pay out-of-pocket for home services

Most FCGs would still need to pay out-of-pocket for home services, but these services are not sufficient to support the caregiving tasks of FCGs of PWDs (Shyu, Huang, Huang, & Chen, 2008). Thus, many caregivers hire foreign care aides (Chen & Wu, 2008). FCGs not only have to provide direct care to PWDs but also have to supervise the care activities of foreign aides. Since FCGs commonly use home services and hire care aides in Taiwan, we recruited both primary and secondary FCGs (those supervising care aides) to reflect the reality of Taiwanese society. Measures Data were collected on PWDs characteristics (age, gender, education [years]), dementia diagnosis, degree of dementia severity, cognitive function, depression, and neuropsychiatric symptoms, as well as FCGs demographic factors (age, gender, marital status, relationship to the PWD), caring-related variables (caregiving distress, caring duration, weekly caring time), depressive symptoms, fatigue, and sleep disturbance. PWDs dementia severity PWDs dementia severity was determined by the Clinical Dementia Rating Scale (CDR) (Hughes, Berg, Danziger, Coben, & Martin, 1982), which rates impairment in six domains: memory, orientation, judgment and problem solving, community affairs, home and hobbies, and personal care. Items are rated on a 5-point scale: 0 (intact), Aging & Mental Health 93 0.5 (questionable dementia), 1 (mild dementia), 2 (moderate dementia), and 3 (severe dementia). The Chinese CDR had appropriate psychometric properties (Lin & Liu, 2003). Higher CDR scores indicate more severe dementia. CDR data on outpatient PWDs were collected from chart review, but research assistants administered the CDR to community-dwelling PWDs. Therefore, we did not calculate Cronbachs a for this scale

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