51
|
Saito T, Wakui T, Kai I. Effects of spousal illness on self-rated health in older couples: Role of sex and proximity to adult children. Geriatr Gerontol Int 2015; 16:1332-1338. [PMID: 26531779 DOI: 10.1111/ggi.12646] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2015] [Indexed: 11/27/2022]
Abstract
AIMS The present study examined the impact of serious spousal illness or hospitalization on community-dwelling older adults' self-rated health (SRH), and explored the moderating effects of sex and residential proximity to adult children using a prospective and representative survey design. METHODS The sample was obtained from a 2-year longitudinal survey of non-institutionalized men and women aged 65 years and older carried out in the Fukui Prefecture, Japan (n = 1573). The effect of serious spousal illness or hospitalization on SRH during the survey period was examined after controlling for baseline SRH, sex, age, socioeconomic status, chronic illness and other baseline covariates. RESULTS Overall, 15.7% of respondents had experienced a serious spousal illness or hospitalization within the previous year. After controlling for covariates, spousal illness had a significant negative effect on SRH at follow-up (P = 0.031). More serious effects of spousal illness were found in older adults whose children lived farther than 30 min away than in couples who lived with their children (P = 0.009). However, there was no significant interaction effect between sex and spousal illness. CONCLUSIONS Serious spousal illness could cause deterioration in the health of older spouses, particularly for older parents whose children live a distance away. Geriatr Gerontol Int 2016; 16: 1332-1338.
Collapse
Affiliation(s)
- Tami Saito
- Department of Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Tomoko Wakui
- Human Care Research Team, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | | |
Collapse
|
52
|
Estructura factorial de la escala de soporte social subjetivo : validación en una muestra de estudiantes universitarios Chilenos. ACTA COLOMBIANA DE PSICOLOGIA 2015. [DOI: 10.14718/acp.2015.18.1.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
El objetivo de este artículo es adaptar y validar la Escala de Apoyo Social Subjetivo (EASS, de Vaux et al., 1986), a la vez que describir su estructura factorial. Esta escala está compuesta por 10 ítems distribuidos en dos dimensiones: apoyo familiar y apoyo de los amigos. Se examinan las propiedades psicométricas de la escala y la dimensionalidad de la misma en una muestra de estudiantes universitarios chilenos (N = 681). Los resultados indican que el EASS constituye un instrumento fiable (α = .86) y válido para la medición del apoyo social subjetivo. Las dimensiones de la EASS obtienen entre sí una correlación significativa y moderada (r = .41; p < .001). Las cargas factoriales para los ítems en el análisis factorial confirmatorio fluctuaron entre .40 y .93, mostrando buenos índices de ajuste para el modelo de dos factores de primer orden correlacionados (CFI = .97, TLI = .93, RFI = .97, IFI = .97, NFI = .96 y RSMEA = .08).
Collapse
|
53
|
Owusu-Ansah FE. Sharing in the life of the person with disability: A Ghanaian perspective. Afr J Disabil 2015; 4:185. [PMID: 28730035 PMCID: PMC5433484 DOI: 10.4102/ajod.v4i1.185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 07/02/2015] [Indexed: 11/24/2022] Open
Abstract
This thought article was a hermeneutic inquiry into the experiences of informal caregivers of the elderly who are also physically disabled. The experiences of some Ghanaian informal caregivers were examined in three clinical cases and laced with the lived experiences of the author as an informal caregiver and clinician. Two processes were explored. The first relates to how a caregiver is changed through the experience of caregiving by examining the intrapersonal and interpersonal dynamics affecting caregiving. Secondly, the positive 'shifts' that occurred in therapy were explored. In the present Ghanaian society it appears that care for the elderly disabled is compounded by the rapid migration of many Ghanaians to 'greener pastures' in search of a brighter future, with consequent empty homesteads and fragmentation of the socio-cultural practices that hitherto buttressed informal care for the aged. In the absence of well-established professional care facilities, informal caregiving with its numerous challenges has become the norm for many. This article posited that caregiver self-care is the most important, and yet often forgotten, aspect of informal caregiving. When this is neglected, caregiver burnout is sure to occur, which results in poor physical, mental and emotional health for the caregiver. In this state caregivers may injure both themselves and the care recipients.
