1
|
Day CB, Bierhals CCBK, Pizzol FLFD, Low G, Santos NOD, Paskulin LMG. A longitudinal study of burden among spouse and non-spouse caregivers of older adults with stroke-induced-dependency. Rev Bras Enferm 2023; 76:e20230052. [PMID: 38055489 DOI: 10.1590/0034-7167-2023-0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/21/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE to assess the burden of spouse and non-spouse caregivers of older adults with stroke-induced-dependency after discharge from a university hospital's Specialized Care Stroke Unit in southern Brazil. METHODS a longitudinal survey. The sample consisted of 48 consenting caregivers, among which 20 were spouse caregivers. Data were collected between May 2016 and July 2018. One week after discharge, caregivers completed a sociodemographic profile, the Functional Independence Measure, and the Caregiver Burden Scale. Burden was also measured two months after discharge. Data were analyzed using Multivariate Analyses of Variance. RESULTS regarding time 1, non-spouse caregivers experienced greater burden with respect to social isolation (p = .01). Along with a persistently greater sense of isolation (p=.04), non-spouse caregivers felt far greater general strain (p =.01). CONCLUSION statistically significant differences in burden over time highlight the importance of assessing caregiver burden after discharge and the need for a formal support program.
Collapse
Affiliation(s)
- Carolina Baltar Day
- Pontifícia Universidade Católica do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | - Gail Low
- University of Alberta. Edmonton, Alberta, Canada
| | | | | |
Collapse
|
2
|
Wang F, Irani E, Tian MC, Yi Lau MM. The Mediating Effect of Caregiving Relationship Quality on the Association Between Caregiving Stressors and Mental Health Problems Among Older Spousal Caregivers. Int J Aging Hum Dev 2023; 97:435-455. [PMID: 36518012 DOI: 10.1177/00914150221143959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Providing care to a spouse can be especially challenging for older adults given their compounding stressors resulting from aging and caregiving. This cross-sectional study examines the relationships between caregiving stressors and caregiver mental health problems and the potential mediator (i.e., caregiving relationship quality) of these associations. A total of 431 Americans (≥65 years) were selected from the National Study of Caregiving. Path analysis shows that care assistance was positively associated with caregiver mental health problems, and this association was mediated by negative relationship quality (Indirect effect = .14, p = .016). Moreover, role overload was positively associated with caregiver mental health problems, which was mediated by negative relationship quality (indirect effect = .13, p = .002). Findings suggest that caregiving stressors can adversely affect mental health by exacerbating negative relationship quality. Interventions that limit negative exchanges and increase compassionate communications between older spousal caregivers and their care-receiving partners are needed.
Collapse
Affiliation(s)
- Fei Wang
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Elliane Irani
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | | | - Mandy Man Yi Lau
- Department of Social Work, Chinese University of Hong Kong, Hong Kong, SAR, China
| |
Collapse
|
3
|
Irani E, Wang F, Meyer K, Moore SE, Ding K. Social Activity Restriction and Psychological Health Among Caregivers of Older Adults With and Without Dementia. J Aging Health 2023:8982643231209089. [PMID: 37937398 DOI: 10.1177/08982643231209089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
OBJECTIVES We examined associations between social activity restriction and psychological distress and well-being for caregivers of older adults with and without dementia, and if the identified associations are different for the two groups. METHODS Using data from the 2017 National Study of Caregiving, we identified caregivers of older adults with (N = 541) and without (N = 1701) dementia. Linear regression models were estimated, adjusting for caregivers' age, gender, race, education, relationship to care recipient, and self-rated health. RESULTS Restriction in visiting friends and family and attending religious services were associated with higher distress in dementia caregivers. Restriction in visiting friends and family was associated with higher distress and lower well-being in non-dementia caregivers. Any activity restriction had stronger association with distress for caregivers of older adults with versus without dementia. DISCUSSION Findings highlight the need for tailored interventions based on caregivers' perceptions of meaningful social activities and dementia-friendly communities to promote social participation.
