Positive Appraisal and Influencing Factors of Family Caregivers for Older Adults with Dementia at Home

Background: Japan has become the world’s first super-aged society, with an increasing number of older adults developing dementia as the population ages. With the promotion of community-based comprehensive care systems, this population is increasingly expected to receive home-based care. Purpose: This study assessed the positive appraisal of family caregivers of older adults with dementia at home and identified its influencing factors. Methods: An internet survey of family caregivers of older adults with dementia was conducted in June 2024. The survey instrument evaluated the profile and care situation of caregivers, demographic profile and activities of daily living of older adults with dementia, and positive appraisal of caregivers. We conducted correlation and factor analyses. Results: In total, 198 family caregivers participated (males: 125 [63.1%]; 40–60 years old: 173 [87.5%]; employed: 139 [70.2%]; self-reported good health: 169 [85.3%]; and highest proportion of more than Japanese yen 5 million annual income: 53 [26.8%]). Regarding caregiving duration, 130 (65.6%) had been providing care for a duration of 1–5 years. A total of 148 (74.7%) participants cared for their own parents, and 99 (50.0%) lived with those they cared for. Of the older adults with dementia receiving care, 136 (68.7%) were female, 93 (47.0%) were aged 80 years, and 87 (43.9%) could walk indoors. Regarding long-term care insurance, 47 (23.7%) patients mostly needed nursing care level 3. Factor analysis of the positive appraisal scale identified two key factors: “caregiving satisfaction” and “caregiver’s self-growth.” Spearman’s correlation analysis showed that “good health” and “high annual income” were significantly associated with positive appraisal. Conclusions: “Caregiving satisfaction” may be effective in alleviating the burden on families who struggle with the challenges of dementia care, particularly those who feel conflicted, restricted, and overwhelmed by long-term caregiving. Notably, more than 80% of the caregivers in this study were middle-aged or older adults, and their sense of personal growth extended beyond daily caregiving tasks. This highlights the role of caregiving in fostering personal development and offers prospects for caregivers. Furthermore, good health and financial situations of these families were important factors influencing the continuation of home care. This underscores the broader societal challenge of providing adequate health and financial support for caregiving families. Keywords: Family caregivers, positive appraisal, older adults with dementia, internet survey