The Association Between Intergenerational Relationships and Caregiving Burden Among Adult Children and Grandchildren of People with Alzheimer's Disease

Background: Alzheimer’s disease is a progressive neurological disease, and it is the most common cause of dementia in Israel and worldwide. The continued increase in life expectancy leads not only to a greater number of people suffering from Alzheimer’s, but also to the burden of caring for these patients being shared by more than one generation of family members. Nevertheless, researchers have yet to study the association between intergenerational relationships and the caregiver burden experienced by two generations simultaneously.

Purpose: To study the association between the intergenerational relationships of adult children and grandchildren of Alzheimer's patients, and the caregiver burden they experience, on the basis of the intergenerational solidarity model and the stress process model.

Method: A cross-sectional study was conducted using a convenience sample that included 45 dyads of adult children and grandchildren of Alzheimer's patients. The participants were recruited via two major sources: adult daycare centers that referred primary family caregivers of Alzheimer's patients to the study, as well as relevant support groups on their social networks. The participants were given a structured questionnaire on which they were asked about their experiences regarding the burden of caring for the family member with Alzheimer’s; primary stress factors related to the patient, such as the patient’s cognitive state, problematic behavior, and treatment situation; and secondary stress factors, such as the participants’ emotional closeness with the patient, the number of phone calls and face-to-face meetings with the patient, and their residential proximity to the patient.

Findings Most of the study’s participants reported medium levels of caregiver burden, alongside relatively high levels of primary stress factors (the patient’s cognitive state and problematic behavior). In terms of the secondary stress factors, participants reported relatively low levels of emotional closeness, yet they also reported relatively high levels of residential proximity, as well as a high number of phone calls and in-person meetings with the patient.

The findings also showed that adult children reported higher levels of caregiver burden than those reported by adult grandchildren. No statistically significant differences were found between adult children and grandchildren in terms of emotional closeness and residential proximity. Hierarchical stepwise multiple regression showed that the study model was statistically significant, F(8,77)=13.55, p<.001, R²=.53, and that the specific family relationship, emotional closeness, and residential proximity parameters accounted for 53% of the variance in caregiver burden. 

Importance: To the best of our knowledge this is the first study to examine the connection between intergenerational relationships of adult children and grandchildren of Alzheimer's patients, and the caregiver burden they experience, using an integrative model based on the combination of two established theoretical models, thus enriching the body of knowledge on the subject. Practically, the study’s findings can assist in creating intervention plans for multigenerational family caregivers of Alzheimer’s patients that may help to detect and prevent significant caregiver burden.