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Templeman ME, Lee S, Haley WE. Factors Associated With Working Caregivers' Well-Being: Comparisons Between Black and White Working Caregivers in the United States. Int J Aging Hum Dev 2024; 99:179-199. [PMID: 37899571 DOI: 10.1177/00914150231208680] [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: 10/31/2023]
Abstract
This study investigated stressors and strains, resources, and well-being among Black working caregivers (BWC) and White working caregivers (WWC) who participated in the Midlife in the United States study (Black: n = 49, White: n = 250). Comparisons were made between BWC and WWC for primary caregiving stressors, secondary strains, resources, and well-being, and hierarchical regression models tested associations among these factors. BWC reported less negative work-to-family spillover, more perceived control and religious/spiritual coping, and higher positive affect than WWC, complementing existing evidence of greater resilience among BWC. Secondary strains stemming from the workplace had stronger associations with well-being than primary caregiving stressors, confirming that the workplace deserves greater attention in stress research and interventions for working caregivers. Finally, perceived control, optimism, and family support were important resources for well-being for both BWC and WWC, substantiating their valuable role in interventions for working caregivers.
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Affiliation(s)
- Maureen E Templeman
- Department of Sociology, Anthropology, and Gerontology, Missouri State University, Springfield, MO, USA
| | - Soomi Lee
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - William E Haley
- School of Aging Studies, University of South Florida, Tampa, FL, USA
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Meyer K, Rath L, Avent E, Benton D, Nash P, Wilber K. How do family caregivers of older adults cope with relationship strain? Aging Ment Health 2023; 27:1990-1999. [PMID: 37574858 DOI: 10.1080/13607863.2023.2247353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 08/08/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVE Studies of families' experiences with caregiving to older adults most often focus on overall burden and stress. Yet, caregiving is also a type of relationship, and the onset of caregiving can contribute to relationship strain between care partners. Despite implications for both care partners, little is known about how caregivers cope with caregiving relationship strain. METHODS The authors conducted nine focus groups and 8 interviews with a purposeful sample of racially and ethnically diverse family caregivers in Los Angeles. Conventional content analysis was applied to transcripts to identify how caregivers cope with relationship strain. RESULTS Analyses revealed four overall coping approaches to manage relationship strain: (1) Self-Care; (2) Adapting Behaviors, (3) Adapting Feelings and Cognitions, and (4) Help and Support. Selected strategies likely vary by care recipient condition. For example, caregivers for persons living with dementia emphasize adapting their own behaviors and feelings, rather than trying to change their loved one's behaviors. CONCLUSIONS Findings suggest that caregivers cope with relationship strain using both interpersonal tension and care management strategies. We also identified possible variations by care recipient condition and caregiver race and ethnicity. These results suggest a need for interventions focused on caregiver coping should also be tested for effects on relationship strain.
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Affiliation(s)
- Kylie Meyer
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
- Archstone Foundation, Long Beach, CA, USA
| | - Laura Rath
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Elizabeth Avent
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Donna Benton
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Paul Nash
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Kathleen Wilber
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
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Baik D, Centi S, McNair B. Assessing Racial and Ethnic Differences in Cardiovascular Disease in U.S. Family Caregivers of Persons With Dementia: Analysis of Data from the 2015-2020 Behavioral Risk Factor Surveillance System. Res Gerontol Nurs 2023; 16:241-249. [PMID: 37450782 PMCID: PMC10990473 DOI: 10.3928/19404921-20230706-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
The current study examined racial and ethnic differences in psychological, behavioral, and metabolic risk factors for cardiovascular disease (CVD) and CVD conditions among family caregivers (FCGs) of persons with dementia. We used the 2015-2020 Behavioral Risk Factor Surveillance System data. The sample included a total of 6,132 FCGs of persons with dementia. Compared to non-Hispanic White FCGs, non-Hispanic Black and non-Hispanic Asian FCGs were less likely to have depression. The Other racial/ethnic FCG group was more likely to currently smoke. Non-Hispanic Black FCGs were less likely to have exercised, more likely to be obese, and more likely to have been diagnosed with diabetes. No differences in CVD conditions (e.g., angina/coronary heart disease, stroke, myocardial infarction) were detected between racial/ethnic minority FCGs and non-Hispanic White FCGs. Future studies should investigate relationships between racial/ethnic minority-specific caregiving and CVD by including a larger, racially and ethnically diverse population of FCGs. [Research in Gerontological Nursing, 16(5), 241-249.].
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Kopel J, Sehar U, Choudhury M, Reddy PH. Alzheimer’s Disease and Alzheimer’s Disease-Related Dementias in African Americans: Focus on Caregivers. Healthcare (Basel) 2023; 11:healthcare11060868. [PMID: 36981525 PMCID: PMC10048201 DOI: 10.3390/healthcare11060868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/19/2023] Open
Abstract
Alzheimer’s disease (AD) and Alzheimer’s Disease-Related Dementias (ADRD) are chronic illnesses that are highly prevalent in African Americans (AA). AD and ADRD are caused by multiple factors, such as genetic mutations, modifiable and non-modifiable risk factors, and lifestyle. Histopathological, morphological, and cellular studies revealed how multiple cellular changes are implicated in AD and ADRD, including synaptic damage, inflammatory responses, hormonal imbalance, mitochondrial abnormalities, and neuronal loss, in addition to the accumulation of amyloid beta and phosphorylated tau in the brain. The contributions of race, ethnicity, location and socioeconomic status all have a significant impact on the care and support services available to dementia patients. Furthermore, disparities in health care are entangled with social, economic, and environmental variables that perpetuate disadvantages among different groups, particularly African Americans. As such, it remains important to understand how various racial and ethnic groups perceive, access, and experience health care. Considering that the mounting data shows AA may be more susceptible to AD than white people, the demographic transition creates significant hurdles in providing adequate care from family caregivers. Furthermore, there is growing recognition that AD and ADRD pose a significant stress on AA caregivers compared to white people. In this review, we examine the current literature on racial disparities in AD and ADRD, particularly concerning AA caregivers.
