INTRODUCTION
1. Background
The estimated number of people with dementia aged 65 or older in Korea was 880,000 in 2021, and this is expected to increase to 1.36 million in 2030 and 3.02 million in 2050 [1]. As the number of older adults with dementia is rapidly increasing annually, interest at the national and social levels is increasing to reduce the burden and care costs on families caring for older adults with dementia [2]. The majority of older adults with dementia want at-home care, and it has been shown that maintaining health while staying in the community is effective in not only improving the individual’s quality of life but also reducing the government’s financial burden. Domestically and internationally, various policy efforts are being made to support older adults to stay healthy in the community longer while maintaining as many aspects of their premorbid lives as possible [3].
Dementia refers to a condition in which cognitive functions such as language, learning, intelligence, and higher mental functions are diminished due to damage or destruction of the normal brain secondary to trauma or disease [1]. Older adults with dementia find it difficult to learn new things or adapt to unfamiliar environments on their own, and as dementia progresses, it becomes difficult to independently perform basic daily activities, such as toilet management, meals, and medication management, so careful care is required. Care includes protection, which includes not only satisfying the physical needs of the older adults with dementia but also emotional aspects, including interest in and intimacy with the older adult with dementia [4]. Most caregivers of older adults with dementia who need a lot of care are family members [5]. There are more women than men who are the primary caregivers of older adults with dementia, and daughters tend to most frequently have the strongest relationships with their parents with dementia [6]. The time that these family caregivers care for the older adults with dementia is reported to be more than 9 hours on average per day [7].
Caring refers to the act of providing care to a person who has difficulty carrying out daily activities on their own. Caring for older adults with dementia includes not only assistance with daily living, such as dressing and eating, but also assistance with safety management and effective communication [3]. It has been reported that the care of a family caregiver not only improves physical health but also improves psychological well-being and cognitive function in persons with dementia. Additionally, as caring behavior improves, the quality of life of the person with dementia and their families improves, and they can maintain their lives in the community where they currently live [8]. Therefore, to improve caring behavior, it is necessary to identify factors that affect caring behavior.
In this study, we aimed to examine care experiences, family resilience, and social support as factors influencing caring behavior. “Care experiences” refers to the subjective (positive and negative) emotions that family caregivers feel about care [9]. Lawton et al. [10] interpreted the care experiences and subjective feelings of family caregivers while caring for the older adults with dementia by categorizing them into burden, satisfaction, mastery, need, and influence; they concluded that there is a need to identify various aspects of care.
Most previous studies that have examined the caregiving experiences of families caring for older adults with dementia have focused on the burden. However, the experience of care is not necessarily burdensome, and positive emotions have also been reported [11]; moreover, the experience of care is not fixed but can change.
A previous study found that the longer a family takes care of an older adult with dementia, the more positively they evaluate the care [9]. This positive evaluation is attributable to the caregivers’ increasing proficiency in care practices as they gain more experience over time. A study by Sanders [12] found that 55% to 90% of families caring for seniors with dementia had positive experiences, such as mutual bonding, a sense of mastery, and accomplishment. In this way, the evaluation of the care experiences of the caregivers of older adults with dementia can be interpreted in various ways depending on the subjective feelings of the caregiver, and because care experiences vary among family caregivers, it is necessary to look at care from various aspects to fully understand it.
Meanwhile, we can look at family resilience as a factor that affects caring behavior. Family resilience refers to the power of a family to grow and become stronger through the will to overcome difficult situations by uniting all family members rather than thinking only of themselves in a crisis situation [13]. In difficult situations, family members solve problems and overcome crises with positive power through family resilience, and they maintain good relationships with each other [14]. A previous study on family resilience found that as family resilience increases, the life satisfaction of the primary caregiver for the older adult with dementia increases [15]. Through this, family resilience can be considered a positive factor in the care of family members.
Social support is another factor that affects caring behavior. Social support alleviates negative events, helps an individual’s psychological stability, strengthens the ability to overcome difficult situations or solve problems, and helps improve positive emotions [6]. It was found that when the primary caregiver receives social help in areas where help is actually needed, it has a positive effect on the attitude toward caring for the older adult with dementia [16]. The driving force for overcoming the difficult situation of caring for an older adult with dementia comes not only from the individual patient but also from the support of the family and society. Therefore, to find ways to use social support resources for the dependents of older adults with dementia, it is necessary to look at the factors affecting caring behavior.
