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Trebbastoni A, Margiotta R, D’Antonio F, Barbetti S, Canevelli M, Diana S, Di Vita A, Imbriano L, Sepe Monti M, Talarico G, Guariglia C, Bruno G. Neuropsychological Effects of the Lockdown Due to the COVID-19 Pandemic on Patients with Alzheimer's Disease and Their Caregivers: The "ACQUA" (Alzheimer-COVID QUArantine Questionnaire) Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1622. [PMID: 39767463 PMCID: PMC11675157 DOI: 10.3390/ijerph21121622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Revised: 11/25/2024] [Accepted: 11/29/2024] [Indexed: 01/11/2025]
Abstract
BACKGROUND The lockdown due to the COVID-19 pandemic, imposed in many countries in 2021, led to social isolation and the interruption of many activities that were useful in stimulating cognition. The impact of these changes has been particularly severe in older subjects with cognitive impairment. METHODS The present study aimed to investigate the effects of lockdown on Alzheimer's disease patients (in cognition, behavior, and autonomy) and on their caregivers (in emotions, burden, and quality of life). We created a questionnaire and performed an extensive semi-structured telephone interview with each caregiver. The main outcomes were (1) changes in cognitive and behavioral symptoms and autonomy levels in the patients and (2) effects on caregivers' emotions, burden, and quality of life. RESULTS The lockdown severely impaired patients' cognition and independence and worsened behavioral and psychological symptoms of dementia. These effects contributed to increasing caregivers' burden and stress levels, with a significant perceived deterioration in quality of life among caregivers with higher education levels (p = 0.047). CONCLUSIONS This study might contribute to our understanding of the impact of lockdown on Alzheimer's disease patients and their caregivers, to guide future public health interventions aimed at preventing and/or reducing the consequences of similar extraordinary events in frail subjects.
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Affiliation(s)
- Alessandro Trebbastoni
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (R.M.); (F.D.); (S.B.); (M.C.); (S.D.); (L.I.); (M.S.M.); (G.T.); (G.B.)
- Stroke Unit, Department of Emergency, Ospedale dei Castelli, 00040 Ariccia, Italy
| | - Roberta Margiotta
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (R.M.); (F.D.); (S.B.); (M.C.); (S.D.); (L.I.); (M.S.M.); (G.T.); (G.B.)
- PhD Program in Behavioral Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Fabrizia D’Antonio
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (R.M.); (F.D.); (S.B.); (M.C.); (S.D.); (L.I.); (M.S.M.); (G.T.); (G.B.)
| | - Sonia Barbetti
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (R.M.); (F.D.); (S.B.); (M.C.); (S.D.); (L.I.); (M.S.M.); (G.T.); (G.B.)
| | - Marco Canevelli
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (R.M.); (F.D.); (S.B.); (M.C.); (S.D.); (L.I.); (M.S.M.); (G.T.); (G.B.)
| | - Sofia Diana
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (R.M.); (F.D.); (S.B.); (M.C.); (S.D.); (L.I.); (M.S.M.); (G.T.); (G.B.)
| | - Antonella Di Vita
- ASReM—Azienda Sanitaria Regionale del Molise, 86100 Campobasso, Italy;
| | - Letizia Imbriano
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (R.M.); (F.D.); (S.B.); (M.C.); (S.D.); (L.I.); (M.S.M.); (G.T.); (G.B.)
| | - Micaela Sepe Monti
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (R.M.); (F.D.); (S.B.); (M.C.); (S.D.); (L.I.); (M.S.M.); (G.T.); (G.B.)
| | - Giuseppina Talarico
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (R.M.); (F.D.); (S.B.); (M.C.); (S.D.); (L.I.); (M.S.M.); (G.T.); (G.B.)
| | - Cecilia Guariglia
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy;
- Cognitive and Motor Rehabilitation and Neuroimaging Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione Santa Lucia, 00179 Rome, Italy
| | - Giuseppe Bruno
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (R.M.); (F.D.); (S.B.); (M.C.); (S.D.); (L.I.); (M.S.M.); (G.T.); (G.B.)
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Falcão DVDS, Paulson D. Quality of relationship between adult children caregivers and parents with dementia. INTERPERSONA: AN INTERNATIONAL JOURNAL ON PERSONAL RELATIONSHIPS 2022. [DOI: 10.5964/ijpr.5481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The main effects for associations between psychosocial stressors and caregiver outcomes are well established, but little is known about the mechanisms of these relationships. Aims of this study were to examine the hypotheses that satisfaction with family relationships (SF) is a mechanism by which quality of relationship (QR) between adult children caregiver and parents with Alzheimer’s disease (AD) influences depression, life satisfaction (LF), and self-rated health (SRH) among these caregivers. The participants were 716 Brazilian adult children who cared for their parents with AD and related disorders. Regression-based path analysis was performed; a PROCESS, bias-corrected and accelerated bootstrapping method was used to test confidence intervals. The relationships between QR and both depression (B = .3263, p < .001) and SRH (B = .3263, p < .001), were fully mediated by SF. The relationship between QR and LF was partially mediated by SF. The primary finding is that SF is one mechanism by which QR relates to depressive symptomatology, self-rated health, and life satisfaction.
