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Maggio MG, Corallo F, De Francesco M, De Cola MC, De Luca R, Manuli A, Quartarone A, Rizzo A, Calabrò RS. Understanding the family burden and caregiver role in stroke rehabilitation: insights from a retrospective study. Neurol Sci 2024:10.1007/s10072-024-07668-5. [PMID: 38958795 DOI: 10.1007/s10072-024-07668-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024]
Abstract
INTRODUCTION Stroke negatively impacts both patients and their families, who must face multiple changes after the onset of the disease. Family caregivers must face new problems with a possible sense of inadequacy, stress and burden. Our retrospective study aimed to assess the burden of caregivers during the rehabilitation process of patients with Stroke. MATERIAL AND METHOD This study included patients with a diagnosis of stroke and their caregiver, who attended the Day Hospital of the IRCCS Neurolesi Center "Bonino-Pulejo", Messina, Italy, between January 2018 and October 2019, using electronic recovery system data. The final sample consisted of 30 patients and their caregivers. RESULTS Significant improvements were observed in patients' cognitive and mood scores, reflecting the efficacy of rehabilitation therapies. Additionally, a correlation emerged between patients' reported anxiety levels and caregivers' reported depression levels, highlighting a dynamic interaction between the emotional states of the two groups. CONCLUSION The study highlights the intricate interplay between caregiver characteristics, patient outcomes, and family dynamics in the context of caregiving. Targeted interventions aimed at improving family resilience and coping mechanisms are crucial to optimizing the well-being of both caregivers and patients.
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Affiliation(s)
- Maria Grazia Maggio
- IRCCS Centro Neurolesi Bonino Pulejo, S.S. 113 Contrada Casazza, Messina, 98124, Italy
| | - Francesco Corallo
- IRCCS Centro Neurolesi Bonino Pulejo, S.S. 113 Contrada Casazza, Messina, 98124, Italy
| | | | | | - Rosaria De Luca
- IRCCS Centro Neurolesi Bonino Pulejo, S.S. 113 Contrada Casazza, Messina, 98124, Italy
| | - Alfredo Manuli
- Physical Medicine and Rehabilitation Unit, Piazza Pugliatti, 1, Messina, 98120, Italy
| | - Angelo Quartarone
- IRCCS Centro Neurolesi Bonino Pulejo, S.S. 113 Contrada Casazza, Messina, 98124, Italy
| | - Amelia Rizzo
- University of Messina, Piazza Pugliatti, 1, Messina, 98120, Italy
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2
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Chen H, Liu W, Xu X, Xiao M, Yin Y. The Effects of a Nonpharmacological Intervention Practice for Older Adults with Mild Cognitive Impairment and Their Family Caregivers in China. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024:1-20. [PMID: 38762891 DOI: 10.1080/01634372.2024.2355152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 05/10/2024] [Indexed: 05/21/2024]
Abstract
Mild cognitive impairment (MCI) marks a critical phase in the progression to dementia. In our study, social workers utilized the Multicomponent Nonpharmacological Intervention Approach (MCNIA) to aid MCI participants (N = 52) and their caregivers, dividing into intervention and control groups. The intervention group underwent an additional regimen of non-pharmacological therapies besides pharmacological treatment. Our findings highlighted that: 1) MCNIA significantly enhanced cognitive and daily living abilities in the intervention group; 2) Caregivers experienced reduced burdens and improved social support; 3) Correlation analyses involving biomarkers indicated that MCNIA was particularly effective in alleviating depression in those with slightly more severe cognitive impairment.
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Affiliation(s)
- Honglin Chen
- Department of Social Sciences, Faculty of Social Science and Business Studies, University of Eastern Finland, Kuopio, Finland
| | - Wenrui Liu
- Department of Social Work, School of Social Development and Public Policy, Fudan University, Shanghai, China
| | - Xian Xu
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- NHC Key Laboratory of Clinical Nephrology, Sun Yat-Sen University and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, China
| | - Meng Xiao
- Department of social work, Tianjin Normal University, Tianjin, China
| | - You Yin
- Department of Neurology, Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital), Shanghai, China
- Department of Neurology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
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3
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Labbé D, Yao DG, Miller WC, Routhier F, Rushton PW, Demers L, Mortenson WB. Positive and negative experiences of caregivers helping power wheelchair users: a mixed-method study. Disabil Rehabil Assist Technol 2024:1-12. [PMID: 38341650 DOI: 10.1080/17483107.2024.2313080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE This study aimed to better understand how the powered wheelchair (PWC) impacts the experiences of family caregivers of PWC users, and explore the strategies and resources used by caregivers to cope with their role. MATERIALS AND METHODS This mixed-methods study was part of a larger cross-sectional research study conducted in four Canadian cities. Twenty-three family caregivers of PWC users, who provided at least 2 h of support per week, completed the Power Mobility Caregiver Assistive Technology Outcome (PM-CATOM), an 18-item measure assessing PWC-related and overall burden experienced by family caregivers. We also conducted semi-structured interviews and analysed them using inductive content analysis. RESULTS From the quantitative PM-CATOM results, the caregivers perceived low level of burden for the wheelchair-related items, (Median:4.5; Range 3 to 5). Most perceived burden when physically helping the wheelchair user and when providing verbal hints. In terms of overall help, the caregivers experienced some level of burden (Median 3.5: Range 3 to 5). Most caregivers identified burden associated with the limitation to their recreational and/or leisure activities (52.2%) and feeling that they have more to do than they can handle. We identified 3 themes in the interviews: the burden experiences of caring for PWC users, the positive experiences of caregiving, and the coping strategies and resources used by caregivers of PWC users. CONCLUSION Our study showed that understanding the experiences of caregivers of AT users is central as they are directly and indirectly impacted by the PWC in their lives and caregiving roles.
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Affiliation(s)
- Delphine Labbé
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Rehabilitation Research Lab, Vancouver, British Columbia, Canada
| | - Daryl G Yao
- Department of Disability and Human Development, University of Illinois at Chicago, Chicago, Illinois, USA
| | - William C Miller
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Rehabilitation Research Lab, Vancouver, British Columbia, Canada
- ICORD Research Center, Vancouver, British Columbia, Canada
| | - François Routhier
- Department of Rehabilitation, Université Laval, Québec, Québec, Canada
- Centre interdisciplinaire de recherche en réadaptation et en intégration sociale (CIRRIS), Québec, Québec, Canada
| | - Paula W Rushton
- School of Rehabilitation, Université de Montréal, Montréal, Québec, Canada
- CHU Sainte Justine Research Center, Montréal, Québec, Canada
| | - Louise Demers
- School of Rehabilitation, Université de Montréal, Montréal, Québec, Canada
- Centre de recherche de l'institut universitaire de gériatrie de Montréal, Montréal, Québec, Canada
| | - W Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Rehabilitation Research Lab, Vancouver, British Columbia, Canada
- ICORD Research Center, Vancouver, British Columbia, Canada
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4
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Ornstein MT, Caruso CC. The Social Ecology of Caregiving: Applying the Social-Ecological Model across the Life Course. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:119. [PMID: 38276813 PMCID: PMC10815033 DOI: 10.3390/ijerph21010119] [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: 08/07/2023] [Revised: 01/07/2024] [Accepted: 01/15/2024] [Indexed: 01/27/2024]
Abstract
Family caregivers provide care to people with disabilities, as well as ill and older adults, often with little to no outside assistance from the formal long-term care system. They are the backbone of long-term care, and it is a misconception that the majority of people institutionalize disabled people and older adults in the United States. Youth caregiving is under-examined in the field of public health and is in need of theoretical and practical attention. Building upon the work of Talley and Crews and Bronfenbrenner, we aim to broaden the scope of the discussion around caregiving through the application of the social-ecological model (SEM) to inform research and practice. This paper picks up where they left off, digging deeper into the ecological model to reimagine research, policy, and practices related to youth and young adult caregivers that are rooted in this framework. This application highlights care as embedded in social relations while allowing for an exploration of the ways structural barriers impact the caring unit. Looking holistically at the unit, rather than individuals as service users, provides an opportunity for understanding the interconnectedness of those giving and receiving care. It does so by rendering visible the interdependence of the caring unit, and the myriad structures, which bear down on care at the individual and household levels. This approach runs counter to dominant thinking, which focuses exclusively on the individuals involved in caregiving relationships, rather than considering them as interdependent units of care. This paper provides an analytic contribution, utilizing a narrative composite vignette based on literature and previous research.