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Affiliation(s)
- Jonathan Kopel
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Moumita Choudhury
- Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - P. Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Department of Public Health, School of Population and Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Neurology, Departments of School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Nutritional Sciences Department, College of Human Sciences, Texas Tech University, Lubbock, TX 79409, USA
- Correspondence: ; Tel.: +1-806-743-3194
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Whitney RL, Bell JF, Kilaberia TR, Link BM, Choula RB, Reinhard SC, Young HM. Diverse demands and resources among racially/ethnically diverse caregivers. ETHNICITY & HEALTH 2023:1-20. [PMID: 36858966 DOI: 10.1080/13557858.2023.2179022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES The family caregiver population in the US is growing in conjunction with greater numbers of older adults with serious illness and complex care needs, and is becoming increasingly diverse. This study described and compared resources, demands, and health outcomes among diverse family caregivers by race/ethnicity. DESIGN This study was a cross-sectional secondary analysis of nationally representative data collected for Black/African-American, Asian American & Pacific Islander, Latino/Hispanic and non-Latino/Hispanic white caregivers (n = 2,010) in the Home Alone Revisited Study. We described available resources (e.g. income, paid help, social support) and demands (e.g. medical/nursing task performance) by racial/ethnic group. Using survey-weighted logistic regression, we examined relationships of resources and demands with caregiver outcomes (i.e. heath status; strain; depressive symptoms) by race-ethnicity controlling for socio-demographic variables. RESULTS Distribution of resources and demands was similar by race/ethnicity, except for higher income for non-Latino/Hispanic white caregivers. Nearly half assisted with personal care (47.5%) or medical/nursing tasks (49.7%). Higher social support and satisfaction with social relationships was associated with positive health outcomes regardless of race/ethnicity, while income was consistently associated with positive health outcomes only for non-Latino/Hispanic white caregivers. Medical/nursing task performance was significantly associated with negative health outcomes for Asian American & Pacific Islanders in multivariable models. DISCUSSION Many caregiving demands and tasks are similar by race/ethnicity and represent considerable investment of time, energy and care. Differences in the effects of resources and demands by race/ethnicity should be explored in future research as they may have implications for assessment and planning of culturally and linguistically appropriate interventions.
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Affiliation(s)
- Robin L Whitney
- The Valley Foundation School of Nursing at San Jose State University, San Jose, CA, USA
| | - Janice F Bell
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, USA
| | - Tina R Kilaberia
- New York University Silver School of Social Work, New York, NY, USA
| | - Benjamin M Link
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, USA
| | | | | | - Heather M Young
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, USA
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Gore JE, Brewster G, Sainz M, Ge Y, Xie J, James T, Epps F. Using a Multiple-Case Study Design to Explore the Worship Experiences of Black Families Affected by Dementia. Clin Gerontol 2023; 46:80-90. [PMID: 34962459 PMCID: PMC9237185 DOI: 10.1080/07317115.2021.2017378] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES The purpose of this multiple-case study was to report on the worship experiences of Black families affected by dementia. METHODS Data were collected through participant observations of family caregivers (n = 4) and persons living with dementia (n = 4) during worship services and semi-structured interviews with the family caregivers over six months. Data were initially analyzed case-by-case, then across-cases. RESULTS Four overarching themes emerged: Welcoming church culture, Community support from the church, Engagement during worship service, and Connectedness between the caregiver and their family member living with dementia. Family caregivers reported that their family member with dementia was attentive and expressed moments of clarity during and immediately after worship services. CONCLUSIONS Worship services can be tailored to support families affected by dementia and can promote engagement of the person living with dementia with church activities and family members. CLINICAL IMPLICATIONS Health practitioners are encouraged to acknowledge the influence of religious practices within Black families affected by dementia and integrate them into interdisciplinary care plans and programs.
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Affiliation(s)
- Janelle E Gore
- Nell Hodgson Woodruff School of Nursing, University, Emory University, Atlanta, Georgia, USA
| | - Glenna Brewster
- Nell Hodgson Woodruff School of Nursing, University, Emory University, Atlanta, Georgia, USA
| | - Mayra Sainz
- Nell Hodgson Woodruff School of Nursing, University, Emory University, Atlanta, Georgia, USA
| | - Yiran Ge
- Nell Hodgson Woodruff School of Nursing, University, Emory University, Atlanta, Georgia, USA
| | - Jane Xie
- Nell Hodgson Woodruff School of Nursing, University, Emory University, Atlanta, Georgia, USA
| | - Taylor James
- Nell Hodgson Woodruff School of Nursing, University, Emory University, Atlanta, Georgia, USA
| | - Fayron Epps
- Nell Hodgson Woodruff School of Nursing, University, Emory University, Atlanta, Georgia, USA
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MacDougall EE. Predicting depression in dementia caregivers: do religious/spiritual struggles play a role? Aging Ment Health 2022; 26:2270-2276. [PMID: 34346796 DOI: 10.1080/13607863.2021.1961124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Using a stress process framework model, the goal of this study was to address the current gap in our understanding of the prevalence and predictive power of specific types of religious/spiritual struggles for mental health outcomes in informal dementia caregivers. METHOD A convenience sample of 156 informal dementia caregivers completed a scale measuring six domains of religious/spiritual struggles, as well as other measures of primary stressors, background/contextual variables, and mental health outcome (depression). RESULTS Overall levels of religious/spiritual struggle were low, but 26 percent of the sample were classified as possible cases of clinically significant religious/spiritual struggle for at least one of the six domains. Of this group, 49 percent acknowledged struggles with ultimate meaning. Religious/spiritual struggles predicted greater self-reported depression over and above number of care recipient problem behaviors (primary stressor), caregiver sex, and caregiver personality (i.e. emotional stability). Although no individual domain of religious/spiritual struggle emerged as most salient, caregivers reported significantly more ultimate meaning struggles than demonic or interpersonal struggles. CONCLUSION Consistent with the stress process framework model, religious/spiritual struggles appeared to operate as a secondary stressor for informal dementia caregivers, adding predictive power to background/contextual factors and to primary stressors for the measured outcome of self-reported depression. One-fourth of the sample self-reported potentially clinically significant religious/spiritual struggles, with ultimate meaning struggles most commonly reported. Further research in this area may advance efforts to better equip both secular and religious professionals to provide evidence-based counsel to informal dementia caregivers.
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Equipping Families and Friends to Offer Spiritual Care to People Living with Dementia: Findings from a Meta-Synthesis. RELIGIONS 2022. [DOI: 10.3390/rel13050462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Our work presents a meta-synthesis of 76 peer-reviewed, qualitative-research journal articles related to our research interest in the spiritual care training available for relatives and friends of people living with dementia. A total of 244 articles was reviewed prior to the application of selection criteria. The final sample of 2698 research participants across our selection of 76 peer-reviewed qualitative-research studies serves to demonstrate the value of spiritual care as an aspect of holistic palliative and dementia care. The development and implementation of spiritual-care standards and practices in healthcare generally is increasingly widespread. Most current training resources are designed for healthcare professionals, and our meta-synthesis identifies the need for training resources that equip and train volunteer spiritual carers, namely, the relatives and friends of people living with dementia. Our meta-synthesis suggests there is a need to develop training resources that equip relatives and friends with skills that prioritise attentive presence, spiritual intelligence, emotional intelligence, and, primarily, sensory spiritual practices. Beyond this meta-synthesis, developing and trialling suitable training materials and events will become the focus of an action research project.