Accordingly, this study aimed to examine how the evaluation of care experiences, family resilience, and social support of the primary caregiver of older adults with dementia affects caring behavior. This will provide basic data to develop practical measures to improve caring behavior.
2. Aims
This study aimed to identify factors influencing the caring behavior of family caregivers of older adults with dementia living at home, and the specific research objectives were as follows.
∙ Identify the evaluation of care experiences, family resilience, social support, and caring behavior.
∙ Identify differences in caring behavior according to the general characteristics of the participants.
∙ Identify correlations among evaluation of care experiences, family resilience, social support, and caring behavior.
∙ Identify factors influencing the caring behavior of participants.
METHODS
Ethic statement: This study was approved by the Institutional Review Board of Hanyang University (approval number: HYUIRB-202207-011). Participants voluntarily signed a consent form to participate in the survey.
1. Study Design
This was a descriptive study conducted to identify factors influencing the caring behaviors of family caregivers of older adults with dementia. The study was described according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement cross-sectional study (https://www.strobe-statement.org).
2. Participants
The participants of this study were primary family caregivers who cared for older adults with dementia at homes registered at dementia care centers in S City (five locations), K Province (one location), J Province (one location), and D City (one location). Specific inclusion criteria included adult men and women over 18 years old, family caregivers primarily responsible for caring for an older adult with dementia at home, and persons who have cared for older adults with dementia for more than 1 month. Exclusion criteria encompassed primary caregivers who care for dementia patients admitted to senior medical welfare facilities (older adult care facility, senior care group living home) or a convalescent hospital, as well as family members supporting older adults with disabilities or mental illnesses other than dementia.
The sample size required for this study was calculated using G*Power 3.1.9.4 (Heinrich Heine University Düsseldorf) based on the multiple determination coefficient (R²) of .235 determined in a previous study investigating factors influencing care behavior [17]. An effect size of .307 was applied, with a significance level of .05, a power of .95, and 13 predictive factors (gender, age, marital status, education, monthly income, religion, life satisfaction, relationship with older adults with dementia, subjective health status, family care experience, care experience evaluation, family resilience, and social support). The minimum sample size required to perform multiple regression analysis was calculated to be 99 people, and considering the dropout rate of 20%, 125 people was chosen as the target sample size. Ultimately, a total of 125 online questionnaires were collected and used in the final analysis.
3. Measurements
1) Evaluation of Care Experiences
The Korean version of the Revised Caregiver Appraisal Scale, adapted by Lee et al. [18] from Lawton et al.’s [10] Revised Caregiver Appraisal Scale, was used as a care experience evaluation tool. This tool consists of the following subscales: sense of burden (nine questions), sense of satisfaction (six questions), sense of mastery (six questions), sense of need (three questions), and sense of influence (three questions), with a total of 27 questions. Each question uses a 5-point Likert scale, with 5 representing “very much” and 1 representing “not at all.” A higher score reflects a more positive perception and evaluation of the experience of caring for an older adult with dementia., Cronbach’s α was .86 in the study by Lee et al. [18] and .89 in our study.
2) Family Resilience
Family resilience was evaluated using a tool developed by Kim [19] and modified by Park [20]. This tool consists of the following subscales: family strengths (five questions), family cohesion (five questions), family resources (six questions), communication (six questions), social support (five questions), and coping strategies (five questions), with a total of 32 questions. Each question uses a 5-point Likert scale, with 5 points representing “strongly agree” to 1 point representing “not at all agree.” A higher score represents higher family resilience. In the study by Park [20], Cronbach’s α was .76, and in our study, Cronbach’s α was .88.
3) Social Support
To evaluate social support, we used the social support tool from friends and community developed by Ma [21] and modified by Cho and Lee [22]. This tool consists of the following sections: emotional support (four questions), informational support (three questions), and practical support (three questions), with a total of 10 questions. Each question uses a 5-point Likert scale, with 5 representing “always” and 1 representing “never.” A higher score reflects a higher degree of social support within the community. Cronbach’s α was .95 in the study by Cho and Lee [22], and .93 in our study.
4) Caring Behavior
To evaluate caring behavior, we used the care activity practice tool for dementia caregivers developed by Hwang and Jang [23] and revised by Kim [3]. This tool consists of the following subscales: communication with the older adult with dementia (five questions), safety management (eight questions), health promotion (six questions), and daily living functions (four questions), with a total of 23 questions. Each question uses a 5-point Likert scale, with 5 points representing “strongly agree” and 1 point reflecting “not at all agree.” A higher score reflects a higher degree of caring behavior. In the study by Kim [3], Cronbach’s α was .85, and in our study, Cronbach’s α was .84.