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Affiliation(s)
| | - Christine C. Caruso
- Bailey College of the Environment, Wesleyan University, Middletown, CT 06459, USA;
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5
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Kanthasamy S, Miskon N, Barlas J, Marsh NV. Family Caregiver Adaptation during the Transition to Adulthood of Individuals with Intellectual Disabilities: A Scoping Review. Healthcare (Basel) 2024; 12:116. [PMID: 38201021 PMCID: PMC10779180 DOI: 10.3390/healthcare12010116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/08/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
During the transition to adulthood, individuals diagnosed with intellectual disability (ID) and their family caregivers have unique experiences. This scoping review studies the sources of the family caregiver's objective burden, support, coping mechanisms, positive caregiving, and quality of life to understand the caregiver's adaptation process when the individual with ID transits to adulthood, according to Joanna Briggs Institute (JBI) Scoping Review methodology guidelines. The inclusion criteria included studies of family caregivers of any age who provide unpaid care and live with individuals diagnosed with ID who are transitioning to adulthood. Of 2875 articles identified, 12 published studies were included. The main themes included caregivers reporting dissatisfaction with the available adult services and exhaustion from being a caregiver. Overall, a vicious cycle of likely increased demands during the transition, with caregivers not being prepared to cope with these demands while concurrently being dissatisfied with the adult services system, leads the caregivers to develop a pervasive sense of helplessness. Future studies would benefit from recruiting caregivers from sources other than adult-only service centres and using qualitative (to identify the broad aspects of the key factors) and quantitative (to identify the significant differences between the key factors) methodologies.
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Affiliation(s)
- Shivasangarey Kanthasamy
- School of Social and Health Sciences, James Cook University, Singapore 387380, Singapore; (S.K.); (J.B.)
- Department of Psychology, Institute of Mental Health, Singapore 539747, Singapore;
| | - Nazleen Miskon
- Department of Psychology, Institute of Mental Health, Singapore 539747, Singapore;
| | - Joanna Barlas
- School of Social and Health Sciences, James Cook University, Singapore 387380, Singapore; (S.K.); (J.B.)
| | - Nigel V. Marsh
- School of Social and Health Sciences, James Cook University, Singapore 387380, Singapore; (S.K.); (J.B.)
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6
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Guan Z, Poon AWC, Zwi A. Social isolation and loneliness in family caregivers of people with severe mental illness: A scoping review. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 72:443-463. [PMID: 37565657 DOI: 10.1002/ajcp.12698] [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: 02/13/2023] [Revised: 06/29/2023] [Accepted: 07/19/2023] [Indexed: 08/12/2023]
Abstract
Family caregivers of people with severe mental illness (SMI) have been increasingly observed to experience social isolation and/or loneliness (SI/L) which are risk factors for ill health. This scoping review aimed to map existing evidence and identify knowledge gaps in studies on SI/L in this population using the Arksey and O'Malley's framework. Parallel searches (2011-2021) conducted in 10 databases identified 51 publications from 18 countries fully meeting the inclusion criteria. Over half of the included studies were quantitative. We found that the definition of loneliness reached a consensus, while the definition of social isolation varied across studies. Risk factors and correlates of SI/L were grouped into sociodemographic factors, illness-related factors, health and wellbeing, and stigma. The evidence showed a lack of comprehensive measurements assessing SI/L, few longitudinal studies, and little knowledge of interventions specifically addressing SI/L. Future studies are recommended to address these knowledge gaps and explore effective interventions on SI/L in family caregivers of people with SMI.
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Affiliation(s)
- Ziyao Guan
- School of Social Sciences, Faculty of Arts, Design & Architecture, University of New South Wales, Sydney, New South Wales, Australia
| | - Abner Weng Cheong Poon
- School of Social Sciences, Faculty of Arts, Design & Architecture, University of New South Wales, Sydney, New South Wales, Australia
| | - Anthony Zwi
- School of Social Sciences, Faculty of Arts, Design & Architecture, University of New South Wales, Sydney, New South Wales, Australia
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von Saenger I, Dahlberg L, Augustsson E, Fritzell J, Lennartsson C. Will your child take care of you in your old age? Unequal caregiving received by older parents from adult children in Sweden. Eur J Ageing 2023; 20:8. [PMID: 37012453 PMCID: PMC10070562 DOI: 10.1007/s10433-023-00755-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2023] [Indexed: 04/05/2023] Open
Abstract
Intergenerational family care provided to older parents by adult children is growing and differs based on gender and socioeconomic status. Few studies consider these elements in relation to both the parent and their adult child, and little is known about the number of care tasks received even though those providing intensive levels of care are at risk of experiencing adverse consequences in their lives. This study uses data from the nationally representative 2011 Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) and includes child-specific information from parents aged 76 years and above. Analyses used ordinal logistic regression and are presented as average marginal effects and predictive margins. Results show that parents in need of care report that one-third of all adult children in the sample provide care to three out of five of them. The care is most often non-intensive, yet nearly one in ten of all children provide more intensive care of two or more tasks. When adjusting for dyad characteristics as well as geographic proximity, results show adult-child gender differences where parents receive more care from manual-working-class daughters than manual-working-class sons. Overall, manual-working-class daughters are most commonly reported as carers among adult children, and they are particularly overrepresented in providing intensive care. We conclude that gender and socioeconomic inequalities exist among care receivers' adult children, even in a strong welfare state such as Sweden. Knowledge about levels and patterns of intergenerational care have important implications for how to reduce unequal caregiving.
