Date of Award

1-1-2023

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Joan K. Monin

Abstract

Background. Identities and dynamics in relationships can change when one spouse develops dementia. This study aimed to understand the various types of goals both spousal care partners and persons living with dementia (PLWD) have for their relationship, and to explore whether approach or avoidance goals were associated with individual wellbeing and relational support – as well as their partners’ wellbeing and support.

Methods. A secondary analysis of data from sixty-two spousal dyads where one partner has dementia was conducted. Thematic goal-type categories were determined through a card-sort content analysis methodology using participants’ brief qualitative responses to a question asking about their relationship goals. Responses were also coded according to the approach-avoidance theoretical framework to be used in inferential analyses examining their association to wellbeing outcome measures. All analyses were completed for care partners and PLWD.

Results. The types of goals expressed by care partners and PLWD were thematically similar and could be categorized into six meaningfully different perspectives: 1) Opportunities for closeness and reciprocity; 2) Emotion regulation and coping mechanisms; 3) Demonstration of relationship commitment; 4) Maintenance of the status-quo; 5) Demoralization in relationship quality; and 6) Other-Miscellaneous. When the PLWD had an avoidance-type goal, their care partner reported significantly higher positive affect compared to care partners with partners with dementia who had approach-type goals. Moreover, PLWD who reported that their relationship was already positive had significantly higher levels of perceived partner responsiveness compared to those who said they did not have any goals for their relationship.

Conclusion. This study sheds light on the different goals, or lack thereof, that both care partners and PLWD have for their relationship. Results also demonstrate the potential positive consequences of having certain relationship goals on wellbeing in the context of dementia. Findings may inform future research and intervention programming to better support spousal dyads through the changes brought on by dementia.

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This is an Open Access Thesis.

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