Momentary appraisals of uncontrollable and unpredictable events predict caregiver well-being: Evidence from an experience sampling study

Family caregivers of people with dementia are at risk of chronic stress, which can adversely affect their mental well-being. Understanding how daily stressors impact caregivers is crucial for developing effective support strategies.

This experience sampling study involved spousal caregivers of home-dwelling individuals with dementia. Data on caregivers' appraisals of daily events and their emotional and behavioural responses were collected over six weeks. The association between perceived controllability and unpredictability of events and caregivers' responses, and how these responses predicted future mental well-being outcomes was analysed using a multi-level modelling.

Family caregivers who perceived events as less controllable experienced higher momentary negative affect (B = −.10, SE = .01, p < .001) and lower momentary positive affect (B = .18, SE = .02, p < .001). Similarly, more unpredictable events were associated with lower positive (B = −.05, SE = .01, p < .01) and higher negative momentary affect (B = .03, SE = .01, p < .05). These stressors were also related to reduced engagement in meaningful activities (B = −.09, SE = .02, p < .001) and lower social participation (B = −.03, SE = .01, p < .01). Greater affective reactivity to unpredictable events was linked to increasing stress (B = −24.62, SE = 12.10, p < .05) and decreasing sense of competence (B = −24.86, SE = 11.29, p < .05) over time. Within- and between-person variability of variables was observed.

Uncontrollable and unpredictable events seem to significantly impact some mental well-being outcomes of dementia caregivers. Future research should further investigate the cause of these stressors and whether they are dementia-specific, also using idionomic methods.