An Alzheimer 's disease caregiver's dilemma: Reasons female caregivers decide to provide care at home or in a nursing home

Due to the progressive symptoms of Alzheimer's disease (AD), individuals diagnosed with AD need a caregiver to provide informal care. Many caregivers accept that nursing home placement is necessary while others continue to care for their loved one at home. Little research has focused on the female caregiver's perspective of this important decision. A qualitative study was conducted to determine reasons that female caregivers of individuals with AD, eligible for nursing home placement, decide to care for their loved one at home or in a nursing home. Female caregivers were identified using the South Carolina AD Registry. Cases (n=292, mean age = 59.93 + 11.02 yrs) were caregivers of nursing home residents and controls (n=262, mean age = 57.23 + 10.04 yrs) were caregivers of individuals staying in the community. Participants were asked about the main reasons for keeping their loved one at home or placing them in a nursing home. The results of the qualitative analysis showed that cases most frequently reported health problems (n=177) and behavior problems (n=91) of the individual with AD. The controls most frequently reported a sense of obligation to the individual with AD (n=147) and the belief of better care at home (n=43). The results suggest that the care recipient's health and caregiver issues play a major role in the decision as to where to best care for their loved one. These findings can help to guide the development of programs designed to provide support to caregivers as they make this difficult decision.