Collapse
Affiliation(s)
- Frances E Owusu-Ansah
- Department of Behavioural Sciences, Kwame Nkrumah University of Science and Technology, Ghana
| |
Collapse
|
54
|
LaVela SL, Landers K, Etingen B, Karalius VP, Miskevics S. Factors related to caregiving for individuals with spinal cord injury compared to caregiving for individuals with other neurologic conditions. J Spinal Cord Med 2015; 38:505-14. [PMID: 24993244 PMCID: PMC4612206 DOI: 10.1179/2045772314y.0000000240] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
CONTEXT/OBJECTIVE To compare outcomes among caregivers of adults with spinal cord injuries (SCIs) to caregivers of adults with other neurological conditions, and determine if caregiving for SCI is associated with poor health status and chronic conditions. DESIGN Secondary data analysis of 2009/2010 Behavioral Risk Factor Surveillance System survey. PARTICIPANTS Informal caregivers of adults with neurological conditions. OUTCOME MEASURES Sociodemographics, caregiving factors (e.g. role, emotional support, life satisfaction), lifestyle behaviors, chronic conditions, and health status. RESULTS Demographics and lifestyle behaviors did not differ in caregivers of adults with SCI vs. caregivers of adults with other neurological conditions (except younger age of SCI caregivers). Greater proportions of caregivers of adults with SCI had coronary heart disease (CHD) (12% vs. 6%, P = 0.06) and were obese (43% vs. 28%, P = 0.03). Frequent physical distress was reported by 20% of caregivers of persons with SCI (vs. 12% of other caregivers, P = 0.09), but mental health did not differ between caregiver groups. A greater proportion of caregivers of adults with SCI experienced insufficient sleep (47% vs. 30%, P = 0.008) and more days without enough sleep (13 vs. 9 days, P = 0.008). Odds of being younger, caregiver of a spouse, having CHD, and being obese were associated with being a caregiver of an adult with SCI. CONCLUSION Caregivers of adults with SCI report similar mental health status, but more poor sleep, and have increased odds of CHD and obesity. Interventions to address physical distress, improve sleep, and address CHD and obesity are needed in this cohort.
Collapse
Affiliation(s)
| | | | - Bella Etingen
- Correspondence to: Bella Etingen, Health Services Research & Development, Department of Veterans Affairs, Edward Hines, Jr. VA Hospital (151-H, Building 1, Office D-322), 5th Avenue & Roosevelt Road, Hines, IL 60141, USA.
| | | | | |
Collapse
|
55
|
Pienaar L, Reynolds F. ' A respite thing': A qualitative study of a creative arts leisure programme for family caregivers of people with dementia. Health Psychol Open 2015; 2:2055102915581563. [PMID: 28070356 PMCID: PMC5193266 DOI: 10.1177/2055102915581563] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
This study explored the meanings of participating in a 5-week creative arts leisure programme designed for family caregivers of people with dementia, using interpretative phenomenological analysis. Eight carers attended and four who met the eligibility criteria agreed to be interviewed. Participants experienced the arts group as providing a sense of freedom and respite, strengthening identity through promoting achievement, offering social support through a collective focus on art- and craft-making and increasing resilience for coping with caring. Some found the 5-week programme too short. Benefits were linked to the security of knowing that loved ones with dementia were close by, being well cared for. Further research is needed into the long-term benefits of creative arts groups for promoting carer well-being.
Collapse
|
56
|
Raivio M, Laakkonen ML, Pitkälä K. Psychological well-being of spousal caregivers of persons with Alzheimer's disease and associated factors. Eur Geriatr Med 2015. [DOI: 10.1016/j.eurger.2014.08.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
57
|
Abstract
Strong evidence has established the medical and health services utilization benefits of home care services for older adults. However, sparse research has been conducted on potential psychosocial benefits. Older adults (65 and over) receiving home care with their needs met are compared with persons who have unmet needs (whether they received home care or not) on three key indicators of quality of life – life satisfaction, loneliness, and perceived life stress. Data are drawn from the 2008-2009 Canadian Community Health Survey respondents who met the study criteria (n = 3,244). Regression analyses showed that older adults who had their home care needs met reported higher levels of life satisfaction, and lower levels of loneliness and perceived life stress, than those with unmet needs, net of co-variates. The results suggest that filling this home care gap would significantly raise quality of life by increasing social and environmental resilience to age in place.