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Rote SM, Moon HE, Kacmar AM, Moore S. Exploring Coping Strategies and Barriers in Dementia Care: A Mixed-Methods Study of African American Family Caregivers in Kentucky. J Appl Gerontol 2022; 41:1851-1859. [PMID: 35543172 DOI: 10.1177/07334648221093618] [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: 11/15/2022] Open
Abstract
This study explores coping strategies and barriers to dementia care experienced by African American dementia caregivers in Kentucky. Utilizing a convergent mixed-method design integrating focus group and survey data on African American dementia caregivers recruited through churches in Kentucky (N = 28), we elucidate three coping strategies: love-based coping, religion-based coping, and family support. Results from survey data supported these themes, with over 90% of participants reporting that they provide care to give back to family members and for religious reasons. However, over half of the caregivers' reported strain due to three barriers identified by focus group data: time constraints, low support, and the high cost of formal care. This exploratory study highlights the importance of intervention tactics for African American dementia caregivers that focus not only on individual and family support but also community-based outreach and support.
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Affiliation(s)
- Sunshine M Rote
- Kent School of Social Work, University of Louisville, Louisville, KY, USA
| | - Heehyul E Moon
- Kent School of Social Work, University of Louisville, Louisville, KY, USA
| | - Allison M Kacmar
- Kent School of Social Work, University of Louisville, Louisville, KY, USA
| | - Sharon Moore
- Kent School of Social Work, University of Louisville, Louisville, KY, USA
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Huang YH, Nagao CA, Santos KMB, Werchowsky MI. Impact of Culture, Spirituality, and Mental Health Attitudes on Intergenerational Asian-American Caregivers: A Pilot Study. Am J Occup Ther 2022; 76:23198. [PMID: 35143608 DOI: 10.5014/ajot.2022.046912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Asian-Americans are more likely than other ethnic groups to care for older family members and less likely to seek mental health services. The research on caregiver burden among Asian-American intergenerational caregivers is limited. OBJECTIVE To investigate how spirituality and mental health help-seeking attitudes correlate with and predict perceived feelings of caregiver burden among Asian-American caregivers. Favorable mental health help-seeking attitudes were predicted to negatively correlate with caregiver burden, and spirituality was predicted to negatively correlate with and negatively predict caregiver burden. DESIGN Quantitative survey research. SETTING Community mental health. PARTICIPANTS One hundred one participants were recruited using the following inclusion criteria: Asian-Americans who currently or previously provided care to an Asian family member at least one generation older than the caregiver for at least 1 mo and in the past 3 yr. Outcomes and Measures: Items from the Burden Scale for Family Caregivers, Spirituality Scale, Expressions of Spirituality Inventory-Revised, Mental Help Seeking Attitudes Scale, and Self-Stigma of Seeking Psychological Help measured caregiver burden, spirituality, and mental health help-seeking attitudes. RESULTS A statistically significant negative correlation was found between caregiver burden and spirituality and between caregiver burden and mental health help-seeking attitudes. Spirituality and number of domains of care were statistically significant predictors of caregiver burden. CONCLUSIONS AND RELEVANCE Spirituality was found to negatively predict caregiver burden among Asian-American intergenerational caregivers. Mental health help-seeking attitudes were negatively correlated with caregiver burden. Occupational therapy practitioners have the opportunity to integrate spirituality and culturally sensitive mental health promotion into their services to Asian-Americans. What This Article Adds: Evidence that spirituality is a negative predictor of caregiver burden for Asian-American intergenerational caregivers offers a unique opportunity for occupational therapy practitioners to offer alternative methods of mental health promotion with this population. Understanding that spirituality and mental health help-seeking attitudes are culturally mediated allows practitioners to be informed about a dynamic in Asian-American culture.
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Affiliation(s)
- Yan-Hua Huang
- Yan-hua Huang, PhD, OTR/L, is Professor, Department of Occupational Therapy, College of Health, Human Services and Nursing, California State University Dominguez Hills, Carson;
| | - Ciara A Nagao
- Ciara A. Nagao, MS, OTR/L, is Occupational Therapist, Orange, CA. At the time of the study, Nagao was Master's Student, California State University Dominguez Hills, Carson
| | - Kelsey Michelle B Santos
- Kelsey Michelle B. Santos, MS, OTR/L, is Occupational Therapist, Orange County, CA. At the time of the study, Santos was Master's Student, California State University Dominguez Hills, Carson
| | - Madison I Werchowsky
- Madison I. Werchowsky MS, OTR/L, is Occupational Therapist, Los Angeles, CA. At the time of the study, Werchowsky was Master's Student, California State University Dominguez Hills, Carson
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Epps F, Moore MA, Chester M, Gore J, Sainz M, Adkins A, Clevenger C, Aycock DM. The Alter Program: A Nurse-Led, Dementia-Friendly Program for African American Faith Communities and Families Living With Dementia. Nurs Adm Q 2022; 46:72-80. [PMID: 34860803 PMCID: PMC8647771 DOI: 10.1097/naq.0000000000000506] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Dementia is a stigmatizing condition requiring enhanced awareness and understanding. Churches are a trusted source of support for African Americans, a demographic disproportionately affected by dementia. However, many African American churches are not equipped with the knowledge and means to provide safe environments, resources, and spiritual and social support for their parishioners living with dementia and their families. This protocol is written to detail the design and implementation of a nurse-led, dementia-friendly congregation program, Alter. The Alter program was developed to increase dementia awareness, develop a supportive, faith-based dementia-friendly infrastructure, and create a community supporting the well-being of African Americans living with dementia and their families. Engagement in this program aims to improve brain health status of older adults, improve physical and mental health outcomes, reduce dementia stigma, and enhance personal agency. Improved outcomes for persons living with dementia translate into lower use of acute and emergency services due to more stability in community care. It is expected that the churches participating in this program will be recognized by their community as a great resource for dementia information and support. The long-term goal of the Alter program is to be widely adapted in various health systems to reduce health disparities associated with dementia in the African American community.
