Developing a New Behavioral Framework for Dementia Care Partner Resilience: A Mixed Research Synthesis.

BACKGROUND AND OBJECTIVES: Caring for a person living with dementia requires resilience, the capacity to recover and grow from challenging situations. Despite the increasing interest in assessing and promoting resilience for dementia care partners, behaviors that indicate this attribute are not well known. The aim of this study was to synthesize the literature to identify resilience-related behaviors and develop a new framework for future validation and intervention research. RESEARCH DESIGN AND METHODS: We searched English-language peer-reviewed articles (January 1991-June 2019) reporting qualitative or quantitative descriptions of resilience-related behaviors among dementia care partners. Thematic analysis was used to categorize behaviors into domains, identify the relationships among them, and generate a thematic map. RESULTS: Sixteen articles were identified according to predefined inclusion criteria. Four domains emerged: (a) problem-response behaviors (problem-solving, problem-distancing); (b) self-growth behaviors (self-care activities, spiritual-related activities, and developing and maintaining meaningful social relationships); (c) help-related behaviors (help-seeking and help-receiving); and (d) learning-related behaviors (learning from others and reflection). Definitions of each domain, identification of corresponding behaviors, and formulation of Care Partner Resilience (CP-R) behavioral framework were informed by mixed research synthesis results and other relevant literature. DISCUSSION AND IMPLICATIONS: The CP-R framework emerged as a result of a new focus on identifying and cultivating strengths instead of evaluating strain and burden. It serves as a useful foundation for understanding the impact of specific behaviors on dementia care partner resilience. Once validated, this framework will inform the development of future measures, research, interventions, and policies for dementia care partners.

Developing a Unifying Model of Resilience in Dementia Caregiving: A Scoping Review and Content Analysis.

Resilience, a capacity for addressing, recovering, and growing from challenging situations, can mitigate dementia care partners' burden. Three main theoretical models predominate, treating resilience variably as an outcome, a trait, or a process. In this scoping review, we examine how these three models inform definitions and measures of resilience in dementia care partners to understand whether there is a single coherent model and identify the gaps in conceptualizing and operationalizing resilience. We searched English-language peer-reviewed articles (January 1991-June 2019) that contained definitions and/or measures of resilience developed for or used with dementia care partners. Data were analyzed using content analysis. We found that perspectives from the three existing theoretical models can be integrated into a unified framework for the study of resilience in dementia care partners. However, major gaps remain in operationalizing resilience for research due to a paucity of resilience outcomes and knowledge about resilience-related behaviors.