Collapse
Affiliation(s)
- Elliane Irani
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Fei Wang
- College of Social Work, University of Tennessee, Knoxville, TN, USA
| | - Kylie Meyer
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Scott Emory Moore
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Kedong Ding
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
4
|
Chow EOW, Fung SF, Singh H. Actor-partner effects of wellbeing, hope and self-esteem on depression in stroke survivor-caregiver dyads: A randomized controlled trial. Clin Rehabil 2023; 37:394-406. [PMID: 36453001 PMCID: PMC9912309 DOI: 10.1177/02692155221128758] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Stroke is a disabling, long-term condition that challenges the mental and physical health of stroke-survivors concurrently with their primary family-caregivers (dyad). However, there has been a lack of emphasis on this dyadic need. Thus, this study aims to investigate the impacts of two interventions on hope, self-esteem and hedonic wellbeing on depression among the stroke-survivor-caregiver dyad. METHODS This randomized-controlled-trial applied the actor-partner interdependence model to 100 randomly-selected dyads (N = 200) of stroke-survivors, mean (SD) age was 73.63(7.22) and family-caregivers, mean (SD) age was 62.49(14.44) years, recruited from Hong Kong hospitals and rehabilitation centres. The intervention was eight-weekly two-hour narrative therapy group sessions (n = 54 dyads), compared with the current model of psychoeducational group to each dyad as needed. Outcomes were collected via questionnaires and interviews, at four time-points: baseline (T1), during-intervention (T2) (1-month), immediately post-intervention (T3) (2-months) and follow-up (T4) (6-months). RESULTS The results demonstrated that there are actor effects on stroke-survivors (β = -0.353, p < 0.05) and caregivers (β = -0.383, p < 0.05), where higher levels of hedonic wellbeing were associated with fewer depressive symptoms. Partner effects were observed as caregivers' depressive symptoms were possessing a significant negative relationship with stroke survivors' wellbeing (β = -0.387, p < 0.05). Those stroke survivors in the intervention group had a significantly higher level of self-esteem associated with lower levels of depression (β = -0.314, p < 0.05). CONCLUSIONS Improving hope, self-esteem and wellbeing through narrative therapy significantly mediates depressive symptoms, strengthening the dyadic support of stroke survivors and family caregivers.
Collapse
Affiliation(s)
- Esther OW Chow
- Department of Social and Behavioural Sciences, City University of Hong
Kong, Hong Kong, China,Esther OW Chow, Department of Social and
Behavioural Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon,
Hong Kong.
| | - Sai-fu Fung
- Department of Social and Behavioural Sciences, City University of Hong
Kong, Hong Kong, China
| | - Hardev Singh
- Department of Social and Behavioural Sciences, City University of Hong
Kong, Hong Kong, China
| |
Collapse
|
5
|
Hall S, Rohatinsky N, Holtslander L, Peacock S. Caregivers to older adults require support: A scoping review of their priorities. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3789-e3809. [PMID: 36251430 DOI: 10.1111/hsc.14071] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 07/01/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
The vast majority of older adults who are chronically ill rely on informal caregivers for support. Caregivers often require additional support to facilitate their role. To the best of our knowledge, there has yet to be a collation of caregiver-identified priorities for support. Using existing research, this scoping review provides a comprehensive picture of what caregivers have indicated as priorities for support. Arksey and O'Malley's scoping review framework guides this review. We searched MEDLINE, CINAHL and PsycINFO databases on July 2, 2021. We selected databases based on their relevance to nursing, health and social science. Inclusion criteria were peer-reviewed research of any design, a sample population of caregivers to older adults (>55 years), manuscripts published in English and the priorities for caregiver support identified by caregivers themselves. We screened a total of 3591 records, and 33 articles met the inclusion criteria. These studies were from geographic settings across the globe and used various quantitative, qualitative and mixed-method study designs. In our synthesis, we quantified the identified priorities within the studies using coding and content analysis. We present the following list of caregiver-identified priorities: (1) orientation to the caregiving role; (2) self-care and respite; (3) adapting healthcare; (4) improved supports; (5) information needs; (6) access to resources; (7) financial assistance. Policymakers, healthcare professionals and non-profit organisations can use evidence from this review to guide decisions when developing support services and interventions for caregivers.