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Affiliation(s)
- Fayron Epps
- Nell Hodgson Woodruff School of Nursing, Emory University
| | - Miranda A. Moore
- Department of Family and Preventive Medicine, School of Medicine, Emory University
| | | | - Janelle Gore
- Nell Hodgson Woodruff School of Nursing, Emory University
| | - Mayra Sainz
- Nell Hodgson Woodruff School of Nursing, Emory University
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Gonyea JG, O'Donnell AE. Religious coping and psychological well-being in Latino Alzheimer's caregivers. Int J Geriatr Psychiatry 2021; 36:1922-1930. [PMID: 34378229 DOI: 10.1002/gps.5606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 08/05/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Prior research has demonstrated the benefits of religion on caregiver well-being; however, less research exists on the processes underlying this relationship, particularly in Latino Alzheimer's disease (AD) families. This study's aim was therefore to explore the direct and indirect influences of positive religious coping (RC-P) and negative religious coping (RC-N) on caregivers' experiences of depression and anxiety. METHODS The data are from the Circulo de Cuidado Study baseline interviews; participant eligibility criteria were that the person identifies as being Latino, providing at least 5 h of care weekly, and their relative has an AD diagnosis and neuropsychiatric symptoms. In person at-home interviews were conducted in Spanish with 67 caregivers. Religious coping was assessed with the Brief RCOPE; depression and anxiety were measured with the Center for Epidemiological Studies Depression Scale-Spanish version and State Anxiety Inventory. Multivariate regression analyses, controlling for caregiving stressors, were used to test our core hypotheses. RESULTS As hypothesized, RC-N had significant direct effect on depression (p < 0.001) and anxiety (p < 0.001) as well as partially mediated the relationship between caregiver subjective stressor and depression (p < 0.01) and anxiety (p < 0.01). However, contrary to our hypothesis, RC-P did not have a direct or indirect effects on psychological well-being. CONCLUSIONS Our findings are consistent with other studies linking RC-N to poorer caregiver outcomes. Caregivers who questioned God's power, perceived God punishing them, or felt abandoned by God reported greater levels of depression and anxiety. The results suggest that caregivers experiencing religious distress may feel overwhelmed and view a more hopeless future.
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Affiliation(s)
- Judith G Gonyea
- Human Behavior, Policy and Research Department, School of Social Work, Boston University, Boston University Institute for Health Systems Innovation & Policy, Boston, Massachusetts, USA
| | - Arden E O'Donnell
- Human Behavior, Policy and Research Department, School of Social Work, Boston University, Boston, Massachusetts, USA
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Farinha FT, Bom GC, Manso MMFG, Prado PC, Matiole CR, Trettene ADS. Religious/spiritual coping in informal caregivers of children with cleft lip and/or dysphagic palate. Rev Bras Enferm 2021; 75Suppl 2:e20201300. [PMID: 34787276 DOI: 10.1590/0034-7167-2020-1300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 07/02/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to identify the use of religious/spiritual coping in informal caregivers of children with cleft lip and/or palate, dysphagic, powered exclusively by probe. METHODS descriptive and cross-sectional study, including 30 informal caregivers. For data collection, a Sociodemographic Questionnaire and the Brief Religious/Spiritual Coping Scale were used. For statistical analysis, ANOVA, Student's t and Spearman's correlation tests were used, with a significance level of 5%. RESULTS the use of religious/spiritual coping was high among participants (mean=3.71), with a predominance of positive (mean=3.30) compared to negative (mean=1.88). It was evident that the greater the reported importance of religiosity/spirituality in the participants' lives, the greater the positive coping (p=0.001). CONCLUSIONS informal caregivers used positive religious/spiritual coping as a way of coping with care demands related to the child's health condition. These findings point to the importance of including spirituality/religiosity as health indicators.
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Affiliation(s)
- Francely Tineli Farinha
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais. Bauru, São Paulo, Brazil
| | - Gesiane Cristina Bom
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais. Bauru, São Paulo, Brazil
| | | | - Priscila Capelato Prado
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais. Bauru, São Paulo, Brazil
| | - Claudia Regina Matiole
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais. Bauru, São Paulo, Brazil
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Liu JF, Xie WP, Lei YQ, Cao H, Chen Q. The relationship between religious beliefs and mental state, care burden, and quality of life in parents of infant patients with congenital heart disease. Cardiol Young 2021; 32:1-5. [PMID: 34645537 DOI: 10.1017/s1047951121004200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To evaluate the relationship between religious beliefs and mental state, care burden, and quality of life in parents of infantile patients with CHD. METHODS A cross-sectional study was conducted at a provincial hospital in Fujian, China. In this study, 114 parents of infant patients with CHD were successfully enrolled. Data were collected using the Duke University Religion Index, Hospital Anxiety and Depression Scale, Zarit Caregiver Burden Interview, and 36-Item Short-Form Health Survey. RESULTS The organisational religious activity, non-organisational religious activity, and intrinsic religiosity of parents were significantly related to the care burden and quality of life, and the two dimensions of non-organisational religious activity and intrinsic religiosity of parents were significantly related to their anxiety symptoms. No association was found between parents' religious beliefs and their depressive symptoms. Among Buddhist parents, non-organisational religious activity and intrinsic religiosity reduced the care burden and improved quality of life. Among Christian parents, organisational religious activity and non-organisational religious activity were found to reduce the care burden, while organisational religious activity and intrinsic religiosity were found to improve quality of life. There was no correlation between the sub-dimensions of religious beliefs and a negative impact on the care process in Muslim parents. CONCLUSION Religious beliefs have a protective effect on the parents of infant patients with CHD. They help relieve parents' anxiety, reduce their care burden, and improve their quality of life. In addition, different religious beliefs have different dimensions of influence on caregivers.
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Affiliation(s)
- Jian-Feng Liu
- Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China
- Department of Cardiac Surgery, Fujian Children's Hospital, Fuzhou, China
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Wen-Peng Xie
- Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China
- Department of Cardiac Surgery, Fujian Children's Hospital, Fuzhou, China
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Yu-Qing Lei
- Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China
- Department of Cardiac Surgery, Fujian Children's Hospital, Fuzhou, China
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Hua Cao
- Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China
- Department of Cardiac Surgery, Fujian Children's Hospital, Fuzhou, China
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Qiang Chen
- Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China
- Department of Cardiac Surgery, Fujian Children's Hospital, Fuzhou, China
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
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15
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Pereira C, LaRoche A, Arredondo B, Pugh E, Disbrow E, Reekes TH, Brickell E, Boettcher A, Sawyer RJ. Evaluating racial disparities in healthcare system utilization and caregiver burden among older adults with dementia. Clin Neuropsychol 2021; 36:353-366. [PMID: 34338590 DOI: 10.1080/13854046.2021.1951844] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To evaluate racial differences in healthcare utilization and caregiver burden in a culturally diverse population of older adults with dementia. METHOD One hundred and thirty-three dyads (person with dementia, PWD and caregiver, CG), with at least one emergency department (ED) visit or hospitalization 12 months prior, were enrolled. Independent sample t-tests and chi-squared analyses were performed to compare racial groups on healthcare utilization and CG burden. Mann-Whitney U test was used for item-level analyses, principal component analysis was used to examine relationships among outcomes, and regressions were used to identify the relationship between race and potential covariates. RESULTS PWD sample mean age was 79 years, predominantly female, and with high school education. Racial distribution was 65% White and 35% Black. CG sample mean age was 64 years, predominantly female, with more than 12 years of education. No differences were found for age or dementia severity across racial groups. Black PWD experienced more ED and ambulance utilization when compared to White counterparts. Non-emergency hospitalization rates were higher for White PWD. No significant differences were found by race for CG burden total score; however, item-level analysis suggested more anger, reduced social life, uncertainty, and inadequacy in White CGs. Regressions demonstrated a positive relationship between Black race and adult-child CGs with increased ED visits, while dyad educational attainment was associated with hospitalizations independent of race. CONCLUSIONS Healthcare utilization disparities extend to older adults with dementia diagnoses. Our findings suggest that culturally tailored interventions may be appropriate. Future research is encouraged to explore the effect of other covariates.
