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Subramaniam A, Mehta KK. Exploring the Lived Experiences of Caregiving for Older Family Members by Young Caregivers in Singapore: Transition, Trials, and Tribulations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:182. [PMID: 38397673 PMCID: PMC10888348 DOI: 10.3390/ijerph21020182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024]
Abstract
Amidst population ageing trends and epidemiological transitions, there has been a growing emergence of young family caregivers, about whom most studies have been conducted in Western countries. Their subjective experiences and perceptions toward caregiving remain underexplored in Asia. This qualitative study explored the lived experiences of caregiving for older family members by young caregivers in Singapore. Interpretative phenomenological analysis was employed to collect and analyse data from semi-structured, in-depth interviews with six young adult caregivers aged between 23 and 29. Interviews were supplemented with photo-elicitation techniques to deepen interview discussions and uncover experiential significance. Findings illustrated transitions into caregiving, challenges across role conflicts and expectations amidst developmental tasks and transitions, and navigation of intergenerational conflicts and ambivalence. Although no definitive conclusions can be reached from this small-scale study, the findings offer important insights into the convergence and intensity of young caregivers' experiences. Given that caregiving challenges are likely to continue amidst Singapore's rapidly ageing population, these necessitate further in-depth research efforts. Implications for policy and practice across multiple stakeholders interfacing with youth and older adults are presented. A whole-of-society approach is called for to enable young caregivers to realise their full potential while contributing to their ageing families and nation.
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Affiliation(s)
- Araviinthansai Subramaniam
- S R Nathan School of Human Development, Singapore University of Social Sciences, Singapore 599494, Singapore;
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Saragosa M, Hahn-Goldberg S, Lunsky Y, Cameron JI, Caven I, Bookey-Bassett S, Newman K, Okrainec K. Young carers' perspectives on navigating the healthcare system and co-designing support for their caring roles: a mixed-methods qualitative study. BMJ Open 2023; 13:e075804. [PMID: 38072468 PMCID: PMC10729167 DOI: 10.1136/bmjopen-2023-075804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVES Despite young carers (YCs) providing regular and significant care that exceeds what would normally be associated with an adult caregiver, we need to learn more about their experience interacting with the healthcare system. The primary study aims were to (1) describe YC experiences in interacting with the healthcare system and (2) identify types of support YC recognise as potentially helpful to their caring role. DESIGN AND SETTING A mixed-methods qualitative study was conducted between March 2022 and August 2022, comprising two phases of (1) semi-structured interviews and focus groups with YCs living in the community to confirm and expand earlier research findings, and (2) a co-design workshop informed by a generative research approach. We used findings from the interviews and focus groups to inform the brainstorming process for identifying potential solutions. RESULTS Eight YCs completed either a focus group or an interview, and four continued the study and participated in the co-design activity with 12 participants. Phase 1 resulted in three overarching themes: (1) navigating the YC role within the healthcare system; (2) being kept out of the loop; and (3) normalising the transition into caregiving. Phase 2 identified two categories: (1) YC-focused supports and (2) raising awareness and building capacity in the healthcare system. CONCLUSION Study findings revealed the critical role that YCs play when supporting their families during pivotal interactions in the healthcare system. Like their older caregiver counterparts, YCs struggle to navigate, coordinate and advocate for their family members while juggling their needs as they transition from adolescence to adulthood. This study provides important preliminary insights into YCs encountering professionals, which can be used to design and implement national support structures.
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Affiliation(s)
- Marianne Saragosa
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
- Science of Care Institute, Sinai Health, Toronto, Ontario, Canada
| | - Shoshana Hahn-Goldberg
- OpenLab, University Hospital Network, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Deptartment of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jill I Cameron
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Isabelle Caven
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Susan Bookey-Bassett
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Kristine Newman
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Karen Okrainec
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
- OpenLab, University Hospital Network, Toronto, Ontario, Canada
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The Young Carers' Journey: A Systematic Review and Meta Ethnography. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105826. [PMID: 35627362 PMCID: PMC9140828 DOI: 10.3390/ijerph19105826] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/29/2022] [Accepted: 05/05/2022] [Indexed: 02/04/2023]
Abstract
Despite growing international interest, the caregiving body of literature lacks a recent understanding of young carers’ experiences and their contact with the health care system. We conducted a systematic review of qualitative studies to (1) synthesize more recent qualitative evidence on young carers’ experience, and (2) to identify how these young carers interact with the health care system in their caregiving role. Using a meta-ethnographic synthesis, a total of 28 empirical studies met inclusion. Key findings helped inform an overarching framework of the experience of young carers as illustrated by a journey map. The journey map is a visual depiction of the stages these young carers go through when in a caregiving role framed by three themes: (1) encountering caregiving; (2) being a young caregiver, and (3) moving beyond caregiving. The caregiving experience is perceived by young people as challenging and complex, which could be improved with more informational navigation and emotional support. Understanding these experiences provides insight into gaps in health services and potential solutions that align with the stages outlined in the journey map.