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Affiliation(s)
- Isabelle von Saenger
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
| | - Lena Dahlberg
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Erika Augustsson
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Johan Fritzell
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Carin Lennartsson
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
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8
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O’Neil E, Ngan J, Miller WC, Mohammadi S. Family Caregivers’ Experiences and Education When Caring for Individuals after Joint Arthroplasty. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2023. [DOI: 10.1080/02703181.2023.2172125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Erin O’Neil
- Department of Occupational Science & Occupational Therapy, University of British Columbia; Vancouver, Canada
| | - Joanne Ngan
- Department of Occupational Science & Occupational Therapy, University of British Columbia; Vancouver, Canada
| | - William C. Miller
- GF Strong Rehabilitation Research Program, Vancouver, Canada
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British ColumbiaVancouver, Canada
| | - Somayyeh Mohammadi
- GF Strong Rehabilitation Research Program, Vancouver, Canada
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British ColumbiaVancouver, Canada
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9
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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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10
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He L, Wu H, Li M, Deng X. A qualitative meta-synthesis of the caregiving experiences of adult children providing care for cancer patients in China: Implications for multidisciplinary healthcare teams. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3829-e3842. [PMID: 36259247 DOI: 10.1111/hsc.14073] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 08/31/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
Qualitative meta-synthesis is a coherent approach to answering an overarching research question by synthesising past qualitative studies so as to create new meanings from their results. We conducted a qualitative meta-synthesis to systematically evaluate and integrate the caregiving experiences of adult children providing care for an elderly parent with cancer. The search was conducted in the databases Web of Science, PubMed, Embase, MEDLINE, Cochrane Library, Grew Literature in the Health Sciences, CNKI, WanFang Data, VIP, SINOMED and China Academic Journals as well as Chinese grey literature databases (China Academic Conference Literature Database/, National Science and Technology Library) from inception to June 9, 2021. Thirteen studies were included in the final synthesis. The caregiver experiences they describe are synthesised into three primary themes: care needs, care burden and care gains, with numerous secondary themes. Besides our findings that seem to align with those from studies focused on other cultures, we have highlighted three main discoveries from the synthesis that stand out in the Chinese context: (1) many sub-themes related to specific caregiving skills; (2) a strong expectation for health professionals to improve their communication skills with family caregivers; (3) the negative and positive influences of filial piety in caregiving experiences. Our findings can help multidisciplinary healthcare teams in China support adult children as caregivers in their emphasis on improving caregiver education and training, ways of making the most of potential care gains, and ways of easing care burdens.
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Affiliation(s)
- Longtao He
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, China
- Department of Sociology, Nanjing University, Nanjing, China
| | - Han Wu
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, China
| | - Menghua Li
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, China
| | - Xiangshu Deng
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, China
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11
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Dang S, Looijmans A, Ferraris G, Lamura G, Hagedoorn M. Exploring the Needs of Spousal, Adult Child, and Adult Sibling Informal Caregivers: A Mixed-Method Systematic Review. Front Psychol 2022; 13:832974. [PMID: 35401295 PMCID: PMC8992373 DOI: 10.3389/fpsyg.2022.832974] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
Informal caregivers (ICGs) provide care to their family or friends in case of an illness, disability, or frailty. The caregiving situation of informal caregivers may vary based on the relationship they have with the care recipient (CR), e.g., being a spouse or being an adult child. It might be that these different ICGs also have different needs. This study aims to explore and compare the needs of different groups of ICGs based on the relationship they have with their CR. We conducted a systematic review, performing a search in the databases PubMed, CINAHL, and PsycINFO. We included studies with qualitative, quantitative, or mixed-method study designs. We analyzed the data using the thematic analysis method. We included 22 articles (18 qualitative; 4 quantitative). The included articles reported the needs of ICGs taking care of a spouse (spousal ICGs), parent (adult child ICG), or sibling aged 18 years or above (adult sibling ICGs). We did not include other relationships due to the limited number of articles on these relationships. The most prominent needs reported by the spousal, adult child, and adult sibling ICGs were the need for information and need for support. The three groups differed in their needs as well. Adult child and adult sibling ICGs indicated a need to be acknowledged by the people around them for their role of carer, while they also needed to be seen as an individual having their own personal needs. Moreover, spousal ICGs indicated a unique need of redefining their role and relationship with their CR. Overall, the findings indicate that along with experiencing common needs, the investigated groups have unique needs as well. Knowing the needs of different groups of ICGs can help develop tailored solutions to improve the quality of life of the ICGs and their CR. Systematic Review Registration: [www.crd.york.ac.uk/prospero/], identifier [CRD42020188560].
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Affiliation(s)
- Srishti Dang
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Anne Looijmans
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Giulia Ferraris
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Giovanni Lamura
- Centre for Socio-Economic Research on Ageing, INRCA IRCCS, National Institute of Health and Science on Ageing, Ancona, Italy
| | - Mariët Hagedoorn
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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12
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Patterns of help and care by adult only children and children with siblings. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22000198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Adult children with siblings can share caring for older parents but adult only children face this responsibility alone. Given increased longevity and reliance on informal care-giving, as well as an increase in one-child families, there is a need to investigate only children's care-giving further. Using data from three large-scale British birth cohorts, this paper investigates patterns of parent-care, care intensity and wellbeing at ages 38 and 42 (N = 17,255, N = 16,703; born 1970), 50 and 55 (N = 12,775, N = 11,339; born 1958) and 63 (N = 2,364; born 1946), how sibling composition intersects with gender in relation to care-giving and whether different care-giving patterns are associated with wellbeing. Only children are more likely to provide parent-care and the pattern is consistent with an interpretation that differences by sibling status might increase with age. Provision is gendered, and the sibling group composition matters for involvement. Although care-giving is related to wellbeing, we found no evidence that this differs between only children and those with siblings. The literature on only children has hitherto focused largely on childhood, suggesting that on some outcomes they benefit from a concentration of parental resources. Our results suggest that in middle adulthood parental care needs may instead be concentrated for the only child without the ‘resource’ of siblings. This indicates a need to develop further our understanding of this growing demographic subgroup.
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13
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Pham Q, El-Dassouki N, Lohani R, Jebanesan A, Young K. The Future of Virtual Care for Older Ethnic Adults Beyond the COVID-19 Pandemic. J Med Internet Res 2022; 24:e29876. [PMID: 34994707 PMCID: PMC8783290 DOI: 10.2196/29876] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 10/18/2021] [Accepted: 12/01/2021] [Indexed: 12/14/2022] Open
Abstract
The COVID-19 pandemic has fundamentally changed how Canadians access health care. Although it is undeniable that the rapid adoption of virtual care has played a critical role in reducing viral transmission, the gap in equitable access to virtual care remains pervasive for Canada’s aging and ethnocultural minority communities. Existing virtual care solutions are designed for the English-speaking, health-literate, and tech-savvy patient population, excluding older ethnic adults who often do not see themselves reflected in these identities. In acknowledging the permanency of virtual care brought on by the pandemic, we have a collective responsibility to co-design new models that serve our older ethnic patients who have been historically marginalized by the status quo. Building on existing foundations of caregiving within ethnocultural minority communities, one viable strategy to realize culturally equitable virtual care may be to engage the highly motivated and skilled family caregivers of older ethnic adults as partners in the technology-mediated management of their chronic disease. The time is now to build a model of shared virtual care that embraces Canada’s diverse cultures, while also providing its older ethnic adults with access to health innovations in partnership with equally invested family caregivers who have their health at heart.