Collapse
Affiliation(s)
- Steven Hall
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Noelle Rohatinsky
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Shelley Peacock
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| |
Collapse
|
6
|
Raemdonck E, Lambotte D, De Witte N, Gorus E. Giving voice to informal caregivers of community-dwelling older adults: A systematic review of empowerment interventions. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3354-e3368. [PMID: 35899425 DOI: 10.1111/hsc.13928] [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: 10/25/2021] [Revised: 04/30/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
Taking care for older adults can place informal caregivers at risk for developing health problems. Therefore, interventions aiming to empower informal caregivers have been developed. Empowerment refers to a health promotion process including strategies to improve informal caregivers' self-care behaviours, stress-management and caregiving skills. In literature, empowerment-oriented interventions often target subsamples of informal caregivers defined through the care receiver's condition. These interventions, however, do not adequately capture the complexity of care needs and might even exclude informal caregivers taking care for older people without a specific diagnosis or with a subthreshold condition. Therefore, the aim of this systematic review is to provide an overview of the content and effectiveness of empowerment-oriented interventions directed at informal caregivers of community-dwelling older adults. Following the PRISMA guidelines, a systematic review was performed by searching the following databases: PubMed, PsycINFO, EMBASE and Web of Science. From a total of 6798 unique publications, 13 intervention studies, of which seven randomised controlled trials, were eligible for inclusion. According to the Mixed Methods Appraisal Tool, eight studies scored poor. The intervention studies under review represented different domains of empowerment, with cultivation of positive feelings being the most prevalent one. Social participation and physical health received little attention in interventions. Although no adverse intervention effects were observed, the studies reported mixed results with 57 positive and 47 neutral effects. The limited number and poor quality of studies emphasise the need for future research investigating the effectiveness of empowerment-oriented interventions targeting informal caregivers of older adults.
Collapse
Affiliation(s)
- Eveline Raemdonck
- Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Deborah Lambotte
- School of Healthcare, HOGENT University of Applied Sciences and Arts, Ghent, Belgium
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Nico De Witte
- School of Healthcare, HOGENT University of Applied Sciences and Arts, Ghent, Belgium
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ellen Gorus
- Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Belgium
| |
Collapse
|
7
|
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].
Collapse
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
| |
Collapse
|
8
|
Smith JL, Chung ML, Miller JL, Biddle M, Schuman DL, Rayens MK, Lennie TA, Smalls B, Hammash M, Mudd-Martin G, Moser DK. Profile of informal rural Appalachian caregivers of patients with chronic illnesses. J Rural Health 2022; 38:240-250. [PMID: 33644897 PMCID: PMC8397797 DOI: 10.1111/jrh.12560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE Caring for a family member with chronic illness increases cardiovascular disease (CVD) risk by 82%, and rurality imparts additional CVD disparities. The purpose of this study was to describe a profile of rural caregivers of patients with chronic illnesses to determine the prevalence of CVD risk factors, and psychosocial and socioeconomic burden, as well as to compare these variables across gender. METHODS Baseline data from a trial of CVD risk reduction in rural caregivers of patients with chronic illnesses were used. We measured depression and anxiety with the PHQ-9 and Brief Symptom Inventory; social, economic, and environmental factors using the MOS-Social Support and Economic and Environmental surveys; body mass index (BMI); blood pressure (BP); and lipid profile. RESULTS Of 181 caregivers (age 53±14 years, 80% female), 69% were married; 88% were caring for a family member, including 46% caring for a spouse and 18% for a parent. A total of 51% were anxious, 25% depressed, and 25% reported lack of social support. Most (51%) caregivers had one or more types of CVD; and 49% were smokers. By examination, 76% had elevated BP; 35% had total cholesterol >200; 50% low-density lipoprotein >100; 56% triglycerides >150; and 79% high-density lipoprotein <60. Based on BMI, 91.5% were overweight or obese. Gender comparisons revealed that women reported higher levels of depressive symptoms than men. CONCLUSIONS Rural caregivers, regardless of gender, are at increased risk of CVD and struggle with factors that make caregiving burdensome and contribute to their own poor cardiac health.