4. Data Collection
The data collection period for this study was August 1, 2022, through September 8, 2022. A researcher reached out via direct phone calls to the heads of eight dementia care centers, detailing the objectives of the study to secure their collaboration. The survey was developed using Naver Form (Seongnam, Korea), an online survey platform. The researcher disseminated a call for participants along with the survey link in the family communities of the dementia care centers that consented to partake in the study. Completing the questionnaire typically required about 15 minutes.
5. Data Analysis
The collected data were analyzed using SPSS Statistics for Windows, version 28.0 (IBM Corp.). The specific data analysis methods were as follows.
∙ The general characteristics of the participants were analyzed as frequencies, percentages, means, and standard deviations.
∙ Evaluations of the participants’ care experiences, family resilience, social support, and degree of caring behavior were carried out using means, standard deviations, and minimum and maximum values.
∙ Differences in caring behavior according to the general characteristics of the participants were analyzed using t-tests and analysis of variance (ANOVA), and post hoc testing was performed using the Scheffé test.
∙ The associations among the participant’s evaluations of care experiences, family resilience, social support, and caring behavior were analyzed using Pearson’s correlation coefficient.
∙ Multiple linear regression was used to determine factors affecting the participant’s caring behavior.
6. Ethical Considerations
This study was approved by the Institutional Review Board of Hanyang University (approval number: HYUIRB-202207-011). Participants were provided with a detailed explanation of the study’s topic and aims. Participants voluntarily signed a consent form to participate in the survey. It was explicitly assured that data from the online survey would be exclusively used for research purposes.
RESULTS
1. General Characteristics of the Participants
There were a total of 125 participants, among whom 103 (82.4%) were women. The mean age was 47.4±14.2 years, with 46 people (36.8%) in their 50s or older, and 95 people (76.0%) were married. The level of education was “university or higher” for 95 people (76.0%), the monthly income was 2.01 to 3.0 million won for 38 people (30.4%), and religion was “yes” for 74 people (59.2%). Fifty people (40.0%) responded “average” regarding life satisfaction, and 53 people (42.4%) were the daughters of older adults with dementia. Seventy-five participants (60.0%) responded that their subjective health status was fair, and 86 (68.8%) responded that they had family care experience. Regarding cohabitation, 103 people (82.4%) answered “yes.” The period of care after dementia diagnosis was more than 36 months for 43 people (34.4%), 13~24 months for 33 people (26.4%), 12 months or less for 28 people (22.4%), and 25~36 months for 21 people (16.8%). The mean daily care time was 9.31±6.11 hours, with 64 people (51.2%) indicating more than 8 hours of daily care time. Forty-four people (35.2%) answered “yes” regarding whether they helped. Among the 125 older adults with dementia receiving home care from study participants, 87 (69.6%) were women. Their mean age was 80.5±6.5 years, and 107 individuals (85.6%) were aged 75 or older (Table 1).
2. Care Experiences, Family Resilience, Social Support, and Caring Behavior
The participants’ mean care experience evaluation score was 3.02±0.51 out of 5, and the mean family resilience score was 3.41±0.44 out of 5. The mean score for social support was 3.15±0.91 out of 5, and the mean score for caring behavior was 3.89±0.40 out of 5 (Table 2).
3. Differences in Caring Behavior According to the General Characteristics of the Participants
Analysis of the caregiving behavior revealed significant associations with the general characteristics of the participants (Table 3). Notably, the age of the primary family caregiver (F=5.62, p=.005) and their perceived health status (F=4.96, p=.008) were significant factors. Additionally, the availability of support (t=3.91, p<.001), as well as the educational level of the patients with dementia (F=3.15, p=.046), were associated with statistically significant variations in caregiving behavior. The post hoc analysis indicated that caregivers aged 31 to 49 exhibited more proactive caring behavior than those aged 50 or older. Additionally, caregivers who rated their own health as “fair” or “good” had higher levels of caring behavior than those who rated their health as “poor.” Furthermore, patients with an education level of “middle school or less” received more attentive care than those with an education level of “university or higher.”