Collapse
|
58
|
Stensletten K, Bruvik F, Espehaug B, Drageset J. Burden of care, social support, and sense of coherence in elderly caregivers living with individuals with symptoms of dementia. DEMENTIA 2014; 15:1422-1435. [PMID: 25525074 DOI: 10.1177/1471301214563319] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Family members are often the care providers of individuals with dementia, and it is assumed that the need for this will increase. There has been little research into the association between the burden of care and the caregiver's sense of coherence or receipt of social support. This study examined the relationship between the social support subdimensions and sense of coherence and the burden of care among older people giving care to a partner with dementia. The study was a cross-sectional observation study of 97 individuals, ≥65 years old and living with a partner who had symptoms of dementia. We used the Informant Questionnaire on Cognitive Decline in the Elderly, the Relative Stress Scale, the Social Provisions Scale, the Sense of Coherence Scale, and a questionnaire on sociodemographic variables. We used multiple regression analysis in a general linear model procedure. We defined statistical significance as p < 0.05. With adjustments for sociodemographic variables, the association with burden of care was statistically significant for the subdimension attachment (p < 0.01) and for sense of coherence (p < 0.001). The burden of care was associated with attachment and with sense of coherence. Community nurses and other health professionals should take necessary action to strengthen attachment and sense of coherence among the caregivers of people with dementia. Qualitative studies could provide deeper understanding of the variation informal caregivers experience when living together with their partner with dementia.
Collapse
Affiliation(s)
- Kari Stensletten
- Faculty of Health and Social Science, Bergen University College, Bergen, Norway; Department of Public Health and Primary Health, University of Bergen, Bergen, Norway
| | - Frøydis Bruvik
- Kavli Centre, Haraldsplass Deaconess Hospital, Bergen, Norway; Haraldsplass Deaconess University College, Bergen, Norway; Ageing and Health, Norwegian Centre for Research, Education and Service Development, Vestfold Hospital Trust, Tønsberg, Norway
| | - Birgitte Espehaug
- Centre for Evidence-Based Practice, Bergen University College, Bergen, Norway
| | - Jorunn Drageset
- Faculty of Health and Social Science, Bergen University College, Bergen, Norway; Department of Public Health and Primary Health, University of Bergen, Bergen, Norway
| |
Collapse
|
59
|
Torgé CJ. Freedom and imperative: mutual care between older spouses with physical disabilities. JOURNAL OF FAMILY NURSING 2014; 20:204-225. [PMID: 24505081 DOI: 10.1177/1074840714524058] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This article explores mutual caregiving between older spouses aging with physical disabilities. Nine older couples, where both partners had lived long lives with physical disabilities, were interviewed as dyads about mutual caregiving. The couples not only had access to different kinds and degrees of formal support but also provided mutual care to each other in a variety of ways. Interview coding using grounded theory led to two overarching categories from which motivation for mutual caregiving could be understood. These categories were Mutual care as freedom and Mutual care as imperative. The results extend understanding about how older couples with disabilities attached meaning to their mutual caregiving, and why mutual care was sometimes preferable, despite the availability of other sources of help and despite practical difficulties of providing this help. These findings suggest that health care professionals need to be sensitive to the dynamics of the couple relationship and carefully explore the couple's preferences for how formal support can best be provided in ways that honor and sustain the integrity of the couple relationship.