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Denham AMJ, Wynne O, Baker AL, Spratt NJ, Turner A, Magin P, Palazzi K, Bonevski B. An online survey of informal caregivers' unmet needs and associated factors. PLoS One 2020; 15:e0243502. [PMID: 33301483 PMCID: PMC7728235 DOI: 10.1371/journal.pone.0243502] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 11/20/2020] [Indexed: 12/19/2022] Open
Abstract
PURPOSE/OBJECTIVE The purpose of this study was to assess the frequency of unmet needs of carers among a convenience sample of carers, and the participant factors associated with unmet needs, to inform the development of interventions that will support a range of caregivers. The aims of this study were to: (1) assess the most frequently reported moderate-high unmet needs of caregivers; and (2) examine the age, gender, condition of the care recipient, and country variables associated with types of unmet needs reported by informal caregivers. RESEARCH METHOD/DESIGN An online cross-sectional survey among informal caregivers in English-speaking countries was conducted. Self-reported unmet needs were assessed using an unmet needs measure with the following five unmet needs domains: (1) Health information and support for care recipient; (2) Health service management; (3) Communication and relationship; (4) Self-care; and (5) Support services accessibility. Informal caregivers were asked "In the last month, what was your level of need for help with…", and the ten highest ranked moderate-high unmet needs presented as ranked proportions. Logistic regression modelling examined the factors associated with types of unmet needs. RESULTS Overall, 457 caregivers were included in the final analysis. Seven of the ten highest ranked unmet needs experienced by caregivers in the last month were in the Self-care domain, including "Reducing stress in your life" (74.1%). Significant associations were found between younger caregiver age (18-45 years) and reporting moderate-high unmet needs in Health Information and support for care recipient, Health service management, and Support services accessibility (all p's = <0.05). CONCLUSIONS/IMPLICATIONS Caregivers are not experiencing significant differences in unmet needs between countries and caree/care recipient conditions, suggesting that general interventions could be developed to support a range of caregivers across countries. Increased awareness of informal caregivers' unmet needs, particularly for younger caregivers, among health care providers may improve support provision to caregivers.
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Affiliation(s)
- Alexandra M. J. Denham
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW, Australia
- Priority Research Centre for Stroke and Brain Injury, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- * E-mail:
| | - Olivia Wynne
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Amanda L. Baker
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Neil J. Spratt
- Priority Research Centre for Stroke and Brain Injury, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
- Department of Neurology, Hunter New England Local Health District, John Hunter Hospital, New Lambton Heights, NSW, Australia
| | - Alyna Turner
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW, Australia
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Parker Magin
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Kerrin Palazzi
- HMRI Clinical Research Design and Statistics (CReDITSS), Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW, Australia
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Giesbers SAH, Hendriks AHC, Hastings RP, Jahoda A, Tournier T, Embregts PJCM. Family-based social capital of emerging adults with and without mild intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:757-769. [PMID: 32743943 PMCID: PMC7540391 DOI: 10.1111/jir.12764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 05/15/2020] [Accepted: 06/27/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Family is recognised as an important context for the self-development of young adults in emerging adulthood, although very little research has addressed the perspective of young people with intellectual disability about their families by using self-report. This study examined how emerging adults with mild intellectual disability define their family support networks, compared with definitions of students without intellectual disability, within a social capital theoretical framework. METHODS Fifty-three participants with mild intellectual disability and 53 students without intellectual disability were interviewed individually using the Family Network Method - Intellectual Disability (FNM-ID). Data from the FNM-ID relate to key social network measures on how individuals define their family groups, and how they perceive existing supportive relationships within their families. Participants with mild intellectual disability and students were compared on the FNM-ID social network measures. RESULTS Participants with mild intellectual disability reported fewer family members who they considered significant to them than students without intellectual disability. They were less likely to include peers (i.e. friends and partners) and siblings in their significant family networks, had fewer relationships with family members in which they received or gave support, had fewer reciprocal support relationships and had a less central position in their family network. DISCUSSION The family-based social capital of emerging adults with mild intellectual disability differed from that of students without intellectual disability. They may remain more dependent on their natural family for emotional support as their supportive networks have not necessarily made the transition to networks with emotionally close peer relationships.
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Affiliation(s)
- S. A. H. Giesbers
- Tranzo, Tilburg School of Social and Behavioral SciencesTilburg UniversityTilburgthe Netherlands
- Dichterbij Innovation and ScienceGennepthe Netherlands
| | - A. H. C. Hendriks
- School of Pedagogical and Educational Science, Faculty of Social SciencesRadboud University NijmegenNijmegenthe Netherlands
| | - R. P. Hastings
- Centre for Educational Development, Appraisal and ResearchUniversity of WarwickCoventryUK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash HealthMonash UniversityClaytonAustralia
| | - A. Jahoda
- Psychological MedicineUniversity of GlasgowGlasgowUK
| | - T. Tournier
- Tranzo, Tilburg School of Social and Behavioral SciencesTilburg UniversityTilburgthe Netherlands
- ASVZSliedrechtthe Netherlands
| | - P. J. C. M. Embregts
- Tranzo, Tilburg School of Social and Behavioral SciencesTilburg UniversityTilburgthe Netherlands
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Lwi SJ, Casey JJ, Verstaen A, Connelly DE, Merrilees J, Levenson RW. Genuine Smiles by Patients During Marital Interactions are Associated with Better Caregiver Mental Health. J Gerontol B Psychol Sci Soc Sci 2019; 74:975-987. [PMID: 29385515 PMCID: PMC6941495 DOI: 10.1093/geronb/gbx157] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 12/08/2017] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE Providing care for a spouse with dementia is associated with an increased risk for poor mental health. To determine whether this vulnerability in caregivers is related to the expression of positive emotion, we examined 57 patients with Alzheimer's disease and behavioral variant frontotemporal dementia and their spouses as they discussed a marital conflict. METHOD Facial behavior during the discussion was objectively coded to identify Duchenne (i.e., genuine) smiles and non-Duchenne (i.e., polite) smiles. Caregiver mental health was measured using the Medical Outcomes Survey. RESULTS Greater expression of Duchenne smiles by patients was associated with better caregiver mental health, even when accounting for covariates (i.e., diagnosis, patient cognitive functioning, and caregiver marital satisfaction). Greater expression of non-Duchenne smiles by patients was associated with worse caregiver health, but only when covariates were entered in the model. Expression of Duchenne and non-Duchenne smiles by caregivers was not associated with caregiver mental health. DISCUSSION Patients' expression of Duchenne and non-Duchenne smiles may reveal important aspects of the emotional quality of the patient-caregiver relationship that influence caregiver burden and mental health.