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Affiliation(s)
- Quynh Pham
- Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Telfer School of Management, University of Ottawa, Ottawa, ON, Canada
| | - Noor El-Dassouki
- Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada
| | - Raima Lohani
- Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada
| | - Aravinth Jebanesan
- Global Health Office, Faculty of Health Science, McMaster University, Hamilton, ON, Canada
| | - Karen Young
- Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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van den Kieboom R, Snaphaan L, Mark R, Bongers I. The Trajectory of Caregiver Burden and Risk Factors in Dementia Progression: A Systematic Review. J Alzheimers Dis 2021; 77:1107-1115. [PMID: 32804093 PMCID: PMC7683084 DOI: 10.3233/jad-200647] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Caring for patients with dementia at home is often a long-term process, in which the independence of the patient declines, and more responsibility and supervision time is required from the informal caregiver. Objective: In order to minimize and reduce caregiver burden, it is important to explore its trajectory and the accompanying risk factors as dementia progresses; the objective of this systematic review. Methods: PRISMA guidelines were followed in this systematic review. Three databases, PubMed, PsycINFO, and EMbase, were systematically searched in November 2019 using specific keywords. Results: 1,506 hits emerged during the systematic search but only eleven articles actually met the inclusion criteria for this review. The trajectory of caregiver burden is highly variable and depends on multiple factors. Important risk factors included: patients’ behavioral and neuropsychiatric symptoms, and their decline in functioning in (I)ADL; the caregiver’s age, gender, and physical and mental health; and, within the dyads (patient/caregiver), cohabitation and kinship. Conclusion: There is no one-size-fits-all for predicting how caregiver burden will change over time, but specific factors (like being a spouse and increased behavioral impairment and decline in functional status in the patient) may heighten the risk. Other factors, not yet comprehensively included in the published studies, might also prove to be important risk factors. Future research in the field of reducing caregiver burden is recommended to integrate the patient, caregiver, and context characteristics in the trajectory of caregiver burden, and to assess more clearly the phase of the dementia progression and use of external resources.
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Affiliation(s)
- Robin van den Kieboom
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.,Research Unit Evidence Based Management of Innovation, Mental Health Care Institute Eindhoven, Eindhoven, Netherlands
| | - Liselore Snaphaan
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.,Research Unit Evidence Based Management of Innovation, Mental Health Care Institute Eindhoven, Eindhoven, Netherlands
| | - Ruth Mark
- Department of Cognitive Neuropsychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Inge Bongers
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.,Research Unit Evidence Based Management of Innovation, Mental Health Care Institute Eindhoven, Eindhoven, Netherlands
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15
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Views and experiences of adult children concerning intergenerational relationships with their older kin: a qualitative study from South India. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21000593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
The tradition of intergenerational care and support exchanges in Indian families is assumed to be disturbed because of changes in family structure brought on by modern life, which is mainly based on studies investigating experiences of older adults regarding the impact of socio-economic change on their care arrangement. However, there is a large gap in understanding the experiences of adult children from a larger relational perspective, more than just care provision to their older relatives. Drawing on 26 in-depth interviews with adult children living in modern and traditional living arrangements from South India, the study explores their experiences with their parents with regard to reciprocity of care and support, the challenges they experience and strategies they adopt to overcome those challenges. The analysis shows adult children perceive the increased demands of modern work life and their older kin's preferences to be heard, lack of flexibility and related extra domestic work and costs, do cause a bigger burden for them in both living arrangements. However, adult children strive to uphold the traditional values of caring for their older kin and sharing emotional bonding with them. This inspiration helps them to employ strategies to accept their older relatives as they are, focus their attention on the benefits they receive from them and distribute care tasks with other relatives to overcome the challenges.
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16
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Knobloch LK, Nichols LO, Martindale-Adams J. Applying Relational Turbulence Theory to Adult Caregiving Relationships. THE GERONTOLOGIST 2020; 60:598-606. [PMID: 31228192 DOI: 10.1093/geront/gnz090] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Indexed: 01/06/2023] Open
Abstract
Although the quality of the relationship between caregivers and care recipients predicts the well-being of both people, gaps exist in understanding the interpersonal dynamics of adult caregiving. We introduce relational turbulence theory as a conceptual framework for understanding how caregivers and care recipients relate to each other. We searched for research on relational turbulence theory as well as research on the relationships of adult care partners. Then, we integrated the two bodies of work. Our review suggests initial support for the theory's three central tenets: (a) transitions, including the transition to caregiving, are key periods within relationships; (b) relational uncertainty and interdependence are relationship parameters that complicate relating during transitions; and (c) relational turbulence predicts outcomes. Recommendations for practice include (a) helping care partners focus on relationship continuity, (b) gearing clinical services toward both people, (c) educating them about relational uncertainty and interdependence, and (d) teaching them communication strategies for diminishing relational turbulence. Making care partners aware of interpersonal challenges may bolster relationship satisfaction.
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Affiliation(s)
| | - Linda O Nichols
- Veterans Affairs Medical Center Memphis and Departments of Preventive Medicine and Internal Medicine, University of Tennessee Health Science Center, Memphis
| | - Jennifer Martindale-Adams
- Department of Preventive Medicine, University of Tennessee Health Science Center and Veterans Affairs Medical Center Memphis, Memphis
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17
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Wong ELY, Liao JM, Etherton-Beer C, Baldassar L, Cheung G, Dale CM, Flo E, Husebø BS, Lay-Yee R, Millard A, Peri KA, Thokala P, Wong CH, Chau PYK, Chan CY, Chung RYN, Yeoh EK. Scoping Review: Intergenerational Resource Transfer and Possible Enabling Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217868. [PMID: 33121044 PMCID: PMC7662476 DOI: 10.3390/ijerph17217868] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 12/14/2022]
Abstract
We explore the intergenerational pattern of resource transfer and possible associated factors. A scoping review was conducted of quantitative, peer-reviewed, English-language studies related to intergenerational transfer or interaction. We searched AgeLine, PsycINFO, Social Work Abstracts, and Sociological Abstracts for articles published between Jane 2008 and December 2018. Seventy-five studies from 25 countries met the inclusion criteria. The scoping review categorised resource transfers into three types: financial, instrumental, and emotional support. Using an intergenerational solidarity framework, factors associated with intergenerational transfer were placed in four categories: (1) demographic factors (e.g., age, gender, marital status, education, and ethno-cultural background); (2) needs and opportunities factors, including health, financial resources, and employment status; (3) family structures, namely, family composition, family relationship, and earlier family events; and (4) cultural-contextual structures, including state policies and social norms. Those factors were connected to the direction of resource transfer between generations. Downward transfers from senior to junior generations occur more frequently than upward transfers in many developed countries. Women dominate instrumental transfers, perhaps influenced by traditional gender roles. Overall, the pattern of resource transfer between generations is shown, and the impact of social norms and social policy on intergenerational transfers is highlighted. Policymakers should recognise the complicated interplay of each factor with different cultural contexts. The findings could inform policies that strengthen intergenerational solidarity and support.
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Affiliation(s)
- Eliza Lai-Yi Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.M.L.); (P.Y.-K.C.); (C.Y.C.); (R.Y.-N.C.); (E.-K.Y.)