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Affiliation(s)
| | - Ashley LaRoche
- Neurology Department, Ochsner Health, New Orleans, LA, USA
| | - Beth Arredondo
- Neurology Department, Ochsner Health, New Orleans, LA, USA
| | - Erika Pugh
- Psychology Department, Louisiana State University, Baton Rouge, LA, USA
| | - Elizabeth Disbrow
- Center for Brain Health, LSU Health, Shreveport, LA, USA.,Department of Neurology, LSU Health, Shreveport, LA, USA.,Department of Pharmacology, Toxicology and Neuroscience, Shreveport, LA, USA
| | - Tyler H Reekes
- Center for Brain Health, LSU Health, Shreveport, LA, USA.,Department of Pharmacology, Toxicology and Neuroscience, Shreveport, LA, USA
| | - Emily Brickell
- Neurology Department, Ochsner Health, New Orleans, LA, USA
| | | | - R John Sawyer
- Neurology Department, Ochsner Health, New Orleans, LA, USA
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16
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Magid KH, Solorzano N, Manheim C, Haverhals LM, Levy C. Social Support and Stressors among VA Medical Foster Home Caregivers. J Aging Soc Policy 2021; 34:788-808. [PMID: 34047675 DOI: 10.1080/08959420.2021.1927619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study aimed to identify sources of social support and stressors that facilitated or hindered caregivers in the Department of Veterans Affairs (VA) Medical Foster Home (MFH) program in performing their duties. We conducted phone interviews with 35 caregivers and found they relied on work-related, religious, and emotional social support. Caregivers' unmet needs included a lack of time to re-charge; affordable respite services; enough VA-paid relief services, adequate relief caregivers; and ability to attend church. To address these needs, VA leadership should make MFH caregivers eligible for VA Caregiver Support Programs, encourage reciprocal caregiving arrangements, and organize virtual church services.
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Affiliation(s)
- Kate H Magid
- Health Science Specialist, Denver-Seattle Center of Innovation, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
| | - Nelly Solorzano
- Research Assistant, Denver-Seattle Center of Innovation, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
| | - Chelsea Manheim
- Social Work Researcher, Denver-Seattle Center of Innovation, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
| | - Leah M Haverhals
- Health Research Scientist, Denver-Seattle Center of Innovation, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
| | - Cari Levy
- Co-Director, Denver-Seattle Center of Innovation, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA.,Professor and Vice Division Head, Division of Health Care Policy & Research, University of Colorado School of Medicine, Aurora, Colorado, USA
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17
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Campione JR, Zebrak KA. Predictors of Unmet Need Among Informal Caregivers. J Gerontol B Psychol Sci Soc Sci 2021; 75:2181-2192. [PMID: 31907540 DOI: 10.1093/geronb/gbz165] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study investigates the relationship of caregiver demographics, caregiving intensity, caregiver support use, and aspects of the caregiving situation to a self-reported measure of unmet need among U.S. informal caregivers of older adults living at home with various conditions. METHODS Response data from 1,558 caregiver participants interviewed by telephone during the December 2016 baseline period of the Outcome Evaluation of the National Family Caregiver Support Program were used. Caregivers who responded "Definitely No" to the question "Are you receiving all the help you need?" were classified as reporting unmet need. Logistic regression was used to find significant factors associated with unmet need among the full sample and among caregivers tiered by three levels of burden. RESULTS Unmet need was reported by 22% of the caregivers. In a fully adjusted model, unmet need was predicted by higher levels of caregiving intensity, non-White race of the caregiver, and the caregiver not feeling appreciated by their care recipient. Other predictors associated with unmet need were no use of caregiver educational services, fewer respite hours, not living in a rural area, and caregiver having an education past high school. DISCUSSION Caregivers who do not feel appreciated by their care recipient and non-White caregivers should be identified as potential targets for intervention to address unmet need, especially if they are also reporting higher levels of caregiver burden. Understanding the factors associated with self-reported unmet need can assist caregiver support programs in measuring and addressing the needs of informal caregivers to support their continued caregiving.
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Affiliation(s)
- Joanne R Campione
- Department of Healthcare Delivery Research and Evaluation, Westat, Inc., Rockville, Maryland
| | - Katarzyna A Zebrak
- Department of Healthcare Delivery Research and Evaluation, Westat, Inc., Rockville, Maryland
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18
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Caregiving intensity and caregiver burden among caregivers of people with dementia: The moderating roles of social support. Arch Gerontol Geriatr 2021; 94:104334. [PMID: 33516077 DOI: 10.1016/j.archger.2020.104334] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 12/03/2020] [Accepted: 12/27/2020] [Indexed: 12/25/2022]
Abstract
Using the Pearlin stress process model, the present study aimed to test if there was an association between caregiving intensity and caregiver burden, to analyze what type of association existed, and to test if different indicators of social support moderated such association among caregivers of people with dementia. Data from the baseline assessment of the Resources for Enhancing Alzheimer's Caregiver Health (REACH II) (N = 637) were used. Caregiver burden (12-item Zarit caregiver burden scale), caregiving intensity (caregiving hours), and social support (Lubben social network, received support, satisfaction with support, and negative interactions) were the main measurements. Separate multivariate regression models were conducted with Stata 16. The results showed that the relationship between caregiving hours and caregiver burden was a nonlinear inversed U shape after controlling all of the socio-demographic variables. Further analyses showed that when caregiving hours reached 14 hours per day, the levels of burden were the highest. In addition, received support, satisfaction with support, and social network significantly buffered the relationship between caregiving hours and caregiver burden when they were examined separately. However, only social network played a significant buffering role when examining the four social support indicators simultaneously. These findings suggest the need for programs and practices that emphasize the importance of identifying, gaining, and strengthening positive aspect of social support, especially in how to broaden a caregiver's social network while caring for a family member with dementia.
