Face-to-face interviews with 50 older women caring at home for a husband with dementia revealed that gratification was associated with greater well-being and frustration with more distress. Wives who perceived continuity in marital closeness since the illness had greater gratification than those who perceived change. Frustrations, in disrupting life plans, are apparently greatest at the onset of symptoms and as routines are developed, diminish despite the need to provide more care. Still, the meanings of caregiving are more important to caregiver well-being than the amount of care provided.
Practitioners may promote caregiver well-being by preserving continuity and minimizing disruption in the lives of caregivers. This can be done by recognizing, initially, the adverse effects of the onset of the illness on caregiver well-being and assisting caregivers in minimizing the initial disruption. Secondly, clinical assessment of the frustrations and gratifications of caregiving can identify caregivers-at-risk. Assessment should be focused on the meaning of caregiving in terms of expressed affection, reciprocity, and continuity of meaningful marriages. Practitioners should not overlook the possibility of the patient as a vital source of support and continuity for the caregiver. Thirdly, practitioners may wish to assist caregivers to sustain meaningful marriages rather than relinquish their caregiving role.