- Correspondence:
| | - Jennifer Mengwei Liao
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.M.L.); (P.Y.-K.C.); (C.Y.C.); (R.Y.-N.C.); (E.-K.Y.)
| | - Christopher Etherton-Beer
- Internal Medicine, Faculty of Health and Medical Sciences, The University of Western, Perth, WA 6009, Australia;
| | - Loretta Baldassar
- School of Social Sciences, Faculty of Arts, Business, Law and Education, The University of Western, Perth, WA 6009, Australia; (L.B.); (A.M.)
| | - Gary Cheung
- School of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1010, New Zealand;
| | - Claire Margaret Dale
- Retirement Policy and Research Centre, Faculty of Business and Economics, The University of Auckland, Auckland 1010, New Zealand;
| | - Elisabeth Flo
- Department of Clinical Psychology, Faculty of Psychology, The University of Bergen, 5020 Bergen, Norway;
| | - Bettina Sandgathe Husebø
- Department of Global Public Health and Primary Care, The University of Bergen, 5020 Bergen, Norway;
| | - Roy Lay-Yee
- Centre for Methods & Policy Application in the Social Sciences, Faculty of Arts, The University of Auckland, Auckland 1010, New Zealand;
| | - Adele Millard
- School of Social Sciences, Faculty of Arts, Business, Law and Education, The University of Western, Perth, WA 6009, Australia; (L.B.); (A.M.)
| | - Kathy Ann Peri
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1010, New Zealand;
| | - Praveen Thokala
- Health Economics and Decision Science, The University of Sheffield, Sheffield S10 2TN, UK;
| | - Chek-hooi Wong
- Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore;
| | - Patsy Yuen-Kwan Chau
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.M.L.); (P.Y.-K.C.); (C.Y.C.); (R.Y.-N.C.); (E.-K.Y.)
| | - Crystal Ying Chan
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.M.L.); (P.Y.-K.C.); (C.Y.C.); (R.Y.-N.C.); (E.-K.Y.)
| | - Roger Yat-Nork Chung
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.M.L.); (P.Y.-K.C.); (C.Y.C.); (R.Y.-N.C.); (E.-K.Y.)
| | - Eng-Kiong Yeoh
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.M.L.); (P.Y.-K.C.); (C.Y.C.); (R.Y.-N.C.); (E.-K.Y.)
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18
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"Home wasn't really home anymore": Understanding caregivers' perspectives of the impact of blood cancer caregiving on the family system. Support Care Cancer 2020; 29:3069-3076. [PMID: 33051829 DOI: 10.1007/s00520-020-05811-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/02/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Research on the impact of family cancer caregiving is primarily dyadic in focus. How caregiving affects the larger family system is less understood, yet knowing this is vital to developing supportive resources for caregivers, patients, and their families. To better understand how blood cancer caregiving impacts the family system, we explored the experiences of adult child caregivers of diagnosed parents and parent caregivers of diagnosed children. METHODS We conducted semi-structured interviews with 39 midlife parent and adult child caregivers of patients with leukemia or lymphoma. Using a family systems theory lens, we conducted a thematic analysis using the constant comparative method to identify how caregiving impacts the larger family system. RESULTS Caregivers ranged from age 30 to 64 (M = 43). They described four ways that caregiving impacted themselves and the larger family system: (1) disruption of home life, (2) emotional (dis)connection, (3) juggling competing roles, and (4) developing resiliency and intimacy. Perspectives within each category differed based on their relational role to the patient or in the broader family. CONCLUSIONS Themes identify ways to provide support to both caregiver types. Support care resources could help families navigate gains and losses impacting the family system after a blood cancer diagnosis. Both caregiver types described experiencing (and/or their family experiencing) a loss in relational connection, feeling alone, and members distancing themselves. Both caregiver types also described gains in family functioning, like strengthened bonds and togetherness. Findings validate the need for family-centered support with key areas to address for healthy family functioning.
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19
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Kong J, Martire LM, Tate AM, Bray BC, Almeida DM. Different Types of Childhood Experience with Mothers and Caregiving Outcomes in Adulthood. FAMILY RELATIONS 2020; 70:1090-1101. [PMID: 34650318 PMCID: PMC8514082 DOI: 10.1111/fare.12511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE AND BACKGROUND The current study examines the types of childhood experiences with mothers (i.e., maternal abuse, affection, discipline) among caregivers of aging mothers, and investigates whether membership in specific latent classes, particularly maternal maltreatment, is associated with psychological functioning among caregivers. METHOD Using data from the Midlife in the United States (MIDUS), we used the Bolck, Croon, and Hagenaars (BCH) approach of latent class analysis (LCA) to predict distal outcomes. RESULTS We identified four latent classes (prevalence rate noted): "Affectionate and authoritative" (65%), "affectionate and permissive" (11%), "emotionally abusive and neglectful" (8%), and "emotionally/physically abusive and authoritative" (16%). Caregivers in the "emotionally/physically abusive and authoritative" class endorsed high probabilities of both maternal affection and abuse and were most negatively affected across the three psychological functioning outcomes (i.e., self-rated mental health, psychological distress, and psychological well-being). CONCLUSION AND IMPLICATIONS In support of the life course perspective, our findings emphasized the importance of examining adult children caregivers' early life experiences with aging mothers and how those experiences can impact the psychological effects of caregiving. This study suggests specific practice implications; for example, assessment tools for evaluating caregiver burden should consider life course factors such as caregivers' childhood experiences with aging parents.
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Affiliation(s)
- Jooyoung Kong
- School of Social Work, University of Wisconsin-Madison, 1350 University Avenue, Madison, WI 53706
| | - Lynn M Martire
- Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802
| | - Ashley M Tate
- Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802
| | - Bethany C Bray
- Center for Dissemination and Implementation Science, University of Illinois at Chicago, Chicago, IL 60607
| | - David M Almeida
- Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802
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20
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Milberg A, Liljeroos M, Wåhlberg R, Krevers B. Sense of support within the family: a cross-sectional study of family members in palliative home care. BMC Palliat Care 2020; 19:120. [PMID: 32767973 PMCID: PMC7414563 DOI: 10.1186/s12904-020-00623-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/27/2020] [Indexed: 12/20/2022] Open
Abstract
Background Despite evidence that family members’ support to each other can be of importance to its members, there are limited studies of factors related to family members’ sense of such support during palliative care. Aim Based on the family systems approach, we evaluated which factors were associated with family members’ sense of support within their closest family in a palliative home care context and developed a model that predicts such sense of support. Design A cross-sectional design was used. We interviewed 209 adult family members (69% of eligible) of adult patients with expected short survival receiving palliative home care. Methods Generalised linear models were used to evaluate individual factors related to family members’ sense of support within their closest family during palliative care. The Akaike Information Criterion (AIC) was applied in the model-building analyses. Results Nineteen variables were identified that were significantly associated with the family members’ sense of support within the closest family. Model building selected six variables for predicting this sense of support (decreasing Wald values): family member perceiving support from other more distant family members; feeling secure with the provided palliative home care; possibility of respite if family member needed a break; family member living alone; being a child of the patient (inverse relationship); perceiving that the patient was supported by other family members. Conclusions Our findings support clinical application of the Family Systems Theory in the context of palliative care. The factors identified may be of value in assisting practitioners in detecting and treating family members sensing a low level of support within the closest family.
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Affiliation(s)
- Anna Milberg
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Advanced Home Care, Linköping University, Norrköping, Sweden
| | - Maria Liljeroos
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden. .,Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden. .,Medical department, Mälarsjukhuset hospital, 631 88, Eskilstuna, Sweden.
| | - Rakel Wåhlberg
- Department of Advanced Home Care, Linköping University, Norrköping, Sweden
| | - Barbro Krevers
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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21
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Andersen HE, Hoeck B, Nielsen DS, Ryg J, Delmar C. A phenomenological-hermeneutic study exploring caring responsibility for a chronically ill, older parent with frailty. Nurs Open 2020; 7:951-960. [PMID: 32587713 PMCID: PMC7308672 DOI: 10.1002/nop2.467] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/17/2019] [Accepted: 02/16/2020] [Indexed: 11/07/2022] Open
Abstract
Aim To provide lifeworld insights into experiences of adult children with caring responsibility for an 80+-year-old chronically ill parent with frailty. Background Informal care is common in Nordic welfare countries; however, little is known about adult children's experience of caring responsibility in this setting. Design A phenomenological-hermeneutic study based on Reflective Lifeworld Research. Methods Diaries and semi-structured interviews with 12 adult children. Results Caring responsibility is identified as "a condition of life, filled with uncertainty." Three constituents contribute to this phenomenon: (a) balancing love, duty and reciprocity; (b) being the parent's advocate and manager; and (c) experiencing concerns and bodily strain. Conclusion Adult children work hard to provide care and enhance the well-being of their parent. Heidegger's concept 'Fürsorge' may help us understand how by showing how caring responsibility means balancing different roles vis-à-vis the parent, one's own life and the health and social systems. Caring responsibility changes the relationship between parent and child.