4. Correlation Between Care Experience Evaluation, Family Resilience, Social Support, and Caring Behavior
Caring behavior was positively correlated with the participants’ care experience evaluation (r=.35, p<.001), social support (r=.32, p<.001), and family resilience (r=.32, p<.001) (Table 4).
5. Factors Influencing Caring Behavior
The regression analysis’ preliminary checks confirmed that the residuals met the independence assumption, evidenced by a Durbin-Watson statistic of 1.96, nearing the ideal value of 2. The tolerance levels ranged from 0.43 to 0.82, all above the threshold of 0.1, and the variance inflation factor values were between 1.21 and 2.32, well below the critical value of 10, thus indicating no concerns of multicollinearity.
Multiple linear regression analysis identified age, subjective health status, availability of help, and the dementia patient’s educational level as significantly associated with the caring behavior of family caregivers. The educational level and availability of help were coded as dummy variables, with “university or higher” education and “absence of help” serving as reference categories, respectively. Notably, the presence of help (β=.22, p=.015), education up to middle school (β=.32, p=.008), and high school education (β=.24, p=.045) significantly predicted caring behavior. Additionally, evaluation of care experiences (β=.21, p=.023), and family resilience (β=.22, p=.014) were influential factors. The model was statistically significant (F=6.27, p<.001) and accounted for 25.4% of the variance in caring behavior (adjusted R2=.25) (Table 5).
DISCUSSION
This study aimed to determine the impact of care experiences evaluation, family resilience, and social support on the caring behavior of family members providing home care to older adults with dementia. the findings will provide basic data to develop practical measures to improve caring behavior.
In this study, the average age of the primary family caregivers was 47.4±14.2 years, notably younger than the average age reported in the 2019 Community Health Survey, which found an average age of approximately 57 years for 2,847 family caregivers of older people with dementia at home [24]. The 2022 Long-Term Care Survey further supports this trend, indicating that individuals in their 50s comprised 34.3% of the total 2,978 respondents [25]. This age difference is likely attributable to variances in data collection methods; while the Community Health Survey and Long-Term Care Survey were conducted face-to-face, our study employed an online survey, potentially attracting younger participants more accustomed to the internet environment.
Daughters emerged as the predominant caregiver group in our study, constituting 42.4% of the total. This aligns with the finding from the 2022 Long-Term Care Survey, which identified daughters as the most common relationship with the recipient at 37.2% [25]. Traditionally, societal expectations placed the responsibility of supporting parents on the eldest son, leading daughters-in-law to often assume the role of caring for parents with dementia. However, with shifts in the support culture, the profile of the primary caregiver is evolving from daughters-in-law to spouses, daughters, or sons-in-law. A shift in support culture is evident in our study with daughters more frequently taking on the role of primary caregivers. This change is indicative of shifting dynamics in caregiving culture, akin to situations observed in developed countries like the United States. According to a previous study [26] on the primary caregivers of older people with dementia in the United States, about 60% of caregivers are daughters, most being middle-aged, 60% employed, and 25% simultaneously caring for one or more children. As primary caregivers, daughters often experience time constraints, juggling responsibilities between caring for the older person with dementia and their children. They may encounter situations where plans need to be sacrificed due to unpredictable events, finding it challenging to allocate time for their own health care. To alleviate the burden of performing multiple roles, it is imperative to focus on supporting the caregiving role of daughters, the primary caregivers, and foster a caring environment in the evolving culture of caregiving. This may involve providing comprehensive care education for all family members.
The average daily care time for family caregivers in our study was 9.31±6.11 hours, aligning with similar findings reported in a study [7] where daily care time for older adults with dementia averaged over 9 hours. Since the implementation of the long-term care insurance system for older adults in 2008, various social supports have been established to alleviate the caregiving burden for families of older adults with dementia. This marks a significant reduction compared to a study [27] from a decade ago, which reported an average daily care time of 14.96 hours for older adults with dementia, with 42.7% of subjects indicating more than 20 hours of care per day. According to the 2022 International Dementia Policy Trends [1], the global average care time for older people with dementia is 8 hours per day, and there is a clear difference depending on income level, with an average of 12 hours in low-income countries and 7.6 hours in high-income countries. Notably, in Korea, a high-income country, families caring for older adults with dementia at home dedicate more hours than the standard legal working hours. The time spent in caring for older adults with dementia directly impacts caregivers’ burden, with increasing care time correlating with heightened burden [7]. To address this, it is crucial to ensure that primary caregivers receive adequate rest. The long-term care insurance system for older adults includes policies such as “elderly caregiver vacation” (full-day home care, short-term care) [2], designed to alleviate the care time burden for dementia family members. Therefore, it is imperative to actively utilize these policies, providing guidance and support to family caregivers to help reduce their caregiving burden.