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Affiliation(s)
- Sandy J Lwi
- Department of Psychology, University of California, Berkeley
| | - James J Casey
- Department of Psychology, University of California, Berkeley
| | - Alice Verstaen
- Department of Psychology, University of California, Berkeley
| | - Dyan E Connelly
- Department of Psychology, University of California, Berkeley
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Wilkins VM, Sirey JA, Bruce ML. Caregiver Reward and Burden: Differing Constructs in Family Members Providing Care for Medically Ill Homebound Older Adults. J Aging Health 2019; 32:361-370. [DOI: 10.1177/0898264319825760] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective: This study examined the relationship between caregiver burden and reward and how each relates to factors, such as depression, within the caregiving dyad. Method: A total of 101 older adults and their primary family caregivers were recruited upon enrolling in home health care services. Patients were assessed for sociodemographic information, depression, disability, pain, and caregiver support at baseline and at 8 weeks. Caregivers were assessed at baseline for sociodemographic information, depression, caregiver burden, caregiver reward, and caregiving tasks they provide. Results: Burden and reward were significantly inversely correlated, but differentially associated with distinct patient and caregiver variables. Patients whose caregivers reported higher baseline levels of caregiver reward were more likely to have lower depression scores at follow-up. Discussion: Given that different aspects of patients and caregivers influence reward and burden, assessing caregivers for both burden and reward may better target caregiver interventions at the individual and family levels, particularly for older adult depression.
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Nagl-Cupal M, Hauprich J. Being we and being me: Exploring the needs of Austrian families with caring children. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:e532-e540. [PMID: 29508478 DOI: 10.1111/hsc.12567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/05/2018] [Indexed: 06/08/2023]
Abstract
Children and adolescents with caring responsibilities are an uncontested reality in our society. Most are hidden from public view, and they perform a broad range of caring activities for chronically ill or disabled family members. The research literature has accumulated a comprehensive body of knowledge about young carers' personal needs. However, knowledge and understanding are limited regarding the needs of young carers' families. This knowledge can contribute to preventing children and adolescents from assuming inappropriate caring roles. A qualitative research approach was used to investigate the needs of young carers' families in terms of managing daily caring demands. Nine family interviews were conducted with 34 individuals including 15 young carers during spring/summer 2015 in eastern Austria. Open and axial coding procedures and constant comparison method were used to analyse the data. The findings revealed that young carers' families need to live in accordance with their inherent family logic. Family logic is generated and maintained via (i) family reciprocity that involves the natural help within the family, (ii) individual developmental space that allows family members to be perceived and act as individuals and (iii) network cooperation that offers formal and informal support and recognition from society in general. The findings contribute to understanding how families with caring children manage the caring demands of their everyday lives. The findings also indicate that formal support for families with young carers should consider the individuality of caring arrangements with respect to the holistic and personal needs and avoid stigmatising families that integrate children into caring.
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Affiliation(s)
- Martin Nagl-Cupal
- Department of Nursing Science, University of Vienna, Austria, Austria
| | - Julia Hauprich
- Department of Nursing Science, University of Vienna, Austria, Austria
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Scott LD, Arslanian-Engoren C. Caring for Survivors of Prolonged Mechanical Ventilation. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2016. [DOI: 10.1177/1084822302014002006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Approximately 54 million adults in the United States are involved in some form of family caregiving, with 15% of these individuals providing complex care in their homes. Therefore, it is essential to identify the nuances associated with complex community-based family caregiving. This study investigated family caregivers’ perceptions of caring for individuals who survived tracheostomy for prolonged mechanical ventilation. Using a quantitative approach, family caregivers (n = 15) reported that they were somewhat prepared for this experience. The findings suggested that family caregivers experience considerable physical and psychological effects throughout their caregiving careers. Despite physical and mental health challenges, the caregivers were able to derive personal gratification from complex care provision. The challenge before home care nurses is to prepare family members for their newly acquired caregiving roles, implement interventions that support their physical and mental well-being, and facilitate the engagement in health-promoting behaviors.
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Kuo YC. Women's Experiences Caring for Their Husbands' Siblings With Developmental Disabilities. Glob Qual Nurs Res 2015; 2:2333393615604169. [PMID: 28462315 PMCID: PMC5342291 DOI: 10.1177/2333393615604169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 08/03/2015] [Accepted: 08/07/2015] [Indexed: 11/28/2022] Open
Abstract
A phenomenological method was used in this study to examine the experiences of women caring for the husband’s sibling with developmental disabilities (DDs) with the aim of establishing how and why they came to care and continued to care for them. Three themes emerged after drawing on stories shared by seven women: for the sake of my husband, powerlessness, and trade-off between cost and rewards. The findings of this study show that Taiwanese women accept the cultural norms, thus accepting the caregiving responsibility. Reciprocity did not help determine whether women started caring for the husband’s sibling with DD. However, when an imbalance in reciprocity is present, women experience negative emotions that often result in tension within the family. Positive factors contributed by the husband and parents-in-law can facilitate the work of caregivers by ameliorating physical pain and psychological distress that can occur during the caregiving process.