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Affiliation(s)
- Helle Elisabeth Andersen
- Department of Public Health NursingAarhus UniversityAarhusDenmark
- Health Sciences Research CentreUCLOdenseDenmark
| | - Bente Hoeck
- Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
| | - Dorthe Susanne Nielsen
- Health Sciences Research CentreUCLOdenseDenmark
- Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
- Migrant Health ClinicOdense University HospitalOdenseDenmark
| | - Jesper Ryg
- Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
- Department of Geriatric MedicineOdense University HospitalOdenseDenmark
| | - Charlotte Delmar
- Department of Public Health NursingAarhus UniversityAarhusDenmark
- Institut for Helse‐ og omsorgsfagNorway's Artic UniversityTromsøNorway
- VIDHelsefagBergenOsloNorway
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22
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Amer Nordin A, Mohd Hairi F, Choo WY, Hairi NN. Care Recipient Multimorbidity and Health Impacts on Informal Caregivers: A Systematic Review. THE GERONTOLOGIST 2020; 59:e611-e628. [PMID: 29982539 DOI: 10.1093/geront/gny072] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Caregiving outcomes have often been reported in terms of care recipients of single disease, rather than multiple health conditions. A systematic review was conducted to outline caregiving health outcomes and its association with care recipient multimorbidity for informal caregivers of older adults. RESEARCH DESIGN AND METHODS A search strategy was applied in six databases and grey literature. Inclusion criteria were primary observational studies on informal caregiving for care recipients aged 60 years and above, in the English language. Informal caregivers were those not formally hired and multimorbidity referred to presence of at least two health conditions. From a total of 2,101 titles, 230 abstracts were screened, and 19 articles were included. Quality assessment was conducted with application of the Newcastle-Ottawa-Scale. RESULTS Health-related and caregiving-related outcomes have been assessed for informal caregivers of older adults with multimorbidity. Caregiver subjective burden was most commonly evaluated and often reported to be low to moderate. In association with care recipient multimorbidity, caregiver burden, quality of life, and perceived difficulty in assisting the older adults were examined in 14 of the studies with mixed results. Studies were heterogeneous, with nonuniform definitions of informal caregivers and multimorbidity as well as measurement tools. DISCUSSION AND IMPLICATIONS This narrative review found that caring for older adults with multimorbidity impacts caregivers, although overall evidence is not conclusive. Despite caregiving-related outcomes being most commonly assessed among the caregivers, particularly subjective burden, findings suggest that it is worthwhile to examine other outcomes to enrich the evidence base.
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Affiliation(s)
- Awatef Amer Nordin
- Department of Social and Preventive Medicine, Faculty of Medicine and Julius Centre University of Malaya (JCUM), University of Malaya, Kuala Lumpur, Malaysia
| | - Farizah Mohd Hairi
- Department of Social and Preventive Medicine, Faculty of Medicine and Julius Centre University of Malaya (JCUM), University of Malaya, Kuala Lumpur, Malaysia.,Julius Centre University of Malaya (JCUM), University of Malaya, Kuala Lumpur, Malaysia
| | - Wan Yuen Choo
- Department of Social and Preventive Medicine, Faculty of Medicine and Julius Centre University of Malaya (JCUM), University of Malaya, Kuala Lumpur, Malaysia.,Julius Centre University of Malaya (JCUM), University of Malaya, Kuala Lumpur, Malaysia
| | - Noran N Hairi
- Department of Social and Preventive Medicine, Faculty of Medicine and Julius Centre University of Malaya (JCUM), University of Malaya, Kuala Lumpur, Malaysia.,Julius Centre University of Malaya (JCUM), University of Malaya, Kuala Lumpur, Malaysia
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23
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Gérain P, Zech E. Informal Caregiver Burnout? Development of a Theoretical Framework to Understand the Impact of Caregiving. Front Psychol 2019; 10:1748. [PMID: 31428015 PMCID: PMC6689954 DOI: 10.3389/fpsyg.2019.01748] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/15/2019] [Indexed: 01/26/2023] Open
Abstract
Informal caregiving is a rewarding but demanding role. The present theoretical framework proposes to adapt the tridimensional concept of burnout to informal caregiving as a way to address the potential consequences of caregiving. This adaptation reflects caregivers' reported difficulties, as well as empirical findings on emotional exhaustion, depersonalization, and personal accomplishment as caregiving outcomes. But to understand burnout in informal caregiving contexts, it is also necessary to find ways to model it. The Informal Caregiving Integrative Model (ICIM) is thus proposed. This model is based on the integration of elements from literature on both informal caregiving stress and professional burnout. The goal of the ICIM is to emphasize the importance of every category of determinants of informal caregiver burnout (i.e., relating to the caregiver, the caregiving setting, and the sociocultural context), with a key mediating role for the caregivers' appraisal of their situation and their relationship with the care-recipient. This article is a first integrative step in the consideration of a form of burnout specific to informal caregivers and supports the design of empirical and interventional studies based on the theoretical foundation that the ICIM proposes.
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Affiliation(s)
- Pierre Gérain
- National Fund for Scientific Research, Brussels, Belgium.,Person Centred Research and Training Lab, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Emmanuelle Zech
- Person Centred Research and Training Lab, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
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24
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Stans S, Dalemans R, de Witte L, Beurskens A. Using Talking Mats to support conversations with communication vulnerable people: A scoping review. ACTA ACUST UNITED AC 2019. [DOI: 10.3233/tad-180219] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- S.E.A. Stans
- Zuyd University of Applied Sciences, Faculty of Health, Heerlen, The Netherlands
| | - R.J.P. Dalemans
- Zuyd University of Applied Sciences, Faculty of Health, Heerlen, The Netherlands
| | - L.P. de Witte
- Centre for Assistive Technology and Connected Healthcare, University of Sheffield, Sheffield, UK
| | - A.J.H.M. Beurskens
- Zuyd University of Applied Sciences, Faculty of Health, Heerlen, The Netherlands
- Maastricht University, Research School CAPHRI, Maastricht, The Netherlands
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25
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Kohl NM, Mossakowski KN, Sanidad II, Bird OT, Nitz LH. Does the Health of Adult Child Caregivers Vary by Employment Status in the United States? J Aging Health 2018; 31:1631-1651. [DOI: 10.1177/0898264318782561] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: This study investigates whether the health effects of informal caregiving for aging parents vary by employment status in the United States. Two opposing hypotheses are tested: dual role strain and role enhancement. Method: Using national longitudinal data from the U.S. Health and Retirement Study, multivariate regression models predicted self-rated health and mental health among older adult children caregiving for their parents (2009-2012) and noncaregivers. Results: A statistically significant interaction was found between caregiving duration and employment, indicating that employed caregivers had significantly worse health than retired caregivers. Caregiving duration also predicted significantly higher levels of depressive symptoms. Discussion: Our results support the dual role strain hypothesis and suggest that caregiving for a parent up to 4 years is enough to predict significantly worse health among older adult Baby Boomers, especially those in the labor force. The broader implications for public health and workplace policies are discussed.
