Empathy, Support Exchanges, and Well-Being in Older Couples Coping With Early Stage Alzheimer’s Disease

项目总结

PROJECT SUMMARY Spouses typically take on the primary caregiver role when older adults have Alzheimer’s disease (AD), which reduces their own well-being. These caregivers, however, vary in the quality of care they provide and the burdens they face. Scholars propose that caregivers’ empathy (i.e., their ability to share and understand others’ emotions) explains this variation and they view empathy as a key point of intervention with caregivers. Yet, little is known about the mechanism through which empathy influences caregiving experiences and outcomes, which hinders the development of interventions intended to benefit both older adults with AD and their caregivers. The proposed study seeks to distinguish among multiple aspects of empathy that have been intertwined in prior research and identify the aspects that facilitate effective caregiving. We also propose to utilize a dyadic approach and examine positive contributions of older adults with AD, who have often been viewed solely as a source of stress and burden. Theories of dyadic coping posit that members of a dyad may engage in joint problem solving in the face of shared stressors including AD-related problems, and that effective dyadic coping is crucial for maintaining both dyad members’ well-being. Older adults with early stage (i.e., mild-to-moderate) AD have preserved socioemotional skills that may allow for the provision of emotional support, and they may also still be able to offer instrumental support with easy tasks. Moreover, these older adults report empathy levels comparable to those of healthy normal older adults, and their empathy likely influences their own behaviors and the care their partners provide. This R21 presents an innovative study that will investigate the dynamics of support exchanges in older couples coping with early stage AD, and examine the dyadic associations between empathy, support exchanges, and well-being. We will draw on self-report data from older adults with early stage probable or possible AD and their spousal caregivers (N = 60 dyads). Aim 1 will investigate how both dyad members’ empathy is associated with the frequency and quality of support to and from each other. Aim 2 will examine how both dyad members’ empathy is associated with their appraisal of support to and from each other. Aim 3 will identify how both dyad members’ empathy is associated with their well-being and consider support experience as an underlying mechanism. We propose to examine within- and cross-spouse quantitative associations, and rely on qualitative data to better understand the meanings and processes underlying these associations. We also will compare associations between dyad members. Findings will advance our understanding of how AD care emanates from an ongoing close tie and how empathy, as a prominent dimension of this tie, facilitates mutually beneficial exchanges. This study will provide essential knowledge to guide the development and refinement of nondrug care interventions, and create a foundation for future R01s to examine whether mutually beneficial exchanges in early stages influence the trajectory of AD- related declines and the way caregivers help and cope with stress in the long run.