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Affiliation(s)
- Yeh-Chen Kuo
- National Taipei University of Education, Taipei City, Taiwan, R.O.C
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Bastawrous M, Gignac MA, Kapral MK, Cameron JI. Factors that contribute to adult children caregivers' well-being: a scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2015; 23:449-66. [PMID: 25472851 DOI: 10.1111/hsc.12144] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/10/2014] [Indexed: 05/14/2023]
Abstract
The ageing of the population will increasingly result in reliance on the family for care in the community. Existing reviews have provided insights into the needs and health outcomes of family caregivers, but are disproportionately skewed towards spousal caregivers. Presently, a large majority of family caregivers are adult children. Adult children are distinct from spousal caregivers in terms of the combination of roles they occupy and the relationship they have with the care recipient. These unique considerations can have important implications for their well-being. A growing body of literature has investigated the factors that contribute to adult children caregivers' (ACCs) well-being; however, no reviews to date have synthesised this body of literature or appraised its methodological quality. Our objective was to identify the range and types of factors that contribute to ACC well-being across studies. A scoping review was conducted. Medline, Psycinfo, EMBASE and CINAHL databases (January 1996-August, 2012) were systematically searched for studies investigating ACC well-being. Inclusion/exclusion criteria were applied, methodological quality was appraised, the data were charted and a narrative synthesis was conducted. Fifty-five studies met our inclusion criteria. Factors that contribute to ACC well-being were found to be either: (i) care recipient-related (e.g. nature of limitations, amount of care required); (ii) caregiver-related (e.g. psychological dispositions of the ACC); or (iii) socially embedded (e.g. parent-child relationship, multiple role involvement, social support available to the ACC). Socially embedded factors that contribute to ACC well-being have received the most attention in the literature. Among these factors, ACC well-being is uniquely impacted by the quality of the parent-child relationship and combination of roles occupied. The majority of studies were cross-sectional. Future studies should therefore employ a longitudinal design to inform our understanding of the changes that take place in the parent-child relationship and multiple role involvement across the care-giving trajectory.
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Affiliation(s)
- Marina Bastawrous
- Graduate Department of Rehabilitation Science, University of Toronto, Toronto, Ontario, Canada
| | - Monique A Gignac
- Division of Healthcare and Outcomes Research, Toronto Western Research Institute, Toronto, Ontario, Canada
| | - Moira K Kapral
- Division of Support, Systems and Outcomes-Cardiovascular, Toronto General Research Institute, Toronto, Ontario, Canada
| | - Jill I Cameron
- Graduate Department of Rehabilitation Science, University of Toronto, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
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McGovern J. Living better with dementia: strengths-based social work practice and dementia care. SOCIAL WORK IN HEALTH CARE 2015; 54:408-421. [PMID: 25985285 DOI: 10.1080/00981389.2015.1029661] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This article first argues that quality of life is possible despite the onset of dementia in late life. It also demonstrates how core concepts of social work practice, such as family systems theory, the strengths perspective, and use of self, can be applied to practice with dementia-affected persons. In addition, it provides practical suggestions for supporting care partners in nurturing "we-ness", focusing on what remains rather than was is lost, and remaining authentic. When strengths-based social work practice is integrated into dementia care protocols, wellbeing can increase. As a result, the more than 40 million persons worldwide who are affected by dementia do not have to resign themselves to the despair, devastation and inevitable demise of quality of life that dominate perception of the illness.
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Affiliation(s)
- Justine McGovern
- a Department of Social Work , Lehman College, The City University of New York , Bronx , New York , USA
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Negative/positive home-based caregiving appraisals by informal carers of the elderly in Japan. Prim Health Care Res Dev 2014; 16:167-78. [DOI: 10.1017/s1463423614000309] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Bastawrous M. Caregiver burden--a critical discussion. Int J Nurs Stud 2012; 50:431-41. [PMID: 23131724 DOI: 10.1016/j.ijnurstu.2012.10.005] [Citation(s) in RCA: 228] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Revised: 09/17/2012] [Accepted: 10/06/2012] [Indexed: 10/27/2022]
Abstract
Currently, 15%, 12.8% and 17.1% of the Canadian, American and European populations, respectively, are 65 years or older. Due to aging-related disabilities, elderly individuals will require support from family members while in the community. Annually, family caregivers save the Canadian and American healthcare systems $25 billion and $350 billion, respectively. However, to maintain the important role they play, caregivers' experiences must be investigated in order to provide appropriate support. Despite the fact that 'caregiver burden' is preponderantly used as an indicator of the caregiving experience, much disagreement remains on what the term entails and how it should be utilized. This paper endeavors to critically discuss the concept of 'caregiver burden', its use in the literature and the implications this has for future research and clinical practice. The vagueness derived from the various 'caregiver burden' definitions limits the term's relevance to policy-making and clinical practice. Additionally, much of the literature on 'caregiver burden' is not theoretically framed, which reduces the conceptual clarity of the term. Quantitative measures are largely used to investigate 'caregiver burden', which can sometimes fail to capture contextual features that are relevant to caregiving outcomes (e.g., culture). Stress theory and role theory are recommended as guiding frameworks for future research that investigates 'caregiver burden'. Future research on 'caregiver burden' would also benefit from integrating qualitative and quantitative approaches into mixed method designs in order to gain a holistic understanding of the concept.
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Affiliation(s)
- Marina Bastawrous
- Graduate Department of Rehabilitation Science, University of Toronto, Canada.