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26
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Wittenberg Y, Kwekkeboom R, Staaks J, Verhoeff A, de Boer A. Informal caregivers' views on the division of responsibilities between themselves and professionals: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:e460-e473. [PMID: 29250848 DOI: 10.1111/hsc.12529] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/17/2017] [Indexed: 06/07/2023]
Abstract
This scoping review focuses on the views of informal caregivers regarding the division of care responsibilities between citizens, governments and professionals and the question of to what extent professionals take these views into account during collaboration with them. In Europe, the normative discourse on informal care has changed. Retreating governments and decreasing residential care increase the need to enhance the collaboration between informal caregivers and professionals. Professionals are assumed to adequately address the needs and wishes of informal caregivers, but little is known about informal caregivers' views on the division of care responsibilities. We performed a scoping review and searched for relevant studies published between 2000 and September 1, 2016 in seven databases. Thirteen papers were included, all published in Western countries. Most included papers described research with a qualitative research design. Based on the opinion of informal caregivers, we conclude that professionals do not seem to explicitly take into account the views of informal caregivers about the division of responsibilities during their collaboration with them. Roles of the informal caregivers and professionals are not always discussed and the division of responsibilities sometimes seems unclear. Acknowledging the role and expertise of informal caregivers seems to facilitate good collaboration, as well as attitudes such as professionals being open and honest, proactive and compassionate. Inflexible structures and services hinder good collaboration. Asking informal caregivers what their opinion is about the division of responsibilities could improve clarity about the care that is given by both informal caregivers and professionals and could improve their collaboration. Educational programs in social work, health and allied health professions should put more emphasis on this specific characteristic of collaboration.
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Affiliation(s)
- Yvette Wittenberg
- Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
- Faculty of Applied Social Sciences and Law, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Rick Kwekkeboom
- Faculty of Applied Social Sciences and Law, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Janneke Staaks
- University Library, University of Amsterdam, Amsterdam, The Netherlands
| | - Arnoud Verhoeff
- Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
- Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - Alice de Boer
- Faculty of Social Sciences, VU Amsterdam and The Netherlands Institute for Social Research, Amsterdam, The Netherlands
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Wells M, Kartoz C. Ask the Right Questions: What Do Non-Caregiving Adult Children Need From Health Care Providers? J Gerontol Nurs 2018; 44:26-31. [PMID: 29437183 DOI: 10.3928/00989134-20180209-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 01/02/2018] [Indexed: 11/20/2022]
Abstract
Extended healthy life spans are a relatively recent phenomenon that increase the amount of time families spend with older adults in non-caregiving roles. As the emphasis of health care moves to population health and health prevention, nurses caring for older adults must be knowledgeable about this family life stage. To learn more about the lived experience of non-caregiving adult children, 16 non-caregiving adult children were interviewed. The purpose of the current article is to share what needs non-caregiving adult children have from the health care system as they obtain care for themselves and accompany their parent for health care visits. Content analysis of transcribed interviews revealed three main themes: Lack of Holistic Care, Lack of Effective Communication, and Fragmented Care and Need for Better Care Management. Participants suggested interventions that are patient- and family-centered and culturally safe. Nurses can use findings from the current study to research interventions using family-centered care strategies to improve health outcomes for older adults. [Journal of Gerontological Nursing, 44(5), 26-31.].
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Viñas-Diez V, Turró-Garriga O, Portellano-Ortiz C, Gascón-Bayarri J, Reñé-Ramírez R, Garre-Olmo J, Conde-Sala JL. Kinship and cohabitation in relation to caregiver burden in the context of Alzheimer's disease: a 24-month longitudinal study. Int J Geriatr Psychiatry 2017; 32:e72-e82. [PMID: 28111798 DOI: 10.1002/gps.4656] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/05/2016] [Accepted: 12/06/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The aims of the study were to identify the clinical characteristics of three groups of caregivers: spouses, live-in adult-child or non-live-in adult-child, and their relation to the degree of perceived burden (Caregiver Burden Interview). METHODS The sample comprised 275 Alzheimer's disease primary caregivers, with a follow-up of 24 months. Cognitive, functional and behavioural characteristics were evaluated in persons with dementia, whilst sociodemographic data, use of socio-medical resources, physical and mental health and self-perceived burden were assessed in caregivers. Generalized estimating equations were used for longitudinal data analysis. RESULTS Spouse caregivers were 45.0% men, sole caregivers (>80%), used few external resources and had worse physical health. The number of female adult-child caregivers was higher (>75%). The live-in adult-child group, compared with the non-live-in adult-child group, was less likely to be married, had a lower level of education, was more commonly the sole caregiver and used fewer external resources. The greatest burden was observed in live-in adult-child caregivers, and the lowest in the non-live-in adult-child group, with no significant variation in the follow-up for both groups. Spouses had an intermediate level of perceived burden, which rose significantly during follow-up (p < 0.001). CONCLUSIONS Kinship and cohabitation with the persons with dementia were associated with different scores and evolution of the burden, with an increase in the follow-up of the spouses, and with more or less burden, depending on cohabitation, in the adult-child groups. Interventions to reduce the level of burden on caregivers should consider these differences. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Vanesa Viñas-Diez
- Dementia Unit, Department of Neurology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Catalonia, Spain
| | - Oriol Turró-Garriga
- Health, Aging and Disability Research Group, Girona Biomedical Research Institute (IDIBGI), Girona, Catalonia, Spain.,Department of Neurology, Institut d'Assistència Sanitària-Institut Català de Salut de Girona, Salt, Catalonia, Spain
| | | | - Jordi Gascón-Bayarri
- Dementia Unit, Department of Neurology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Catalonia, Spain
| | - Ramón Reñé-Ramírez
- Dementia Unit, Department of Neurology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Catalonia, Spain
| | - Josep Garre-Olmo
- Health, Aging and Disability Research Group, Girona Biomedical Research Institute (IDIBGI), Girona, Catalonia, Spain.,Department of Medical Sciences, University of Girona, Girona, Catalonia, Spain
| | - Josep Lluís Conde-Sala
- Health, Aging and Disability Research Group, Girona Biomedical Research Institute (IDIBGI), Girona, Catalonia, Spain.,Faculty of Psychology, University of Barcelona, Barcelona, Catalonia, Spain
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29
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Whitmore R, Crooks VA, Snyder J. A qualitative exploration of how Canadian informal caregivers in medical tourism use experiential resources to cope with providing transnational care. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:266-274. [PMID: 26503715 DOI: 10.1111/hsc.12302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/20/2015] [Indexed: 06/05/2023]
Abstract
Canadians travelling abroad for privately arranged surgeries paid for out-of-pocket are engaging in what has come to be known as medical tourism. They are often accompanied by friends or family members, who we call caregiver-companions. Caregiver-companions provide care in and across a variety of formal and informal settings, such as in hotels, airplanes and at home. This qualitative study examines the experiences of informal caregivers in medical tourism to learn more about the lived experiences or 'experiential resources' they draw upon to cope with providing care and avoiding caregiver burden. The care-giving literature has demonstrated that such burden can negatively impact caregivers' well-being. The unique, transnational context of care-giving in medical tourism and recent growth in popularity of this practice means that there are few supports or resources currently in place to assist informal caregivers. In this article, we report on an analysis that sought to detail how caregiver-companions draw upon their previous lived experiences to cope with providing transnational care and to minimise or avoid the onset of caregiver burden. We conducted semi-structured telephone interviews with 20 Canadians who had accompanied their friends or family members abroad for surgery between September 2013 and January 2014. Thematic analysis revealed the ways that participants had developed practical strategies to deal with the challenges they faced in medical tourism. The interviews revealed three important experiential resources drawn upon by participants: (i) previous experiences of international travel; (ii) previous experiences of informal care-giving; and (iii) dimensions of the existing relationship with the care recipient. Differences in access to and use of these experiential resources related to participants' perspectives on medical tourism and the outcomes of the trip. By identifying the experiential resources drawn upon by informal caregivers in medical tourism, we can more effectively identify supportive interventions.