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19
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Wong CSC, Zelman DC. Caregiver expressed emotion as mediator of the relationship between neuropsychiatric symptoms of dementia patients and caregiver mental health in Hong Kong. Aging Ment Health 2020; 24:1690-1699. [PMID: 31274003 DOI: 10.1080/13607863.2019.1636200] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: Quality of life among Hong Kong's family dementia caregivers is a current heightened public health concern. This was one of the first East Asian studies to examine the role of family expressed emotion (EE) in the negative caregiver outcomes associated with dementia caregiving. EE comprises overinvolved and critical communications in families of people with mental illness. In this research, caregiver EE was evaluated as a mediator of the relationship between behavioral and psychological problems associated with dementia (BPSD) and negative caregiver outcomes.Method: Participants were 89 Hong Kong family caregivers (79% female, 84% married, 43% >50 years of age) of people with diagnosed dementia, recruited from elder day care centers. Caregivers completed the Neuropsychiatric Inventory (NPI), Cohen Mansfield Agitation Inventory (CMAI), Level of Expressed Emotion scale (LEE), Zarit Burden Interview, and Center for Epidemiological Studies Depression Scale (CES-D).Results: Agitation, delusions, hallucinations, aggression and irritability were BPSD most associated with caregiver burden and depression. EE significantly mediated the BPSD-negative caregiver outcome relationship. Among EE subscales, intrusiveness was significantly more common and less associated with negative caregiver outcomes. Caregiving hours, low family support, and religious nonaffiliation were associated with EE and poorer caregiver outcomes.Conclusions: The negative impact of BPSD on dementia caregivers in Hong Kong is influenced by EE. Higher scores on EE intrusiveness may be partly accounted for by filial piety, a strong sense of family responsibility characterized by high attentiveness to elderly family members. As EE is a potentially modifiable factor, interventions are considered.
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Affiliation(s)
| | - Diane C Zelman
- California School of Psychology, Alliant International University, Hong Kong SAR, China
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20
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Díaz A, Ponsoda JM, Beleña A. Optimism as a key to improving mental health in family caregivers of people living with Alzheimer's disease. Aging Ment Health 2020; 24:1662-1670. [PMID: 31960702 DOI: 10.1080/13607863.2020.1715342] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: The aim of the present work was to study the serial multiple mediating role of optimism, perceived social support and subjective burden in the relationship between objective burden and psychological distress in caregivers of people with Alzheimer´s Disease (AD).Method: One hundred and forty family caregivers of people living with AD were recruited from randomly selected Alzheimer Association Centres. They answered the General Health Questionnaire (GHQ), the Life Orientation Test-Revised (LOT-R), the Functional Social Support Questionnaire (DUKE.UNC), the Zarit Burden Interview (ZBI) and questions relating to gender, age and the amount of time spent on daily caregiving.Results: Results indicated that objective burden and subjective burden were both high in these caregivers. Optimism mediated on psychological distress through social support and through subjective burden with a full mediation role. When comparisons between indirect effects were performed, optimism was the mediator with the greatest effect between objective burden and psychological distress.Conclusion: This study highlights the indirect role of optimism and the advantages that interventions in optimism training in the early stages of the person with AD could produce. Thus, alleviating subjective burden and increasing perceived social support, which would lead to an improvement in the mental health of family caregivers of people with AD.
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Affiliation(s)
- Amelia Díaz
- Faculty of Psychology, Department of Personality, Assessment and Psychological Treatments, University of Valencia, Valencia, Spain
| | - José M Ponsoda
- Faculty of Psychology, Department of Personality, Assessment and Psychological Treatments, University of Valencia, Valencia, Spain.,Association of Relatives and Friends of Alzheimer Disease Patients and Other Dependent Patients in Cocentaina Region, Alicante, Spain
| | - Angela Beleña
- Faculty of Psychology, Department of Personality, Assessment and Psychological Treatments, University of Valencia, Valencia, Spain
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21
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Epps F, Choe J, Alexander K, Brewster G. Designing Worship Services to Support African-American Persons Living with Dementia. JOURNAL OF RELIGION AND HEALTH 2020; 59:2163-2176. [PMID: 32020382 PMCID: PMC11194184 DOI: 10.1007/s10943-020-00993-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The church has played an integral role in the African-American community for a number of years. With the growth in population of African-American older adults living with dementia, it is critical for the church to understand how they can support these individuals in continuing their engagement in meaningful religious activities. The purpose of this qualitative descriptive study was to explore how to design or modify worship services to support African-Americans living with dementia. Interviews were conducted with church leaders, current and former caregivers, and service providers (n = 12). Analysis of their responses revealed worship services should include components in relation to the following categories: "simplicity," "support," "imagery and sound," and "music." Although participants held different views on the delivery of worship services for persons living with dementia, interview results provided key elements on how worship services can be meaningful and supportive of African-Americans living with dementia.
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Affiliation(s)
- Fayron Epps
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Office 238, Atlanta, GA, 30322, USA.
| | - Jenny Choe
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Office 238, Atlanta, GA, 30322, USA
| | - Karah Alexander
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Office 238, Atlanta, GA, 30322, USA
| | - Glenna Brewster
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Office 238, Atlanta, GA, 30322, USA
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22
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Kevern P, Stifoss-Hanssen H. The challenges of dementia care and the (un)making of meaning: Analysis of an online forum on carer spirituality. DEMENTIA 2020; 19:1220-1236. [PMID: 30170499 DOI: 10.1177/1471301218797248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although one writer has called dementia ‘the theological disease’, there has been remarkably little research on how people with dementia and their carers find spiritual meaning and significance in their experience. While there is a significant body of literature examining the role of existing spiritual or religious beliefs and practices in supporting the carer of a person with dementia, there is very little research which offers an insight into the reverse process: how the experience of caring challenges a carer’s sources of spiritual or religious meaning, and what strategies are adopted to resolve the experienced tension between belief and experience. The present study aimed to supplement this incomplete picture by examining the archive of an online forum responding to a request for ‘thoughts which lend a spiritual perspective to going through dementia’. Interpretative Phenomenal Analysis (IPA) was undertaken on two levels. First, attention was focussed on the forum as an integrated discussion, identifying its recurrent and superordinate themes. The contributions of selected individual participants were then analysed to further examine the way in which their positions were developed. The analysis uncovered the importance which at least some carers of people with dementia attached to spiritual perspectives, as supplying strength for and meaning to the challenges they faced; but also how meaning was undermined by their experience. Few participants identified with traditional religious resources, but attempted to find meaning by reflection on their personal narrative. Six distinct types of response to the initial question were identified. These findings indicate that the wellbeing and resilience of at least some carers may benefit from validation of their spiritual concerns along with sensitive and attentive spiritual support. In this task, a key resource is their reflection on their personal narrative in relation to current challenges.
