Nomenclature Used by Family Caregivers to Describe and Characterize Neuropsychiatric Symptoms

Author:

Gilmore-Bykovskyi Andrea1231ORCID,Mullen Shannon1,Block Laura1,Jacobs Abigail1,Werner Nicole E24

Affiliation:

1. School of Nursing Madison, Wisconsin

2. Division of Geriatrics, Department of Medicine, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, Wisconsin

3. Geriatric Research Education and Clinical Center (GRECC), William S. Middleton Hospital, United States Department of Veterans Affairs, Madison, Wisconsin

4. Department of Industrial and Systems Engineering, College of Engineering, University of Wisconsin–Madison, Madison, Wisconsin

Abstract

Abstract Background and Objectives Neuropsychiatric symptoms (NPS) are a core feature of Alzheimer’s disease and related dementias that are characterized by a fluctuating course. NPS are challenging to manage and contribute to high rates of burden among family caregivers. Successful information exchange between clinicians and family caregivers is critical for facilitating effective management of NPS. However, this communication is often challenging due to inconsistent terminology and classification of symptoms and limited understanding of how family caregivers recognize and describe symptoms. The objective of this study was to examine the language family caregivers’ use to describe and contextualize NPS. Research Design and Methods Descriptive qualitative study of 20 family caregivers in a mostly urban county in the Midwestern United States using semistructured interviews. Caregiver descriptions of NPS were analyzed using directed content and text analysis to examine terminology, followed by a thematic analysis approach to examine contextualization of NPS. Results Caregivers employed shared terminologies to describe NPS that differed substantially from clinical terminology used to classify symptoms. Caregivers frequently engaged sense-making as a strategy to explain NPS. This sense-making served to contextualize patterns in behavior and was characterized by explanatory, situational, and strategy-oriented frameworks for understanding behavior in terms of its purpose and meaning. Caregivers’ descriptions of NPS reflected broad overlap between individual NPS (i.e., agitation and care resistance) that would generally be considered clinically distinct symptoms. Discussion and Implications Nomenclature surrounding NPS may vary considerably between family caregivers and clinicians, and should be evaluated in partnership with people with dementia and their caregivers to ensure supportive interventions and resources are responsive to caregivers’ interpretation of symptoms and sense-making.

Funder

National Institutes of Health

National Science Foundation

Wisconsin Alzheimer’s Disease Research Center

UW School of Medicine and Public Health

Clinical and Translational Science Award (CTSA) program

National Center for Advancing Translational Sciences

Publisher

Oxford University Press (OUP)

Subject

Geriatrics and Gerontology,Gerontology,General Medicine

Reference34 articles.

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