Collapse
Affiliation(s)
| | - Misook L. Chung
- College of Nursing, University of Kentucky, Lexington, Kentucky
- College of Nursing, Yonsei University, Seoul, Korea
| | | | - Martha Biddle
- College of Nursing, University of Kentucky, Lexington, Kentucky
| | - Donna L. Schuman
- College of Social Work, University of Kentucky, Lexington, Kentucky
| | - Mary Kay Rayens
- College of Nursing, University of Kentucky, Lexington, Kentucky
| | - Terry A. Lennie
- College of Nursing, University of Kentucky, Lexington, Kentucky
| | - Brittany Smalls
- College of Medicine, University of Kentucky, Lexington, Kentucky
| | - Muna Hammash
- School of Nursing, University of Louisville, Louisville, Kentucky
| | - Gia Mudd-Martin
- College of Nursing, University of Kentucky, Lexington, Kentucky
| | - Debra K. Moser
- College of Nursing, University of Kentucky, Lexington, Kentucky
| |
Collapse
|
9
|
Chow EOW, Wong YY, Fok DYH, Liao X, Li C. Positive life stories of Stroke-Survivor's spousal caregiving in Hong Kong: Lessons for policy and practice. Soc Sci Med 2021; 291:114476. [PMID: 34700116 DOI: 10.1016/j.socscimed.2021.114476] [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: 04/17/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Advances in medical-care for immediately post-stroke mean that many stroke-survivors now live a normal lifespan, although they may suffer residual disability. They are often cared for at home by their spouse, who may be ill-prepared for this task, and may also have health concerns. As demands on formal services increase with population aging in Hong Kong, equipping spousal-caregivers with positive effective caring strategies is increasingly important. OBJECTIVE To understand what constitutes positive spousal-caregiving for stroke-survivors in Hong Kong within the cultural lens of 'Zhong (Loyalty)' METHOD: Naturalistic qualitative research was employed to hear stories about positive caregiving from Hong Kong couples living with stroke sequelae. Three in-depth face-to-face semi-structured interviews were undertaken with eleven dyads (stroke-survivor alone, spousal-caregiver alone, then the couple together). Data validation was by member-checking, further questions, and feedback at a second interview, and corroboration by field-notes. FINDINGS A strength-based interactive model of positive spousal-caregiving was described, whose core tenet was Zhong (Loyalty). This fostered, and in turn was nurtured by, three paired key behaviours (1. Learning new skills linked with satisfaction when efforts paid off; 2. Utilizing formal and informal resources linked with supporting others; 3. Cherishing and bringing out the best linked with managing life- and self-care). Couples' capacity to develop these behaviours reflected their inner strengths. CONCLUSIONS Couples who practiced positive caring and were resilient in the face of adversity were likely to optimise dyadic health and deal constructively with unexpected challenges. To address a looming shortfall between client need, and formal health and social services in Hong Kong, evidence-based policies are required to support effective, positive community-based spousal-caregiving.
Collapse
Affiliation(s)
- Esther O W Chow
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong.
| | - Yuk Yi Wong
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong
| | - Doris Y H Fok
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong
| | - Xu Liao
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong
| | - Chaoyu Li
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong
| |
Collapse
|
10
|
Zauszniewski JA, Burant CJ, Martin RJ, Sweetko JS, DiFranco E. Caregivers' Use of Personal and Social Resourcefulness: Differences by Care Recipient Condition. West J Nurs Res 2021; 44:288-295. [PMID: 34622720 DOI: 10.1177/01939459211050951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although family caregivers who use both the personal and social resourcefulness skills have the best health outcomes, it is unknown whether their tendency toward personal or social resourcefulness varies by their care recipient's condition. This cross-sectional study of existing data from 234 caregivers of persons with various conditions examined five item pairs from the Resourcefulness Scale© with responses capturing personal and social resourcefulness in relation to anxiety, anger, sadness, indecision, and financial distress. Caregivers were categorized by the recipient's condition (amyotrophic lateral sclerosis, cancer, dementia, mental illness, Parkinson's disease, stroke, traumatic brain injury, other, or multiple conditions). Findings showed that across most groups, caregivers used both personal and social resourcefulness when angry, sad, or indecisive and personal resourcefulness when anxious or managing money. Caregivers of persons with cancer, traumatic brain injury, stroke, and mental illness differed. The findings provide a basis for future clinical trials across diverse caregiver groups.