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23
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Unson C, Flynn D, Chukwurah Q, Glendon MA, Testut T. Uncertainty in Transition of African American Caregivers. Issues Ment Health Nurs 2020; 41:445-454. [PMID: 32186923 DOI: 10.1080/01612840.2019.1678080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to gain an understanding of the ambiguities and uncertainties experienced by a diverse group of African-American caregivers. The study applied Schlossberg's transition theory (TT) and Mishel's revised uncertainty theory to narratives of self-identified African-American caregivers who provided care at least 5 h a week. The men (6) and women (8) were mostly unmarried, mostly caring for a parent or grandparent. The caregivers' average age was 52 (SD = 19; ages ranged from 24 to 82 years); and the care recipients' average age was 84 (SD = 9). Six care recipients had dementia and the remainder had multiple disease diagnoses. Narratives were obtained by in-depth interviews or focus group discussions. These were audio-recorded, transcribed verbatim professionally and analyzed independently by trained coders. Schlossberg's TT contextualized whereas Mishel's RUIT illuminated the characteristics of the transition, its associated uncertainty, and their relationship to the development of caregiver stress. Situational factors such as difficulties with illness symptoms of the care recipient, conflict between previous experience and current expectations and the adjustments to the new caregiving role, burdened younger caregivers more than older caregivers. Self-factors related to lack of knowledge about the illness and feelings of lack of control. Social support was predominantly provided by family members, and its absence resulted in conflict among siblings and caregiver stress. The most common coping strategies include religiosity, expectations of reciprocity, and coming to terms with the uncertainty. Understanding the feelings, perceptions and needs of caregivers in transition is tantamount to providing nursing care.
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Affiliation(s)
- Christine Unson
- Department of Public Health, Southern Connecticut State University, New Haven, Connecticut, USA
| | - Deborah Flynn
- Department of Public Health, Southern Connecticut State University, New Haven, Connecticut, USA
| | | | - Mary Anne Glendon
- Department of Nursing, Southern Connecticut State University, New Haven, Connecticut, USA
| | - Tammy Testut
- Sacred Heart University, College of Nursing, Fairfield, Connecticut, USA
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24
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Hansen BR, Hodgson NA, Budhathoki C, Gitlin LN. Caregiver Reactions to Aggressive Behaviors in Persons With Dementia in a Diverse, Community-Dwelling Sample. J Appl Gerontol 2020; 39:50-61. [PMID: 29457520 PMCID: PMC5824433 DOI: 10.1177/0733464818756999] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: To describe caregiver challenges with and confidence managing three aggressive behavior types in persons with dementia: verbal aggression, destroying property, and threatening to hurt others. Design and Method: Secondary analysis of baseline data from the 2001-2004 Resources for Enhancing Alzheimer's Caregiver Health II (REACH II) initiative. Results: One or more aggressive behaviors within 1 week were reported by more than a third of caregivers, with most expressing upset but fewer expressing confidence managing the behaviors. Caregiver distress and confidence differed by race/ethnicity in response to verbal aggression, with more White/Caucasian caregivers expressing upset than Hispanic/Latinos or Black/African Americans. Fewer Hispanic/Latinos expressed confidence managing verbal aggression, compared with White/Caucasians or Black/African Americans. Discussion: Aggressive behaviors challenge caregivers, with reactions varying by behavior type and race/ethnicity. Cultural and contextual factors suggest the need to tailor interventions, especially skill-building interventions that increase confidence managing aggressive behaviors while decreasing upset.
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Affiliation(s)
- Bryan R. Hansen
- Assistant Professor, Johns Hopkins School of Nursing, 525 North Wolfe Street, Baltimore, Maryland 21205, Office: 410-614-4820
| | - Nancy A. Hodgson
- Associate Professor, University of Pennsylvania School of Nursing
| | | | - Laura N. Gitlin
- Distinguished Professor, Director, Center for Innovative Care in Aging, Johns Hopkins School of Nursing
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25
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Fields NL, Xu L, Richardson VE, Parekh R, Ivey D, Calhoun M. Utilizing the Senior Companion Program as a platform for a culturally informed caregiver intervention: Results from a mixed methods pilot study. DEMENTIA 2019; 20:161-187. [PMID: 31488021 DOI: 10.1177/1471301219871192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
To address the need for accessible, affordable, and sustainable Alzheimer's disease and related dementia caregiver interventions with minority populations, we developed the Senior Companion Program Plus, a three-phase pilot study that used a mixed methods experimental design. The intent was to determine if participation in a lay provider, peer-led psychoeducational intervention designed for African American Alzheimer's disease and related dementia caregivers (N = 16) improved caregiver burden and/or stress, coping skills, and social support. Focus groups with Senior Companions informed the intervention design. Quantitative results indicated that caregivers experienced improvement in their overall level of social support and well-being in meeting basic needs. Qualitative findings suggested that caregivers experienced improvement in their knowledge about the disease, experienced increased coping with Alzheimer's disease and related dementia caregiving, and reported benefits of using a lay provider model. Overall, the data suggest that the Senior Companion Program Plus is a promising intervention for African American Alzheimer's disease and related dementia caregivers.
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Affiliation(s)
| | - Ling Xu
- The University of Texas at Arlington, TX, USA
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26
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del-Pino-Casado R, Rodríguez Cardosa M, López-Martínez C, Orgeta V. The association between subjective caregiver burden and depressive symptoms in carers of older relatives: A systematic review and meta-analysis. PLoS One 2019; 14:e0217648. [PMID: 31141556 PMCID: PMC6541277 DOI: 10.1371/journal.pone.0217648] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 05/15/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Family carers are an important source of care for older people. Although several studies have reported that subjective caregiver burden is related to depressive symptoms there are no systematic reviews quantifying this association. OBJECTIVE To establish the extent to which subjective caregiver burden is associated with depressive symptoms and whether this association would vary by study or care characteristics. METHODS We searched major databases such as PubMed, CINAHL, PsycINFO, Scopus and ISI Proceedings up to March 2018, and conducted a meta-analysis of included studies. Summary estimates of the association were obtained using a random-effects model to improve generalisation of findings. RESULTS After screening of 4,688 articles, 55 studies were included providing a total of 56 independent comparisons with a total of 9,847 carers from data across 20 countries. There was a large, positive association between subjective caregiver burden and depressive symptoms ([Formula: see text] = 0.514; 95% CI = 0.486, 0.541), with very low heterogeneity amongst individual studies (I2 = 8.6%). Sensitivity analyses showed no differences between cross-sectional or repeated measures ([Formula: see text] = 0.521; 95% CI = 0.491, 0.550; 51 samples) and longitudinal studies ([Formula: see text] = 0.454; 95% CI = 0.398, 0.508; 6 samples). We found a higher effect size for those caring for people living with dementia compared to those caring for frail older people, and stroke survivors. Carer sex, age and kinship did not change the estimate of the effect. CONCLUSIONS Subjective caregiver burden is a significant risk factor for depressive symptoms in carers of older people and may precipitate clinical depression. Those caring for people with dementia experience greater burden. There is a need for longitudinal evaluations examining the effects of potential mediators of the association of subjective burden and depressive symptoms. Future interventions should test whether minimizing subjective burden may modify the risk of developing depression in carers of older relatives.