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del-Pino-Casado R, Frías-Osuna A, Palomino-Moral PA. Subjective burden and cultural motives for caregiving in informal caregivers of older people. J Nurs Scholarsh 2011; 43:282-91. [PMID: 21884374 DOI: 10.1111/j.1547-5069.2011.01407.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The aims of this study were to investigate variables related to cultural caregiving motives (obligation and reciprocity) and to analyze the relationship between these cultural caregiving motives and subjective burden in informal caregivers of disabled older people. DESIGN AND METHODS A secondary analysis of the last cross-sectional Spanish survey of informal caregivers of older people (n= 1,284, probability sample) was performed. Measurements included sociodemographic characteristics of caregivers (gender, age, relationship with care recipient, primary caregiver status, and duration of caregiving), intensity of care (hours per week, type of care, and number of activities of daily living [ADL] assisted), cultural motives for caregiving (obligation and balanced reciprocity), and caregiver subjective burden. Statistical analyses included descriptive (means, percentages, and 95% confidence intervals), bivariate (chi-square test), and multivariate (binary logistic regression) analyses. FINDINGS Obligation and reciprocity were higher in spouses than in other relatives and in nonrelatives and obligation increased with age as well as providing help with ADL. Balanced reciprocity was high in men. Obligation was not related with subjective burden, whereas balanced reciprocity was positively related. CONCLUSIONS Reciprocity had a protective effect on subjective burden. No cultural differences have been found on this issue. Obligation may be a multidimensional concept that encompasses personal beliefs and social demands. CLINICAL RELEVANCE Balanced reciprocity is useful for early prevention and early intervention of subjective burden and must be included in nursing care plans for caregivers. Cultural factors support the comprehension of the caregiving process.
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Li T, Fok HK, Fung HH. Is reciprocity always beneficial? Age differences in the association between support balance and life satisfaction. Aging Ment Health 2011; 15:541-7. [PMID: 21815845 DOI: 10.1080/13607863.2010.551340] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Reciprocity in support exchanges is believed to be beneficial to psychological well-being. This study examined perceived emotional and instrumental support balance from either family or friends, and the relationship between each support balance and life satisfaction among young and older adults. METHOD The sample included 107 older adults and 96 young adults. They rated their life satisfaction, as well as the emotional and instrumental support they provided to and received from family members and friends. RESULTS Consistent with the socioemotional selectivity theory, age differences were found in perceived emotional support balance with friends. Older adults reported more emotionally reciprocal friendships than did young adults. Moreover, contrary to the equity rule, emotionally over-benefited friendships were associated with higher life satisfaction for older adults than were reciprocal friendships. CONCLUSION Age, type of support, and source of support should be considered when studying the relationships between support balance and psychological well-being.
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Affiliation(s)
- Tianyuan Li
- Department of Psychology, Chinese University of Hong Kong, Hong Kong, China
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16
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‘Returning the love’, not ‘balancing the books’: talk about delayed reciprocity in supporting ageing parents. AGEING & SOCIETY 2011. [DOI: 10.1017/s0144686x11000523] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTA desire to ‘return’ or ‘pay back’ past care has been identified as a potential motivator of support provided by adult children to their ageing parents. The purpose of this study is to examine whether, how and in what ways adult children interpret and apply the concept of delayed reciprocity in filial relationships. Twenty-eight men and women supporting one or both ageing parent(s) in a Western Canadian city participated in a qualitative study of filial responsibility. Data were analysed interpretively, using thematic coding, contextualised reflection and guiding questions. Findings suggest delayed reciprocity is limited as an interpretive framework for describing parent support. Overall, comments reflected qualification or rejection of ‘paying back’ in the sense of a filial contract. Delayed reciprocity appears for most participants to symbolise imbalance, expectedness or obligation, and a lack of affection. In response, participants tended to reject delayed reciprocity in favour of interpretations emphasising mutuality, family role duties and reciprocated love. Findings are discussed in relation to interpretive purposes, symbolic meanings of parent support, participant characteristics and cultural contexts.
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McPherson CJ, Wilson KG, Chyurlia L, Leclerc C. The caregiving relationship and quality of life among partners of stroke survivors: a cross-sectional study. Health Qual Life Outcomes 2011; 9:29. [PMID: 21554723 PMCID: PMC3111340 DOI: 10.1186/1477-7525-9-29] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Accepted: 05/09/2011] [Indexed: 11/23/2022] Open
Abstract
Background Since the majority of stroke survivors return home following their stroke, families play a pivotal role in their care. Few studies have addressed both positive and negative aspects of this role or the broader construct of health-related quality of life (HRQL). Furthermore, little consideration has been given to the context of care in terms of relationship quality, and reciprocity. The present study examined the relationships between caregiver quality of life (HRQL), caregiver role, relationship satisfaction, balance and reciprocity in caregivers of partners who had experienced a stroke. Specific hypotheses were made based on equity theory in social relations. Methods Fifty-six partner caregivers completed a postal survey that included measures of HRQL (SF-36), caregiver role (negative and positive aspects), relationship satisfaction, reciprocity and balance. Data were also collected on the care recipients' quality of life (Stroke Specific Quality of Life scale). Results Compared to a normative sample, caregivers' HRQL was lower for all SF-36 domains. Care recipient and caregiver age, care recipient quality of life and caregiver role (negative) significantly predicted physical component summary scores on the SF-36, while care recipient quality of life and caregiver role (negative) significantly correlated with mental component summary scores. Relationship satisfaction and intrinsic rewards of caregiving were found to be important predictors of positive aspects of the caregiver role. Caregivers who viewed their relationship as less balanced in terms of give and take had significantly greater caregiver burden than those who viewed their relationship as more equitable. Conclusions The study highlights the importance of taking a broader approach to examining partner caregiving in the context of stroke, in terms of the caregiving relationship and their influence on the health and well-being of caregivers.