The evaluation of the care experiences by the primary family caregivers in our study had an average score of 3.02±0.51 out of 5. This score surpasses the average of 2.64 reported in a study by Kim and Kim [28], which specifically focused on families caring for older adults with dementia utilizing daycare centers. Notably, primary family caregivers living with older adults with dementia tend to have a more positive perception and evaluation of their care experiences as the time spent together increases [12]. In our study, 82.4% of the primary family caregivers resided with older adults with dementia, likely contributing to the more favorable evaluation of their care experiences compared to the findings of the aforementioned study [28].
The average score for social support in this study was 3.15±0.91 points out of 5, slightly lower than the average score of 3.24 reported by Park [29] in a study targeting families caring for older adults with dementia who use home welfare services. This discrepancy may be attributed to the different service usage among subjects. The participants in this study are the primary family caregivers from the Dementia Care Center, some of whom may not be actual recipients of care services from the center. In Park’s study [29], caregivers were utilizing home welfare services, receiving substantial social support, which could account for the higher scores. This aligns with findings from another study [16], indicating that dementia families perceive high social support when they receive practical help. Therefore, it is crucial to ensure that primary caregivers of older adults with dementia at home are receiving practical social support within the community. Establishing support systems that provide concrete assistance to these caregivers is imperative.
In this study, the caring behavior of the primary caregiver scored an average of 3.89±0.40 out of 5. Conversely, study by Oh et al. [16] reported a lower average caring behavior score of 3.14 points. This discrepancy is believed to be due to differences in the age demographics of the research subjects. Specifically, in the current study, daughters constituted the majority (42.4%) of the family caregivers for older adults with dementia, with an average age of 47.4±14.2 years. In contrast, the study by Oh et al. [16] had spouses as the primary caregivers at 31.9%, with an average age of 82 years. It is suggested that the caring behavior was lower in Oh et al.’s study [16] because the caregivers were older spouses of older adults with dementia.
Significant differences in caring behavior were observed in relation to the general characteristics of the subjects, specifically age, subjective health status, availability of help, and the educational level of the older adults with dementia. Those aged 31 to 49 exhibited higher levels of caring behavior than those aged 50 or older. This is in line with the findings of Oh et al. [16], who also reported a notable age-related variation in caring behavior among caregivers of older adults with dementia. Furthermore, this study found that caring behavior was higher when the subjective health status of the family’s primary caregiver was good, echoing the results of Yeom and Seo [30], where subjects reporting their health as “fair” or “good” demonstrated greater caring behavior than those who rated their health as “poor.” These insights suggest that the perceived health status of the primary family caregiver is positively associated with their level of caring behavior. This underscores the influence of the caregiver’s health on the quality of care provided to older adults with dementia, highlighting the importance of attending to and managing the health of not only the dementia patients but also their primary caregivers.
Factors influencing the caring behavior of primary caregivers for older adults with dementia included the availability of help, the educational level of the older adults with dementia, evaluation of care experience, and family resilience. The finding that higher family resilience correlates with greater caring behavior is consistent with the research by Jung and Kim [14], which examined families caring for children with developmental disabilities. Similarly, previous research [15] has indicated that family resilience is the most significant factor in the adaptation of families caring for older adults with dementia. Hence, enhancing family resilience may be an effective strategy to improve caring behavior. In Korea, community dementia care centers are instrumental in developing and running various programs aimed at strengthening the resilience of family caregivers of older adults with dementia. For these programs to be genuinely beneficial, proactive dissemination and encouragement of the dementia family support services offered by dementia care centers and related community organizations are essential [1]. Moreover, when family caregiving is a collaborative effort, the level of caring behavior tends to be higher [16]. Thus, when providing counseling to family caregivers, it is beneficial to implement strategies such as role analysis to redistribute caregiving responsibilities among family members, allowing each to effectively contribute to the caregiving process.