Collapse
Affiliation(s)
- Jaclene A Zauszniewski
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Christopher J Burant
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Richard J Martin
- The Breen School of Nursing and Health Professions, Ursuline College, Cleveland, OH, USA
| | - John S Sweetko
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Evelina DiFranco
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
11
|
Liu R, Chi I, Wu S. Caregiving Burden among Caregivers of People with Dementia through the Lens of Intersectionality. THE GERONTOLOGIST 2021; 62:650-661. [PMID: 34606599 DOI: 10.1093/geront/gnab146] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Caregivers may be at different risks of various types of burdens by virtue of their gender and racial/ethnic status. This paper explores the differences in caregiving burdens across the intersectionality of race and gender. RESEARCH DESIGN AND METHODS Using Round 5 (conducted in 2015) and Round 7 (conducted in 2017) of National Study of Caregiving and National Health and Aging Trends Study data, the study examined differences in caregiver burdens across and within different gender and racial/ethnic groups, within the realms of financial, emotional, and physical burdens. The sample consisted of 1,206 caregivers who provided services to Medicare beneficiaries. Logistic regressions were performed to assess the three types of burdens each subgroup was experiencing. RESULTS Results indicated that within the intersectionality framework, compared to White female caregivers, Black male caregivers were 3.3 times (95% CI 1.77-6.22) more likely to experience financial burden, and Black female caregivers were 54% less likely to experience physical burden. Surprisingly, compared to White female caregivers, all the other groups were 37% (95% CI 0.41-0.95) to 71% (95% CI 0.15-0.56) less likely to have emotional burden. DISCUSSION AND IMPLICATIONS The findings highlighted that Black male caregivers are experiencing financial burden and White female caregivers are experiencing emotional burden disproportionately. To develop effective interventions and programs for dementia caregivers, a special focus should be put on monitoring the differences in the types of burdens that the above-mentioned population subgroups experience.
Collapse
Affiliation(s)
- Ruotong Liu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA.,Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, California, USA
| | - Iris Chi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA.,Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, California, USA
| | - Shinyi Wu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA.,Daniel J. Epstein Department of Industrial and Systems Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California, USA
| |
Collapse
|
12
|
Barbosa F, Delerue Matos A, Voss G, Costa P. Spousal Care and Pain Among the Population Aged 65 Years and Older: A European Analysis. Front Med (Lausanne) 2021; 8:602276. [PMID: 34046416 PMCID: PMC8144647 DOI: 10.3389/fmed.2021.602276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 03/29/2021] [Indexed: 01/17/2023] Open
Abstract
Background: Spousal care is the most important source of informal care in old age. Nevertheless, despite the growing importance of this issue, the association between providing spousal care inside the household and pain remains unexplored in Europe. Objective and Methods: This study aims to estimate the prevalence of pain reported by spouse caregivers aged 65 plus that provide care inside the household and to investigate the association between providing spousal care and pain. Data from 17 European countries that participated in wave 6 of the Survey of Health, Aging and Retirement in Europe (SHARE) is used. The analyses are based on 26,301 respondents aged 65 years and older who provide informal care inside the household to their spouse/partner exclusively (N = 1,895) or do not provide any informal care (inside or outside the household) (24,406). Descriptive statistics and multilevel logistic regressions (individual-level as level 1, and country as level 2) were performed. Results: Overall, spouse caregivers report pain more often (63.4%) than their non-caregiver's counterparts (50.3%). Important differences in the prevalence of pain among spouse caregivers were found between countries, with Portugal (80.3%), Spain (74.6%), France (73%), Italy (72.4%), and Slovenia (72.1) showing the highest prevalence of pain, and Denmark (36%), Switzerland (41.5) and Sweden (42.3%), the lowest. Results from multilevel logistic regressions show that European individuals aged 65+ who provide spousal care have an increased likelihood of reporting pain (OR 1.30; CI = 1.13-1.48). Conclusion: Our results suggest that in Europe, spouse caregivers aged 65+ are at greater risk of experiencing pain. Therefore, European policymakers should consider spouse caregivers as a health priority group, and take measures to ensure they receive comprehensive health and socio-economic support.
