UC Berkeley

Caring for a person with dementia (PWD) can be associated with considerable declines in health and well-being during active caregiving, although less is known about how former caregivers fare after caregiving has ended (i.e., after the death of the PWD). There is striking variability in the extent to which caregivers experience declines in health, so it is important to identify factors related to their vulnerability and resilience in order to reveal potential intervention targets. Studies have linked the quality of the PWD-caregiver relationship to caregivers’ health, but little is known about the specific interpersonal emotional mechanisms that contribute to long-term caregiver health. The present study addresses these gaps by evaluating caregivers’ emotional connection to the PWD in two independent samples and examining associations with caregivers’ depression, anxiety, and physical health—concurrently (in current caregivers) and longitudinally (in former caregivers, after caregiving has ended). In Study 1 (N = 82), caregivers and PWDs engaged in a conflict conversation in the laboratory, after which caregivers viewed video recordings of the conversation and provided second-by-second ratings of their own affective valence and the PWD’s affective valence during the conversation using a rating dial. Caregivers’ emotional connection to the PWD was operationalized by summing the number of seconds in which they reported experiencing positive or negative affect simultaneously with the PWD (i.e., co-experienced positive or negative affect). In Study 2 (N = 335), caregivers were asked to describe a recent time they felt connected to the PWD, and their responses were recorded verbatim. Caregivers’ emotional connection to the PWD was operationalized by summing the number of positive and negative words from the transcripts using text analysis software (i.e., positive and negative emotional connection language). Results revealed that greater co-experienced negative affect between caregivers and PWDs (Study 1) and caregivers’ lower positive emotional connection language (Study 2) were associated with higher levels of caregiver depression. In addition, caregivers’ positive emotional connection language predicted longitudinal decreases in caregiver depression after caregiving had ended (Study 2), which was robust when accounting for relevant covariates (e.g., caregiver demographics, PWD dementia severity). These findings identify caregivers’ greater negative and lower positive emotional connection to the PWD as potential risk factors for caregivers’ mental health problems. Future research should explore whether interventions that enhance social connection between caregivers and PWDs are effective in reducing depression and increasing quality of life.