Another predictor of caring behavior is the availability of help. Caring behavior tends to be higher when primary caregivers receive assistance, indicating a positive impact on caring behavior by alleviating the support burden. In the 2022 Long-Term Care Survey [25], the utilization of long-term care allowances was associated with reduced physical, psychological, and economic burdens for caregivers, along with improvements in social participation activities. Despite this, the awareness rate of resources like “elderly caregiver vacation” and “day and night care centers dedicated to dementia” remains low at 26.2% to 41.0%, and the utilization rate is only 14.1% to 21.8%. In formulating a comprehensive care support plan, considerations must extend beyond cost aspects to encompass environmental factors, such as information accessibility and service availability to enable primary caregivers’ effective utilization of available resources. Additionally, alongside formal care support, emphasizing informal care within families is crucial. Implementing family education programs that highlight the importance and strategies of seeking assistance from those around them can provide practical help.
Furthermore, the evaluation of care experiences emerges as a predictive factor for caring behavior. A positive perception of care experiences correlates with improved caring behavior. Therefore, when implementing nursing interventions for primary caregivers, strategies to enhance the positive perception of care experiences should be considered. A previous study [5] highlighted that positive care experiences were linked to emotional rewards such as satisfaction with the caregiving role and recognition for caregiving efforts. Primary caregivers’ confidence and self-esteem increased as they achieved tasks they initially deemed challenging, fostering positive experiences like self-reflection, self-awareness, increased patience, and an improved sense of competence. Encouraging caregivers to share their care experiences promotes self-understanding and reflection, fostering a more positive perception of the care experience. Thus, providing opportunities for caregivers to share experiences, offering emotional support, and encouraging an optimistic perspective can contribute to the development of a caring attitude that focuses on positive aspects rather than solely viewing caregiving negatively [5].
Meanwhile, in this study, social support did not emerge as a significant factor influencing caring behavior, in contrast to Lee’s research [17], which identified social support as a significant determinant of caring behavior. One possible explanation for the lack of perceived impact of social support on caregiving behavior in this study could be that primary family caregivers may not be receiving sufficient social support for the care of older adults with dementia. Family caregivers often encounter barriers in accessing community resources, as their social networks may diminish due to the demands of caregiving [22]. Currently, the management services of dementia care centers are available only to individuals over 60 with dementia, whose income is less than 120% of the median based on health insurance contributions. Dementia treatment costs are subsidized to delay symptom progression through consistent medication regimens. Support services are also income-dependent, targeting those at or below 120% of the median household income [1]. Consequently, dementia care services are predominantly utilized by individuals with low income or facing financial hardship, including those on basic livelihood security and those eligible for out-of-pocket expense reductions. Due to these policy constraints, even if primary caregivers are aware of dementia management services, they may not perceive themselves as receiving tangible social support. Therefore, there is a perceived need to broaden the eligibility criteria for dementia care services beyond the median income threshold, as stipulated by the Ministry of Health and Welfare’s dementia policy project.
As seen in the above discussion, enhancing the caring behavior of the primary family caregiver involves fostering a more positive perception of the care experience, establishing regular connections with community resources for ongoing assistance, and implementing interventions to strengthen family resilience. The limitations of this study are as follows. The research is confined to families registered at a dementia care center, limiting the generalizability of the findings. Additionally, the study lacks information on the condition of people with dementia, including factors such as dementia severity, which may impact the caring behavior of primary family caregivers. Lastly, although the education level of older adults with dementia was identified as an influential factor in caring behavior, limitations arise from the absence of prior research for comprehensive comparison. Nevertheless, this study holds significance in identifying and analyzing factors influencing the caring behavior of primary caregivers for older adults with dementia at home. It provides foundational data for implementing community dementia nursing care and developing strategies to enhance caring behavior.
CONCLUSION
This study was conducted to provide basic data to prepare intervention measures to improve the caring behavior of family caregivers by evaluating the care experience of family caregivers of older adults with dementia at home and identifying the factors that influence family resilience and social support on caring behavior.
As a result of the study, factors influencing caring behavior were identified, including the availability of help, educational level of older adults with dementia, care experience evaluation, and family resilience. Notabley, family resilience emerged as the most influential factor, collectively explaining 25.4% of caring behavior. To enhance the caregiving behavior of family caregivers for older adults with dementia at home, it is crucial to promote a positive perception of dementia care as a rewarding and fulfilling experience. Furthermore, it is necessary to develop programs to increase family resilience so that family members can rely on each other and overcome difficult situations. Additionally, fostering social support networks and establishing connections to local resources is crucial to ensure that family caregivers receive practical assistance.
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