Collapse
Affiliation(s)
- Fátima Barbosa
- Communication and Society Research Centre, Institute of Social Sciences, University of Minho, Braga, Portugal
| | - Alice Delerue Matos
- Communication and Society Research Centre, Institute of Social Sciences, University of Minho, Braga, Portugal
- Department of Sociology, Institute of Social Sciences, University of Minho, Braga, Portugal
| | - Gina Voss
- Communication and Society Research Centre, Institute of Social Sciences, University of Minho, Braga, Portugal
| | - Patrício Costa
- School of Medicine, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal
- ICVS (Life and Health Sciences Research Institute)/3B's (Biomaterials, Biodegradables and Biomimetics) Associate Laboratory, Guimarães, Portugal
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| |
Collapse
|
13
|
Stewart S. Spousal Caregiving in Community Settings in Canada: Implications for Nursing Professionals. Gerontol Geriatr Med 2020; 6:2333721420914476. [PMID: 32284955 PMCID: PMC7139178 DOI: 10.1177/2333721420914476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/07/2020] [Accepted: 02/07/2020] [Indexed: 11/16/2022] Open
Abstract
Objective: Spousal caregivers report significantly more health
effects and psychological consequences than caregivers of aging parents.
Traditional approaches to assist these caregivers often include lifestyle
approaches with a lack of health promotion initiatives. Consequently,
alternative approaches to facilitate the adaptation to the social context of
spousal caregivers’ experiences are needed. Method: This article
systematically reviewed literature on spousal caregiving in Canada using a
health promotion approach. Nine peer reviewed articles were identified from the
health and social care literature and critically analyzed for relevant themes.
Results: Gender, social support, health care, and income
emerged as themes in the literature published to date. Discussion:
The article concludes with directions for future research in Canada and
suggested solutions for family nursing practice.
Collapse
|
14
|
DiGiacomo M, Chang S, Luckett T, Agar M, Phillips J, Lam L. Financial stress experienced by informal carers of adults with a chronic disease: Results from an Australian population-based cross-sectional survey. Australas J Ageing 2019; 39:254-262. [PMID: 31680413 DOI: 10.1111/ajag.12739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 09/16/2019] [Accepted: 09/18/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To identify caregiving characteristics that are associated with financial stress in Australian carers of people with a chronic disease. METHODS Data were collected via the South Australian Health Omnibus, an annual population-based, cross-sectional survey. Individuals who provided care to someone with prevalent chronic conditions were asked about financial stress and caregiving characteristics. RESULTS Of 32.4% (988/3047) who were carers, 13.4% (132/988) experienced financial stress. Adjusting for age and household income, providing more than 20 hours of care per week (AOR = 2.39, 95% CI = 1.48-3.86), transport assistance (AOR = 1.89, 95% CI = 1.15-3.09) and assistance with household tasks (AOR = 1.92, 95% CI = 1.14-3.26) and caring for a person with a mental illness (AOR = 2.01, 95% CI = 1.24-3.28) were associated with a significant increase in odds of experiencing financial stress. Caring for a person with cancer (AOR = 0.49, 95% CI = 0.30-0.81) or dementia (AOR = 0.40, 95% CI = 0.21-0.76) was associated with decrease in odds. CONCLUSIONS Financial stress was reported by more than 13% of carers, and factors other than household income were implicated.