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Affiliation(s)
- Christine J McPherson
- School of Nursing, Faculty of Health Sciences, University of Ottawa, 451, Smyth Road, Ottawa, Ontario K1H8M5, Canada.
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Jones PS, Winslow BW, Lee JW, Burns M, Zhang XE. Development of a caregiver empowerment model to promote positive outcomes. JOURNAL OF FAMILY NURSING 2011; 17:11-28. [PMID: 21343620 DOI: 10.1177/1074840710394854] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Family members caring for aging parents experience both negative and positive outcomes from providing care. Theoretical explanations for negative outcomes have been developed. There is need for models that explain and predict positive outcomes. This article describes the evolution of the Caregiver Empowerment Model (CEM) to explain and predict positive outcomes of family caregiving. Although empirical findings support positive outcomes of family caregiving, less attention has been given to theoretical rationale for positive effects. The CEM predicts that, in the presence of filial values and certain background variables, caregiving demands are appraised as challenges instead of stressors. Appraising caregiving demands as a challenge, finding meaning, and using certain types of coping strategies are posited to be associated with growth and well-being. The CEM extends our understanding of the complexity of the caregiving experience, and can serve as a framework to guide in developing and testing theory-based interventions to promote positive outcomes.
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Abstract
OBJECTIVES People caring for family members who have dementia often experience considerable levels of anxiety and depression. However, relatively little is known about the awareness of carer distress among people with dementia. This study investigated whether or not people with dementia are aware of the level of distress experienced by their carers. METHOD Two groups of participants were studied, a dementia group and a control group of people with arthritis. Each group consisted of pairs of people, the person with dementia or arthritis and the family member who acted as their main carer; 40 pairs participated in total. For both groups, the carer's psychological health was rated by the carer themselves and by the care-recipient, using the Hospital Anxiety and Depression Scale. For the dementia group, memory functioning in the person with dementia was rated by the care-recipient themselves and by the carer, using the Memory Function Scale. The ratings made by the carer and care-recipient were compared to give an indication of the level of awareness in the care-recipient. RESULTS People with dementia have a significant level of awareness of their carers' state of psychological health. Their awareness follows the same pattern as that shown by a control group of people with arthritis. The level of awareness of carer psychological health shown by the dementia group was not related to their level of awareness of their own memory difficulties. CONCLUSION The clinical implications of awareness of carer distress in people with dementia should be considered.
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Affiliation(s)
- Astri Ablitt
- Department of Psychology, University of Warwick, Coventry, UK.
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20
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O'Connell B, Heslop L, Fennessy H. An Evaluation of a Wellness Guide for Older Carers Living in the Community. Public Health Nurs 2010; 27:302-9. [DOI: 10.1111/j.1525-1446.2010.00859.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Family stress, family adaptation, and psychological well-being of elderly coronary artery bypass grafting patients. Dimens Crit Care Nurs 2008; 27:125-31. [PMID: 18434872 DOI: 10.1097/01.dcc.0000286845.15914.c0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
As our population ages, more elderly patients will undergo coronary artery bypass grafting. The psychological well-being of a patient is influenced by many factors, including family support. This descriptive, correlational pilot study was conducted to examine the relationship between family characteristics and psychological well-being in elderly coronary artery bypass grafting patients. The results of this study, which consists of 42 participants, are presented, as well as implications for critical care nursing.
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Abstract
AIM AND OBJECTIVES The purpose of this study was to describe family dynamics in families with severe chronic obstructive pulmonary disease (COPD) on the basis of Barnhill's framework for healthy family systems. The sample consisted of 35 severe COPD patients and 30 family members at Tampere University Hospital, Finland or in the neighbouring regions. BACKGROUND Chronic obstructive pulmonary disease is a public health problem worldwide. It is a slowly progressive airway disease, producing a decline in lung function which is not fully reversible. DESIGN The sample included the families of patients without oxygen therapy and the families of patients who had long-term oxygen therapy (LTOT). The data were collected using the Family Dynamics Measure 2 (FDM2) and the Family Dynamics Questionnaire (FDQ). METHOD A quantitative research method was employed in the study. Frequency and percentage distributions, as well as cross-tabulations, were used to describe the data. Mean values and standard deviations were calculated for the sum variables of six dimensions of the FDM2. RESULTS In the dimensions of individuation, mutuality and flexibility, dynamics in the families of patients with LTOT was significantly better than of the patients without oxygen therapy. Especially in the dimension of mutuality, the families of LTOT patients functioned very well, while in the dimensions of communication and roles, family dynamics in these families was notably worse, although still good. CONCLUSION Poor self-identity--enmeshment, isolation from others and lack of flexibility to varying conditions--in families with severe COPD can weaken the ability of the families to manage in everyday life. RELEVANCE TO CLINICAL PRACTICE Families need family nursing to adapt to alterations occurring when a family member has severe COPD. Nurses can give support and help for these families for their roles of patient and caregiver, as well as opportunities to speak with someone about their situation.
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Affiliation(s)
- Merja Kanervisto
- Department of Nursing Science, University of Tampere, Etelä-Pohjanmaa Hospital District, Tampere, Finland.