Collapse
|
60
|
Lavela SL, Etingen B, Louise-Bender Pape T. Caregiving experiences and health conditions of women veteran and non-veteran caregivers. Womens Health Issues 2013; 23:e225-32. [PMID: 23816152 DOI: 10.1016/j.whi.2013.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 04/03/2013] [Accepted: 04/04/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Unique experiences, for example, trauma, of women veteran caregivers may create differences in the caregiving experience and may be associated with health concerns. We examined caregiving factors and health concerns in women veteran caregivers compared to non-veteran women (civilian) caregivers, and identified variables associated with being a woman veteran caregiver. METHODS We conducted secondary data analyses using data from a multistate survey to examine sociodemographics, the caregiver experience (relationship to recipient, duration as caregiver, hours of care provided, area help is needed, and greatest difficulty faced as a caregiver); emotional support; life satisfaction; lifestyle behaviors; general, physical, and mental health; and chronic conditions in women informal caregivers. FINDINGS Of women caregivers, more veteran caregivers provided activities of daily living (ADL) help (33%) than non-veteran caregivers (21%; p = .02). There were no differences in years as a caregiver, hours of care provided, or the relationship to the recipient. Poor sleep and poor mental health were experienced by more women veteran caregivers (vs. non-veteran), but physical health, general health, and chronic condition prevalence did not differ. Women veteran caregivers had twofold greater odds of being Black, never married, college educated, and providing ADL assistance. Odds of obesity were lower for women veteran caregivers relative to other women caregivers. CONCLUSIONS Women veteran caregivers experience health concerns, including sleeplessness, poor mental health, and some chronic conditions. Our cohort were young women, yet had concerns that may be exacerbated by being a veteran and assuming a caregiver role. Comprehensive services to support their needs as veteran patients and as caregivers are needed.
Collapse
Affiliation(s)
- Sherri L Lavela
- Department of Veterans Affairs, Hines VA Hospital, Hines, Illinois; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
| | | | | |
Collapse
|
61
|
Allen JY, Haley WE, Small BJ, Schonwetter RS, McMillan SC. Bereavement among hospice caregivers of cancer patients one year following loss: predictors of grief, complicated grief, and symptoms of depression. J Palliat Med 2013; 16:745-51. [PMID: 23697816 DOI: 10.1089/jpm.2012.0450] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Informal caregivers are an integral part of end-of-life care for hospice patients with cancer. Although adjustment following loss is highly individual, many caregivers have significant psychological distress after the death of a loved one. This study investigated risk factors that may predict psychological distress, which could aid hospice bereavement departments in targeting bereavement services. METHOD Demographic characteristics, patient impairment, caregiver baseline symptoms of depression, and caregiver resources were assessed among 188 cancer patient-caregiver dyads. Regression analyses identified predictors of symptoms of depression, grief, and complicated grief one year following loss. RESULTS Over 50% of bereaved caregivers had clinically significant depressive symptoms one year after death of their relative. Caregivers with fewer years of education and more baseline symptoms of depression had significantly worse grief, complicated grief, and depression. Younger patient age was a significant predictor of poorer outcomes for grief and complicated grief; and less patient impairment was a significant predictor of more post-loss symptoms of depression. Lower social support satisfaction was correlated with worse grief and complicated grief but was not a significant multivariate predictor of poorer outcomes. CONCLUSION Despite having access to hospice bereavement services, many former caregivers had high psychological distress one year following loss. Bereavement departments could consider utilizing readily available risk factors to target services to former caregivers who may benefit from bereavement services. Bereavement departments might also consider including brief, standardized screenings of caregiver depression in initial risk assessments. Future studies should investigate evidence-based approaches for assessment and interventions among highly distressed former hospice caregivers.
Collapse
Affiliation(s)
- Jessica Y Allen
- Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey 08901, USA.
| | | | | | | | | |
Collapse
|
62
|
McGhan G, Loeb SJ, Baney B, Penrod J. End-of-life caregiving: challenges faced by older adult women. J Gerontol Nurs 2013; 39:45-54. [PMID: 23641930 DOI: 10.3928/00989134-20130402-01] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 08/22/2012] [Indexed: 11/20/2022]
Abstract
In the United States, the number of people older than 60 is expected to triple over the next 50 years, and as the population ages so do family caregivers. Increased levels of depression and low ratings of subjective well-being in caregivers are consistently associated with older age, the spousal relationship, and female caregiver gender. Less well known is the effect care delivery models have on the older adult as his or her spouse approaches the end of life. The purpose of this study was to explore the challenges faced by older adult spousal caregivers providing end-of-life care across different life-limiting illness trajectories in distinctive care delivery models. An instrumental case study using purposive sampling identified the following themes for older spousal caregivers: balancing multiple morbidities; feeling overwhelmed and exhausted; dealing with personal health issues; feeling isolated; and coordinating care. Implications for health care providers are also examined.
