Author ORCID Identifier

https://orcid.org/0000-0002-5988-2648

Year of Publication

2020

Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation

College

Communication and Information

Department

Communication

First Advisor

Dr. Allison Gordon

Abstract

Currently there are more than 16 million unpaid Alzheimer’s disease and dementia caregivers in the United States. These caregivers are often family members of the person living with dementia, and as they navigate the process of giving care to the patient, they must also maintain relationships with each other. Families enter the dementia experience with a history of their relational experiences, and their relational experiences potentially change as they navigate family experiences after the dementia diagnosis. Much existing scholarship examining family communication in the context of progressive Alzheimer’s disease and other related dementias has focused on the perspectives of one individual within a family, single communication encounters, and has operationalized communication in terms of frequency. This dissertation applied the multiple goals theory of interpersonal relationships (Caughlin, 2010) to address some of the gaps in extant scholarship by focusing on family dyads, collective past communication experiences, and measured the quality of family communication. Seven research questions were presented, which inquired about the associations between pre-diagnosis relational dynamics, post-diagnosis communication satisfaction, post-diagnosis interaction goals, and post-diagnosis relational dynamics.

Perspectives of adult family members of U.S. dementia patients were elicited through self-guided online questionnaires. Participants were recruited in dyadic pairs, and the total sample included 53 family dyads (n = 106 individuals). Data were analyzed using path analyses in actor-partner interdependence models to examine the relationships between variables. Statistically significant actor effects were observed between pre-diagnosis relational dynamics and post-diagnosis communication satisfaction, post-diagnosis interaction goals and communication satisfaction, and post-diagnosis communication satisfaction and relational dynamics. Statistically significant actor and partner effects were observed between pre-diagnosis relational dynamics and post-diagnosis interaction goals, pre- and post-diagnosis relational dynamics, and post-diagnosis interaction goals and relational dynamics.

The results of this dissertation provide compelling evidence that actual communication experiences are important to how family members evaluate their ability to attend to interaction goals in the context of dementia, and those perceptions in turn affect family relational dynamics after the dementia diagnosis. Findings of this research demonstrate that pre-diagnosis relational dynamics aggregate and influence post-diagnosis perceptions and evaluations of own and other’s interaction goals and satisfaction with enacted communication. Additionally, results of this dissertation show family members’ ratings of relational closeness increased and functioning decreased from pre- to post-diagnosis.

Results of this dissertation have several theoretical and practical implications. Theoretically speaking, these findings provide evidence supporting previous multiple goals research and extending this work into the family dementia context. Actual communication experiences are important to how family members evaluate their ability to attend to interaction goals in this context, and those perceptions in turn affect family relational dynamics after the patient’s dementia diagnosis. The current research also provides some initial evidence that more global perceptions of interaction goals are related to more global relational concepts. Additionally, the findings from this dissertation can be used to inform the evidence-based evaluation of dementia caregiver interventions, education programs, and online social support resources. The interwoven experience of family members navigating the experience of dementia is complex. The practical insight gained from these results can be used to assist caregivers and families with their relational needs and to mitigate the negative implications associated with caregiving. These findings can be utilized to ultimately improve health outcomes for family members of dementia patients and patients themselves.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2020.085

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