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23
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Kanervisto M, Kaistila T, Paavilainen E. Severe chronic obstructive pulmonary disease in a family's everyday life in Finland: perceptions of people with chronic obstructive pulmonary disease and their spouses. Nurs Health Sci 2007; 9:40-7. [PMID: 17300544 DOI: 10.1111/j.1442-2018.2007.00303.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aim of this study is to describe the experiences of people with severe chronic obstructive pulmonary disease (COPD) in their everyday lives by using the World Health Organization's International Classification of Functioning, Disability, and Health. Five people with COPD and four spouses participated in the study. The data were collected by thematic personal interviews and were analyzed by deductive content analysis. The findings describe the impairment of body function of people with COPD, they provide knowledge of those factors that promote the well-being of people with COPD, how they cope on a daily basis, and the importance of their spouse. Knowledge about COPD for all health-care professionals is a precondition to ensure that people receive the help they need. People with COPD found it important to have a care relationship with their own treatment unit. The findings of the present study showed that peer support was an important matter.
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Affiliation(s)
- Merja Kanervisto
- Department of Nursing Science, University of Tampere, Tampere, Finland.
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24
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Reid CE, Moss S, Hyman G. Caregiver Reciprocity: The effect of reciprocity, carer self-esteem and motivation on the experience of caregiver burden. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2007. [DOI: 10.1080/00049530500141022] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Catherine E. Reid
- Department of Psychology, Monash University, Clayton, Victoria, Australia
- Monash University, Department of Psychology, Clayton, PO Box 17, Monash University, Vic. 3800, Australia
| | - Simon Moss
- Department of Psychology, Monash University, Clayton, Victoria, Australia
| | - Graeme Hyman
- Department of Psychology, Monash University, Caulfield, Victoria, Australia
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Musil CM, Warner CB, Zauszniewski JA, Jeanblanc AB, Kercher K. Grandmothers, caregiving, and family functioning. J Gerontol B Psychol Sci Soc Sci 2006; 61:S89-98. [PMID: 16497965 PMCID: PMC6689403 DOI: 10.1093/geronb/61.2.s89] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES We used McCubbin's Resiliency Model of Family Stress, Adjustment and Adaptation ( McCubbin, Thompson, & McCubbin, 2001) to examine how demographic factors, family stress, grandmother resourcefulness, support, and role reward affect perceptions of family functioning for grandmothers raising grandchildren, grandmothers living in multigenerational households, and grandmothers not caregiving for grandchildren. METHODS A sample of 486 grandmothers completed a mailed questionnaire. We used structural equation modeling to (a) test the effects of demographic factors (i.e., grandmother's age, race, marital status, and employment), family stressful life events and strain, grandmother's resourcefulness, subjective and instrumental support, and role reward on perceptions of family functioning for each grandmother group; (b) evaluate differences in the measurement and structural models between the grandmother groups using multisample analysis; and (c) test the model on the full sample, coding for caregiver status. RESULTS The models did not differ significantly by grandmother group; therefore we assessed the composite model using a multisample analysis. We found general support for the resiliency model and equivalence of the models across grandmother groups. Less support, resourcefulness, and reward, and more intrafamily strain and stressful family life events contributed to perceptions of worse family functioning. DISCUSSION Findings demonstrate the importance of the quality of family functioning for grandmothers in all types of families.
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Affiliation(s)
- Carol M Musil
- School of Nursing, Case Western Reserve University, Cleveland, OH 44106-4904, USA.
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26
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Scott LD, Arslanian-Engoren C. The Decision to Care: A Life-Altering Experience. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2005. [DOI: 10.1177/1084822304270021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The decision to care is often mandated by unavoidable alterations within the family, requiring a primary caregiver. One population that often requires complex community-based care is survivors of prolonged mechanical ventilation (PMV). This investigation explored the choices and challenges of eight family caregivers of PMV survivors. Using content analysis, several mutually exclusive themes emerged describing the caregiving experience as a physically exhausting, emotionally stressful decision that required a lifestyle change to actualize. Even with the burdensome challenges and overwhelming nature of the caregiving experience, participants identified positive rewards associated with the caregiving role. Home health care nurses are in a unique position to facilitate an effective transition to the caregiving role, serving as conduits for caregiver education and skill acquisition and advocating for the development of vital infrastructures that will provide resources, reassurance, and respite from burdensome caregiving challenges.
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27
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Maijala H, Paavilainen E, Väisänen L, Astedt-Kurki P. Caregivers' experiences of interaction with families expecting a fetally impaired child. J Clin Nurs 2004; 13:376-85. [PMID: 15009340 DOI: 10.1046/j.1365-2702.2003.00869.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND On the basis of earlier research, caregivers' actions when interacting with clients should be developed. However, nursing research has focused little attention on the interaction between caregivers and families expecting a fetally impaired child. AIM The study aimed at generating a practical family nursing theory of caregivers' interaction with families expecting a malformed child. METHODS A grounded theory study was undertaken at Tampere University Hospital in Finland in 1999-2000. Data consisted of semi-structured interviews with 22 (n=22) nurses and doctors. The data were analysed using the constant comparative method. RESULTS The interaction process starts when a caregiver informs the parents of the fetal impairment. The process is influenced by caregivers' attitude towards issues related to the family's life situation. Caregivers' views of their job, and of human coping and cultural attitudes towards these issues are also of importance. These factors account for their goals in the interaction, which, in turn, underlie their actions. When the caregiver's interpretation is that the family accepted the help provided, the outcome of the interaction is satisfaction with having been able to help. Correspondingly, in the case of an opposite interpretation, the caregiver experiences strain caused by inadequacy of the help he/she is providing. The core of interaction consists of two dimensions: gaining strength and losing strength in relation to impairment issues. CONCLUSIONS Caregivers' views of helpful interaction were consistent with earlier research on the subject, but the findings of this study showed that more attention should be focused on the family as a whole. Furthermore, caregivers rarely criticized their own actions, thus their interaction skills should be upgraded by focusing on systematic self-assessment through training. Nursing research deepening our understanding of why interaction fails is warranted. RELEVANCE TO CLINICAL PRACTICE The study results can be used in the family nursing practice as tools in reinforcing the caregivers' ability to helpful interaction with families expecting a fetally impaired child. The results may enhance caregivers' systematic self-evaluation and conscious use of the self.
