological characteristics and post-surgery pain response and impairment of life activities following each of two sessions of periodontal surgery. Forty-two female periodontal patients between the ages 26 and 67 participated. None had experienced previous peridontal surgery. Pre-surgery scores on dental anxiety, fatigue, and depression were positively associated with measures of post-surgery pain after the first surgery, and were negatively associated with positive well-being scores. A similar, though weaker pattern of associations was evident after the second surgery. Younger women reported significantly greater impairment of life activities during recovery than did the older women after both surgery episodes. The study points to the relevance of pre-surgery well-being and psychological stability as predictors of post-surgery pain and degree of impairment of life activities, as seen in the time sequence of repeated surgeries.

Stature, head height, and growth of the vertical face

Six hundred sixty-three cephalometric radiographs are used in a mixed longitudinal sample of fifty-one subjects (twenty-six males and twenty-five females) in order to determine patterns of vertical facial change during growth and to discern lower, mid-, and upper facial relationships with stature and head height. Results indicate that the absolute growth of the face is similar to the neural pattern and that throughout growth the face is larger among males than among females. However, when facial values are examined relative to stature and head height, the vertical face changes at a rate that resembles statural growth. Moreover, when relative growth values are standardized in order to reduce scaling differences, they indicate that, although relative growth for all three facial measures falls between neural and skeletal values, it is closer to the postcranial pattern of change than to the neural pattern. In addition, relative size of the upper face is highly correlated with relative size of the lower face. It is concluded that stature is of greater importance than head height in the prediction of vertical facial growth.

The sexual functioning of elderly hypertensive women.

Abstract To assess the sexual interest and behavior of a large cohort of 60-80 year-old women with mild to moderate hypertension, data from a large multicenter study were analyzed. Of the 142 hypertensive women with partners, 87 (61 %) were sexually active and 55 (39%) were sexually abstinent. The sexually active women were somewhat younger, had higher household incomes, and reported higher ratings of subjective sexual interest than didthe abstinent women. For sexually abstinent women, two major factors appeared to determine the leuel of sexual activity: their partnerS level of sexual desire and his health. Of particular note is the finding that the majority of women in both groups indicated moderate or high satisfaction with their sexual 1ife. When the sample was divided into “younger” elderly (age 69 or below) and “older” elderly (70 or above), the percentage of women displaying moderate or high sexual interest was quite similar (76% and 65%, respectively). Difficulty achieving orgasm and lack of vagina...