Collapse
Affiliation(s)
- Gwen McGhan
- School of Nursing, The Pennsylvania State University, University Park, PA, USA.
| | | | | | | |
Collapse
|
63
|
Chow EOW, Ho HCY. The relationship between psychological resources, social resources, and depression: results from older spousal caregivers in Hong Kong. Aging Ment Health 2013; 16:1016-27. [PMID: 22690796 DOI: 10.1080/13607863.2012.692769] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The rapidly ageing population in Hong Kong has led to a major concern in providing care for the elderly. Due to the current social changes in Hong Kong, such as smaller family size, longer life spans, and increasing employment demands, spouses increasingly serve as the primary caregivers for older adults. To explore the mental health of older spousal caregivers, this study investigated the relationships between psychological resources, social resources, and depression. METHOD One hundred fifty-eight spousal caregivers aged 55 and above were recruited from 13 caregiver resource centres in Hong Kong. Data were collected using structured questionnaires. RESULTS Hierarchical regression analysis revealed that the number of duties and psychological resources including purpose in life, caregiver burden, and personal wellbeing explained 56% of the variance in depression. Logistic regression analysis further indicated that purpose in life predicted the likelihood of depression reported by caregivers. Social resources did not significantly predict depression. CONCLUSION Results suggest that mental health enhancement programs should be developed for Chinese spousal caregivers with a focus on purpose in life, burden, and personal wellbeing.
Collapse
Affiliation(s)
- Esther O W Chow
- Department of Applied Social Studies, City University of Hong Kong, Kowloon, Hong Kong.
| | | |
Collapse
|
64
|
LaVela SL, Johnson BW, Miskevics S, Weaver FM. Impact of a multicomponent support services program on informal caregivers of adults aging with disabilities. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2012; 55:160-174. [PMID: 22324332 DOI: 10.1080/01634372.2011.642472] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A multicomponent support services program was implemented for veterans aging with disabilities and their informal caregivers (n = 42 dyads). Caregiver outcomes (satisfaction, physical and mental health status, burden, and benefits) were evaluated before and after program use. Caregivers reported significant improvements in mental health post-program. Caregivers who provided care to individuals with impaired physical health experienced meaningful improvements in burden after the support services were rendered. Supporting caregiver health status through such programs is vital to preserve noninstitutional long-term care for persons aging with disabilities, particularly when care is provided over many years to an individual with physical impairments.
Collapse
Affiliation(s)
- Sherri L LaVela
- Center for Management of Complex Chronic Care, Hines Veterans Affairs Hospital, Illinois 60141, USA.
| | | | | | | |
Collapse
|
65
|
Thinnes A, Padilla R. Effect of educational and supportive strategies on the ability of caregivers of people with dementia to maintain participation in that role. Am J Occup Ther 2011; 65:541-9. [PMID: 22026322 DOI: 10.5014/ajot.2011.002634] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
A systematic review of evidence of the effectiveness of educational and supportive strategies for enabling caregivers of people with Alzheimer's disease (AD) or related dementias to maintain participation in that role was conducted as part of the American Occupational Therapy Association's Evidence-Based Literature Review Project. Forty-three articles met inclusion criteria. Results suggest that interventions that jointly engage people with AD and their caregivers in education and training in the home setting are more successful than strategies that focus solely on people with AD. Greater carryover is noted when education and training are implemented at the time that the caregiver identifies concerns. Interventions should provide caregivers with problem solving, technical skills, support, simple home modification strategies, and referral to community resources. Interventions mediated by technology have a positive effect on the caregiver and are especially important for those who live in rural areas.
Collapse
Affiliation(s)
- Andrea Thinnes
- Department of Occupational Therapy, School of Pharmacy and Health Professions, Creighton University, Omaha, NE 68178, USA
| | | |
Collapse
|
66
|
Affiliation(s)
- John D. Piette
- Department of Veterans Affairs Ann Arbor VA HSR&D Center of Excellence Ann Arbor, MI, USA, , Department of Internal Medicine University of Michigan Ann Arbor, MI, USA, Michigan Diabetes Research and Training Center University of Michigan Ann Arbor, MI, USA
| |
Collapse
|