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Kallander EK, Weimand BM, Hanssen-Bauer K, Van Roy B, Ruud T. Factors associated with quality of life for children affected by parental illness or substance abuse. Scand J Caring Sci 2021; 35:405-419. [PMID: 32383213 DOI: 10.1111/scs.12868] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 04/05/2020] [Accepted: 04/13/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND There have been inconsistent findings from studies examining factors associated with quality of life (QoL) for children affected by parental illness. AIM The aim of this study was to explore factors associated with self-reported QoL in children affected by parental illness or parental substance abuse. DESIGN A cross-sectional multicentre study. METHODS The sample included 246 families with children 8-18 years recruited via ill parents who received treatment for severe physical illness, mental illness or substance abuse in specialised health services. We performed multiple linear regression analyses to examine factors associated with the children's self-reported QoL. MAIN OUTCOME MEASURE KIDSCREEN-27. RESULTS The children's self-reported QoL was positively associated with the ill parent's self-reported physical health, the children's self-reported social skills, the degree to which other adults took over the ill parent's responsibilities, provision of sibling care, provision of health care for the ill parent and positive outcome of caregiving. The children's QoL was negatively associated with the children's self-reported responsibilities due to parental illness, provision of emotional care for the ill parent, negative outcomes of caregiving and external locus of control. The model explained 63% of the variance (adjusted R2 ) in children's total QoL. STUDY LIMITATIONS Sampling bias may have occurred during recruitment. CONCLUSIONS The findings suggest factors of importance for the children's QoL. Clinicians should assess whether an ill parent's physical health may influence negatively on their ability to perform daily responsibilities at home and care for their children, and clinicians can use children's self-reported QoL to identify children who are most negatively affected.
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Affiliation(s)
- Ellen Katrine Kallander
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Fafo Research Foundation, Oslo, Norway
| | - Bente M Weimand
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Faculty of Health Sciences, Department of Nursing and Health Promotion, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Ketil Hanssen-Bauer
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Betty Van Roy
- Department of CAMHS, Clinic of Children and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Torleif Ruud
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Kavanaugh MS, Cho CC, Howard M, Fee D, Barkhaus PE. US data on children and youth caregivers in amyotrophic lateral sclerosis. Neurology 2020; 94:e1452-e1459. [PMID: 32188763 DOI: 10.1212/wnl.0000000000009217] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 11/07/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE An estimated 1.4 million young caregivers (<19 years of age) in the United States provide care to ill family members yet remain hidden from state and national caregiving programs and services, including amyotrophic lateral sclerosis (ALS) caregiving services. Given the intensive care needs and acuity of ALS, appreciation of the young caregiver experience within the family context may have a significant impact on patient and family quality of life. This article seeks to identify family and youth caregiver characteristics and perceptions of care through interviews with 38 youth caregivers and their families with ALS. METHODS Online adult surveys and follow-up youth interviews were conducted with families with ALS across the United States in this cross-sectional study. Participants were accessed through chapters of the ALS Association. Both thematic content analysis and descriptive statistics were used. RESULTS Youth caregivers (n = 38) ranged in age from 8 to 18 years and spent an average of 5 h/d providing care for an average of 12 tasks. Persons with ALS relied on youth primarily due to cost and identified complex feelings about relying on youth caregivers, including feeling like a failure, guilty, but proud. CONCLUSION Youth are intricately involved in all areas of caregiving in ALS. They are isolated and have little training or guidance in care, yet they are able to identify ways to manage their care burden. Results provide clear implications for health care professionals in designing best care and support practices for persons with ALS and their young caregivers.
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Affiliation(s)
- Melinda S Kavanaugh
- From Social Work (M.S.K., M.H.), Helen Bader School of Social Welfare, College of Health Science (C.C.C.), and Center for Aging and Translational Research (C.C.C.), University of Wisconsin-Milwaukee; University of Wisconsin-Milwaukee (M.H.); and Departments of Neurology (D.F., P.E.B.) and Physical Medicine & Rehabilitation (P.E.B.), ALS Multidisciplinary Clinic (D.F., P.E.B.), and Neuromuscular and Autonomics Program (D.F., P.E.B.), Medical College of Wisconsin, Milwaukee.
| | - Chi C Cho
- From Social Work (M.S.K., M.H.), Helen Bader School of Social Welfare, College of Health Science (C.C.C.), and Center for Aging and Translational Research (C.C.C.), University of Wisconsin-Milwaukee; University of Wisconsin-Milwaukee (M.H.); and Departments of Neurology (D.F., P.E.B.) and Physical Medicine & Rehabilitation (P.E.B.), ALS Multidisciplinary Clinic (D.F., P.E.B.), and Neuromuscular and Autonomics Program (D.F., P.E.B.), Medical College of Wisconsin, Milwaukee
| | - Megan Howard
- From Social Work (M.S.K., M.H.), Helen Bader School of Social Welfare, College of Health Science (C.C.C.), and Center for Aging and Translational Research (C.C.C.), University of Wisconsin-Milwaukee; University of Wisconsin-Milwaukee (M.H.); and Departments of Neurology (D.F., P.E.B.) and Physical Medicine & Rehabilitation (P.E.B.), ALS Multidisciplinary Clinic (D.F., P.E.B.), and Neuromuscular and Autonomics Program (D.F., P.E.B.), Medical College of Wisconsin, Milwaukee
| | - Dominic Fee
- From Social Work (M.S.K., M.H.), Helen Bader School of Social Welfare, College of Health Science (C.C.C.), and Center for Aging and Translational Research (C.C.C.), University of Wisconsin-Milwaukee; University of Wisconsin-Milwaukee (M.H.); and Departments of Neurology (D.F., P.E.B.) and Physical Medicine & Rehabilitation (P.E.B.), ALS Multidisciplinary Clinic (D.F., P.E.B.), and Neuromuscular and Autonomics Program (D.F., P.E.B.), Medical College of Wisconsin, Milwaukee
| | - Paul E Barkhaus
- From Social Work (M.S.K., M.H.), Helen Bader School of Social Welfare, College of Health Science (C.C.C.), and Center for Aging and Translational Research (C.C.C.), University of Wisconsin-Milwaukee; University of Wisconsin-Milwaukee (M.H.); and Departments of Neurology (D.F., P.E.B.) and Physical Medicine & Rehabilitation (P.E.B.), ALS Multidisciplinary Clinic (D.F., P.E.B.), and Neuromuscular and Autonomics Program (D.F., P.E.B.), Medical College of Wisconsin, Milwaukee
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