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Affiliation(s)
- Rebecca Whitmore
- Department of Geography, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Valorie A Crooks
- Department of Geography, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Jeremy Snyder
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
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30
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Hwang AS, Rosenberg L, Kontos P, Cameron JI, Mihailidis A, Nygård L. Sustaining care for a parent with dementia: an indefinite and intertwined process. Int J Qual Stud Health Well-being 2017; 12:1389578. [PMID: 29050539 PMCID: PMC5654011 DOI: 10.1080/17482631.2017.1389578] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/05/2017] [Indexed: 11/12/2022] Open
Abstract
This study aimed to understand how adult children sustain caring for persons with dementia (PwDs) within their family and formal care contexts in Canada. Half-day focus groups were conducted with adult daughters and adult sons in Toronto, Canada. Using constructivist grounded theory, we examined both substantive concepts and group dynamics. Sustaining care was interpreted as an indefinite process with three intertwined themes: reproducing care demands and dependency, enacting and affirming values, and "flying blind" in how and how long to sustain caring (i.e., responding to immediate needs with limited foresight). Family values and relationships, mistrust toward the institutional and home care systems, and obscured care foresight influenced care decisions and challenged participants in balancing their parents' needs with their own. Positive and negative aspects of care were found to influence one another. The implications of these findings for research and policy are discussed.
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Affiliation(s)
- Amy S. Hwang
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Lena Rosenberg
- Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
| | - Pia Kontos
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Jill I. Cameron
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Alex Mihailidis
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Louise Nygård
- Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
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Oldenkamp M, Hagedoorn M, Slaets J, Stolk R, Wittek R, Smidt N. Subjective burden among spousal and adult-child informal caregivers of older adults: results from a longitudinal cohort study. BMC Geriatr 2016; 16:208. [PMID: 27923347 PMCID: PMC5142272 DOI: 10.1186/s12877-016-0387-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 12/01/2016] [Indexed: 11/12/2022] Open
Abstract
Background Pressures on informal caregivers are likely to increase due to increasing life expectancy and health care costs, which stresses the importance of prevention of subjective burden. The present study examined the correlates of overall subjective burden and multiple burden dimensions among spousal and adult-child caregivers of Dutch older adults, both cross-sectional and longitudinal (12-months follow-up). Methods In 2010 and 2011 baseline and follow-up data was collected in a sample of informal caregivers and care recipients in the Northern provinces of the Netherlands. Subjective burden included 7 burden dimensions and a summary score for overall subjective burden, based on the Care-Related Quality of Life Instrument (CarerQoL-7D). Objective stressors were the time investment in caregiving (hours of household care, personal care, practical care) and the health situation of the care recipient, including multimorbidity, functional limitations (Katz Index of Independence Basic Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL), and cognitive functioning problems (EQ-5D + C). Correlates of subjective burden were evaluated with linear and logistic regression analyses. Results The sample consisted of 356 caregivers at baseline (43% spousal, 57% adult-child caregivers), and 158 caregivers at follow-up (45% spousal, 55% adult-child caregivers). At baseline and follow-up, spousal caregivers experienced a higher overall subjective burden, and reported more often mental health problems, physical health problems, and problems with combining daily activities, compared to adult-child caregivers. For spousal caregivers, a poorer health situation of the care recipient was associated with higher subjective burden, while adult-child caregivers reported higher levels of subjective burden when their time investment in caregiving was high. Subjective burden at follow-up was mainly explained by baseline subjective burden. Conclusions These results indicate that for effective caregiver support, it is crucial to take the type of care relationship into account, since the level and correlates of overall subjective burden and burden dimensions varied for spousal and adult-child caregivers. In addition, reducing subjective burden will also positively impact the subjective burden over time. Electronic supplementary material The online version of this article (doi:10.1186/s12877-016-0387-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marloes Oldenkamp
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
| | - Mariët Hagedoorn
- Department of Health Sciences, Health Psychology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Joris Slaets
- Department of Geriatrics, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.,Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333 AA, Leiden, The Netherlands
| | - Ronald Stolk
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Rafael Wittek
- Department of Sociology, University of Groningen, Grote Rozenstraat 31, 9712 TG, Groningen, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.,Department of Geriatrics, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
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Naef R, Hediger H, Imhof L, Mahrer-Imhof R. Variances in family carers' quality of life based on selected relationship and caregiving indicators: A quantitative secondary analysis. Int J Older People Nurs 2016; 12. [PMID: 27863032 DOI: 10.1111/opn.12138] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 09/19/2016] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To determine subgroups of family carers based on family relational and caregiving variables and to explore group differences in relation to selected carer outcomes. BACKGROUND Family caregiving in later life holds a myriad of positive and negative outcomes for family members' well-being. However, factors that constitute family carers' experience and explain variances are less well understood. DESIGN A secondary data analysis using cross-sectional data from a controlled randomised trial with community-dwelling people 80 years or older and their families. METHODS A total of 277 paired data sets of older persons and their family carers were included into the analysis. Data were collected via mailed questionnaires and a geriatric nursing assessment. A two-step cluster analysis was performed to determine subgroups. To discern group differences, appropriate tests for differences with Bonferroni correction were used. RESULTS Two family carer groups were identified. The low-intensity caregiver group (57% of carers) reported high relationship quality and self-perceived ease of caregiving. In contrast, the high-intensity caregiver group (43% of carers) experienced significantly lower relationship quality, felt less prepared and appraised caregiving as more difficult, time intensive and burdensome. The latter cared for older, frailer and more dependent octogenarians and had significantly lower levels of quality of life and self-perceived health compared to the low-intensity caregiver group. CONCLUSIONS A combination of family relational and caregiving variables differentiates those at risk for adverse outcomes. Family carers of frailer older people tend to experience higher strain, lower relationship quality and ability to work together as a family. IMPLICATIONS FOR PRACTICE Nurses should explicitly assess family carer needs, in particular when older persons are frail. Family carer support interventions should address caregiving preparedness, demand and burden, as well as concerns situated in the relationship.
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Affiliation(s)
- Rahel Naef
- Institute of Nursing, Zurich University of Applied Sciences, Winterthur, Zurich, Switzerland.,Centre for Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Hannele Hediger
- Institute of Nursing, Zurich University of Applied Sciences, Winterthur, Zurich, Switzerland
| | - Lorenz Imhof
- Institute of Nursing, Zurich University of Applied Sciences, Winterthur, Zurich, Switzerland
| | - Romy Mahrer-Imhof
- Institute of Nursing, Zurich University of Applied Sciences, Winterthur, Zurich, Switzerland
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