CARE PREFERENCES IN DEMENTIA: THE IMPACT OF INCONGRUENCE ON PERSONS WITH DEMENTIA AND CARE PARTNERS

The psychosocial impact of care preference incongruence on persons with dementia and their family caregiver remains unexplored in the literature. In-depth interviews were conducted with 128 dyads each consisting of a person with dementia and a family caregiver. Baseline data from an intervention study were used to examine incongruence between the preferences of the caregiver and the person with dementia (actual incongruence) as well as the caregiver’s own preferences and the caregiver’s perception of the person with dementia’s preferences (perceived incongruence). Preferences for three care-related domains were recorded: personal activities of daily living (PADLs), instrumental activities of daily living (IADLs), and socioemotional tasks. Outcomes included dyadic relationship strain, quality of life, and mood for both the caregiver and person with dementia. Results indicated that perceived incongruence of care preferences was a better predictor of negative psychosocial outcomes than actual incongruence. Actual incongruence for socioemotional care preferences was a predictor of greater relationship strain and worse mood for the person with dementia, while perceived incongruence for socioemotional care preferences was related to lower quality of life and worse mood for the caregiver. Unexpectedly, perceived incongruence for PADLs predicted higher quality of life and better mood for the caregiver. Findings have implications for communication between care partners, especially regarding socioemotional care preferences. These socioemotional preferences, which might be overlooked in the creation of a care plan, may influence the person with dementia’s well-being.