The influence of community-based services on the burden of spouses caring for their partners with dementia.

Despite the vast literature on caregiver stress, few studies have explored how community services affect the stress process for spousal caregivers. The current study explores the differential effects of emotional and tangible support provided by family and friends and by formal services, and caregivers' perceptions of community services on spousal caregivers' burden. The study used a survey design with a sample of 85 spousal caregivers caring for their partners with dementia in the community. The study found that in-home services, as they are currently offered, do little to reduce the burden of spouses caring for their partners with dementia. Rather the most effective service is the provision of adult day programs, which provide not only respite for the spousal caregiver, but also opportunities for social interaction for their partners with dementia. This study further found that spousal caregivers experience a relatively high level of service-related stress. However, when examined alongside care recipient behavioral challenges and frequency of day program use, caregivers' perceptions of and experiences with the service system did not uniquely explain their burden. Implications of the findings for policy, research, and practice are discussed.