# (Dis)Agreement in Siblings’ Perceptions of Parents’ Dementia Symptoms: Impact on Caregiver Burden

## TL;DR

Siblings who disagree about their parent's dementia symptoms, especially depressive ones, report higher caregiver burden.

## Contribution

This study reveals how disagreements between siblings on dementia symptoms affect caregiver burden.

## Key findings

- Minor disagreements on total BPSD symptoms increase caregiver burden.
- Major disagreements on depressive symptoms are linked to higher caregiver burden.
- Disagreements on disturbance and memory symptoms do not affect caregiver burden.

## Abstract

More severe behavioral and psychological symptoms of dementia (BPSD) are associated with higher caregiver burden. Typically, BPSD is measured using reports from one caregiver although disagreements between multiple caregivers may exacerbate the challenges of care. However, the consequences of caregivers’ disagreements regarding BPSD symptoms remain unknown. Therefore, we examined whether adult child caregivers’ (dis)agreements on total BPSD symptoms and subscales for depression, disturbance, and memory were associated with sibling reports of caregiver burden. We used data from 91 sibling dyads (mean age = 57.30, SD = 9.32) who were caring for a parent with dementia (mean age = 82.30, SD = 7.74). Actor-partner interdependence models revealed that sibling dyads who reported minor disagreements (within 1 SD) regarding their parent’s total BPSD symptoms reported higher caregiver burden compared to siblings who were in agreement about their parent’s symptoms (b = 2.67). This effect was primarily driven by disagreements on the parent’s depressive symptoms, where major disagreements (>1 SD) were associated with heightened caregiver burden (b = 1.81), relative to siblings who agreed on their parent’s symptoms. In contrast, disagreements on the parents’ disturbance and memory symptoms were not linked to sibling caregiver burden. These findings suggest that when siblings’ perceptions of their parent’s depressive symptoms are aligned, they report lower caregiver burden. This research has implications for health and long-term care providers, whose contact regarding the parent’s symptoms may be limited to only one caregiver. Ensuring consistency and alignment across the care network may help promote better caregiver well-being.