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Abstract
Interpersonal connections, friendships, and belonging play important roles in a person's emotional and physical well-being. However, recent studies reveal that persons with developmental disabilities often live with few connections and friendships within unwelcoming communities. Through this qualitative study, we enter this relatively unexplored area of friendships between persons with and without developmental disabilities by interviewing four existing friendship dyads in the intentional community of L'Arche. In this research these friendships are described, factors that foster or inhibit their development are identified, and communal influences on the relationships are discussed.
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Affiliation(s)
- Colin Pottie
- Virginia Commonwealth University, Psychology Department, 808 W. Franklin St., PO Box 842018, Richmond, VA, 23284-2018, USA.
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29
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Rural African American Caregivers' and Stroke Survivors' Satisfaction with Health Care. TOPICS IN GERIATRIC REHABILITATION 2002. [DOI: 10.1097/00013614-200203000-00007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
The purpose of this research was to describe strategies used by sufferers of catastrophic illnesses and injuries. Participants were adult men and women with a variety of serious illnesses and injuries. Qualitative research approaches to data collection and data analysis, using grounded theory methods were employed. Descriptions of the participants indicate that several strategies are used; this discussion focuses on strategies to protect themselves from further suffering. Situations where participants use protecting strategies are identified and described. The findings indicate how care-recipients try to lessen the burden on their care-givers and to protect them from the stress of the sufferer's problems.
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Affiliation(s)
- A Dewar
- School of Nursing, University of British Columbia, Vancouver, Canada.
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32
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Courts NF, Barba RE, Tesh A. Family caregivers' attitudes toward aging, caregiving, and nursing home placement. J Gerontol Nurs 2001; 27:44-52. [PMID: 11817437 DOI: 10.3928/0098-9134-20010801-12] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Nursing home placement (NHP) is stressful both for older adults and for their family caregivers. This descriptive survey research investigated family caregivers' attitudes toward aging, their emotional appraisal of nursing home placement, and their reactions to caregiving roles. Eighty-eight survey packets were mailed and 35 usable packets were returned for a response rate of 39.5%. Sixty-four percent of the respondents were age 65 or older. Respondents reported that they felt "privileged to care" for their residents and that caregiving had little impact on their personal schedules. Further, they did not feel abandoned by other family members. Fifty percent reported feelings of sadness when thinking about nursing home placement though they indicated that they were mostly pleased. The respondents had mostly positive attitudes about aging. It may be that those who responded to the survey were coping at a high level. Caregiver reactions might differ in the group that did not respond. Included are specific nursing implications and needs for further research.
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Affiliation(s)
- N F Courts
- Adult Health Division, University of North Carolina-Greensboro School of Nursing, 27402-6172, USA
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Abstract
BACKGROUND Original testing of the Caregiving Effectiveness Model, in a randomly drawn national sample (n = 111) of family caregivers, explained variance in the home care outcomes of patient physical condition, technology side effects, and quality of life. The variables in the resulting model reflected the challenges specific to family caregivers managing complex home care for the growing populations of technology-dependent patients. OBJECTIVE To seek further empirical verification of the relationships among home care outcomes and the variables in the original trimmed model. METHOD Data were collected from family caregivers (n = 31) and adult patients (n = 31) requiring lifelong daily total parenteral nutrition (TPN) infusion technology for nonmalignant bowel disease. Hierarchical regression was used with variables entered in the two stages that coincided with the model configuration of Caregiving and Adaptive concepts, with a criteria of alpha = .05 at a power of > .80. RESULTS The model variables explained variance in all four outcomes. Specifically, Caregiving and Adaptive concept variables contributed to the explained variance in quality of life of both caregivers (R2 = .559, F = 4.65, p = .003) and patients (R2 = .464, F = 5.17, p = .04). Variance in patients' physical condition (R2 = .345, F = 6.37, p = .032) and the technological side effects outcomes (R2 = .357, F = 3.60, p = .018) were accounted for by variables in the model. CONCLUSIONS In this sample, the Caregiving Effectiveness Model concepts accounted for significant variance in home care outcomes (quality in patients' and caregivers' lives, patients' physical condition, and technological side effect). Longitudinal study of this sample will determine if variables explain variance over time, as in the original model testing.
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Affiliation(s)
- C E Smith
- School of Nursing, University of Kansas, Kansas City, USA
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Abstract
According to Social Exchange Theory, reciprocity in relationships is essential to functioning within the social context and is an important component in well-being as people age. Because of a potential relationship to meaning in life and hence to self health behaviors this study addressed: (1) Does reciprocity relate to self health care and (2) does reciprocity contribute to the explanation of self health care within a model including functional status, satisfaction with social support, and sense of meaning in life? Data were collected from 69 community dwelling women aged 65 to 99. Analysis indicated general health perception, support provided to others and sense of meaning in life were significant predictors of self health care.
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Affiliation(s)
- B J Craft
- University of Nebraska College of Nursing, Omaha 68198-5330, USA
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