Collapse
Affiliation(s)
- Michelle DiGiacomo
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia
| | - Sungwon Chang
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia
| | - Tim Luckett
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia
| | - Meera Agar
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia.,South Western Sydney Clinical School, Liverpool Hospital, University of New South Wales (UNSW), Liverpool, NSW, Australia.,Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Jane Phillips
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia
| | - Lawrence Lam
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia.,Tung Wah College, Hong Kong SAR, China
| |
Collapse
|
15
|
Greenfield JC, Hasche L, Bell LM, Johnson H. Exploring how workplace and social policies relate to caregivers' financial strain. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2018; 61:849-866. [PMID: 29944091 DOI: 10.1080/01634372.2018.1487895] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Informal caregiving is a critical component of the US long-term care system, but can have significant negative impacts on caregiver employment, finances, and well-being. An online survey of Colorado caregivers was piloted in 2016-17 to explore whether workplace and social policies such as access to paid family leave and public health insurance can buffer the negative financial impacts of caregiving and help caregivers to remain in the workforce. Using standardized measures, the survey assessed caregivers' employment and financial status, well-being (physical and mental health, caregiver strain, benefits of caregiving), access to workplace supports, and covariates (e.g., caregiver demographics, health, social support, and service utilization). Ninety-five caregivers, recruited through community agency partners, completed the survey. Respondents were predominately female (89%), middle-aged (M = 57), non-Hispanic White (64%) or Latino/a (22%), and caring for a parent (40%) or spouse (30%) for over one year. Half (51%) reported working full- or part-time jobs, while 16.4% had stopped working because of caregiving. In multivariate regression modeling, predictors of financial strain included the care recipients' financial strain and the caregiver's reduction or ceasing of work. Medicare may be protective to minimize caregivers' need to reduce or cease work. Implications for caregivers' ability to stay engaged in the workforce and prepare for their own retirement are explored.
Collapse
Affiliation(s)
| | - Leslie Hasche
- a University of Denver, Graduate School of Social Work, Denver, CO, USA
| | - Lauren M Bell
- a University of Denver, Graduate School of Social Work, Denver, CO, USA
| | - Heidi Johnson
- a University of Denver, Graduate School of Social Work, Denver, CO, USA
| |
Collapse
|
16
|
Grant JS, Graven LJ. High Priority Problems Experienced by Informal Caregivers of Individuals With Heart Failure. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2018. [DOI: 10.1177/1084822318800296] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The purpose of this study was to identify high priority problems experienced by informal caregivers when providing care for individuals with heart failure in the home. This secondary analysis was part of a cross-sectional, descriptive study using online self-report instruments (N = 530), including one researcher-developed item identifying top priority problems for heart failure caregivers. Content and quantitative data analyses were conducted. Performing multifaceted activities and roles that evolve around daily heart failure demands (n = 463) and maintaining caregiver physical, emotional, social, and financial well-being (n = 138) were the two most common themes experienced by caregivers of individuals with heart failure. Each of these two problems had several dimensions. Another theme was providing unending care (n = 40), with two dimensions.
Collapse
|
17
|
Lee K, Martin P, Poon LW. Predictors of caregiving burden: impact of subjective health, negative affect, and loneliness of octogenarians and centenarians. Aging Ment Health 2017; 21:1214-1221. [PMID: 27438060 DOI: 10.1080/13607863.2016.1206512] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES This study aimed (1) to determine whether octogenarian and centenarian care recipients' self-report on physical, social, and emotional status are different from caregivers' reports, (2) to assess associations between octogenarian and centenarian care recipients' poor physical, social, and emotional status and caregiver burden, and (3) to determine which report, the care recipients' self-report or caregivers' report, about the participants' physical and emotional status predicted more accurately levels of caregiver burden. METHOD Self-ratings and caregiver informant ratings were obtained from 309 participants of the Georgia Centenarian Study. Care recipients' health, negative affect, and loneliness were reported by both the caregivers and care recipients for the analyses. Differences between care recipients' and caregivers' reports were assessed by t-test. Blockwise multiple regression analysis was computed to assess predictors of caregiver burden. RESULTS Caregivers' reports on the three measures were significantly higher than self-reports. Caregivers' negative affect and loneliness, not physical health, reported by caregivers predicted higher caregiver burden. Care recipients' reports did not predict caregiver burden. CONCLUSION Caregivers perceived care recipients' social and emotional status more negatively, and caregivers' negative perceptions on care recipients' well-being status were an important predictor of caregiver burden.
Collapse
Affiliation(s)
- Kyuho Lee
- a Department of Human Development and Family Studies , Iowa State University , Ames , IA , USA
| | - Peter Martin
- a Department of Human Development and Family Studies , Iowa State University , Ames , IA , USA
| | - Leonard W Poon
- b Institute of Gerontology, University of Georgia , Athens , GA , USA
| |
Collapse
|