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Affiliation(s)
| | | | | | - Vasiliki Orgeta
- Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
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27
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Fields NL, Xu L, Miller VJ. Caregiver Burden and Desire for Institutional Placement-The Roles of Positive Aspects of Caregiving and Religious Coping. Am J Alzheimers Dis Other Demen 2019; 34:199-207. [PMID: 30700106 PMCID: PMC10852480 DOI: 10.1177/1533317519826217] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
Based on stress coping theory, this study investigated whether and how positive aspects of caregiving (PAC) and religiosity buffered the association between caregiving burden and desire to institutionalize (DTI). Secondary data (N = 637) were drawn from the baseline assessment of the Resources for Enhancing Alzheimer's Caregiver Health II project. Descriptive analysis, bivariate correlation, and multiple linear regressions were conducted. The results indicated that higher levels of caregiver burden, daily care bother, and Revised Memory and Behavioral Problem Checklist bother were all significantly associated with higher level of DTI. Both PAC and religious coping were negatively associated with DTI; however, only PAC was significant. Only the interaction between daily care bother and religious coping was significant, which indicated that the harmful effect of daily care bother on DTI was significantly buffered among those who have religiosity. Study findings have important implications for policy makers and for providers who serve dementia family caregivers.
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Affiliation(s)
- Noelle L. Fields
- The University of Texas at Arlington, School of Social Work, Arlington, TX, USA
| | - Ling Xu
- The University of Texas at Arlington, School of Social Work, Arlington, TX, USA
| | - Vivian J. Miller
- The University of Texas at Arlington, School of Social Work, Arlington, TX, USA
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28
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Rote SM, Angel JL, Moon H, Markides K. Caregiving Across Diverse Populations: New Evidence From the National Study of Caregiving and Hispanic EPESE. Innov Aging 2019; 3:igz033. [PMID: 31517066 PMCID: PMC6733633 DOI: 10.1093/geroni/igz033] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The current study employs population-based data to determine the extent to which stress and coping factors are related to self-rated health and distress for informal caregivers (CGs) from the 3 largest racial/ethnic groups in the United States (non-Latino White, African American, and Mexican American). RESEARCH DESIGN AND METHODS Data on primary, informal CGs are obtained from the 2015 National Study of Caregiving (NSOC) (n = 667) and the 2016 Hispanic Established Populations for the Epidemiologic Studies of the Elderly (H-EPESE) CG supplement (n = 287). Logistic regression models of health are presented for all CGs and specifically for dementia CGs. RESULTS Caregiving intensity is related to health for non-Latino White CGs and African American dementia CGs. Support from family and friends is related to better self-rated health, but only for African American dementia CGs. While better relationship quality is related to better health for African American CGs and White dementia CGs, formal support utilization is related to worse CG health for Mexican American dementia CGs. DISCUSSION AND IMPLICATIONS Findings emphasize the importance of earlier detection and intervention with CGs at the beginning in the caregiving career, the interplay of formal and informal support, and appropriate ways to intervene with dementia CGs. Culturally tailored home- and community-based care options are needed to supplement the low levels of CG support, especially for the Mexican American population.
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Affiliation(s)
- Sunshine M Rote
- Kent School of Social Work, University of Louisville, Kentucky
| | - Jacqueline L Angel
- School of Public Affairs and Department of Sociology, The University of Texas at Austin, Galveston
| | - Heehyul Moon
- Kent School of Social Work, University of Louisville, Kentucky
| | - Kyriakos Markides
- Preventive Medicine & Community Health, University of Texas Medical Branch, Galveston
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Epps F, Brewster G, Alexander K, Choe J, Heidbreder V, Hepburn K. Dementia-friendly faith village worship services to support African American families: Research protocol. Res Nurs Health 2019; 42:189-197. [PMID: 30892713 DOI: 10.1002/nur.21940] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/02/2019] [Accepted: 02/20/2019] [Indexed: 11/05/2022]
Abstract
African American caregivers for persons living with dementia frequently experience emotional strain, burden, social isolation, and depression. One source of support for them when in distress is their church community. However, many African American churches do not have programs to support families and congregants living with dementia. Dementia often restricts persons living with dementia and their caregivers from attending church. Both become increasingly uncomfortable in church settings due to fear of embarrassment, uncertainty about the behavior of the person living with dementia, and shame. Church attendance and religion has been shown to be beneficial for caregivers and elders living with dementia. However, there is little work exploring how involvement in religious practices together (caregivers and persons living with dementia) might enhance the quality of life for these families. This protocol is written to detail the designing and testing of the feasibility and preliminary efficacy of a dementia-friendly faith village worship service. In the study, we will examine how dementia-friendly faith village worship services support the well-being of caregivers and care recipients in three African American churches through observation, interviews, and surveys. A sample of 30 dyads of African American caregivers and persons living with dementia will be asked to attend six modified worship services together over 6 months. In this study, we hope to demonstrate the significant role of churches in the lives of African American family caregivers and persons living with dementia and show that a faith-based, family-oriented approach can promote a greater quality of life for African American families living with dementia.
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Affiliation(s)
- Fayron Epps
- Byrdine F. Lewis College of Nursing & Health Professions, Georgia State University, Atlanta, Georgia
| | - Glenna Brewster
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | - Karah Alexander
- School of Public Health, Georgia State University, Atlanta, Georgia
| | - Jenny Choe
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | | | - Kenneth Hepburn
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
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McLennon SM, Anderson JG, Epps F, Rose KM. "It's just part of life": African American daughters caring for parents with dementia. J Women Aging 2018; 32:168-182. [PMID: 30457489 DOI: 10.1080/08952841.2018.1547002] [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: 10/27/2022]
Abstract
The purpose of this study was to gain a greater understanding of the experiences of African American daughters caring for parents with Alzheimer's disease or a related dementia (ADRD). In this secondary analysis of a subset (N = 12) of the sample from a previous study, daughters averaged 54 years of age and were caring for parents with moderate to severe ADRD. Results revealed two main categories: Caregiver Concerns and Caregiver Coping. Subcategories included challenging behaviors, social aspects, integration, and family culture and values. Findings offer insight into cultural factors relevant to practice along with research recommendations.
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Affiliation(s)
- Susan M McLennon
- College of Nursing, University of Tennessee, Knoxville, Tennessee, USA
| | - Joel G Anderson
- College of Nursing, University of Tennessee, Knoxville, Tennessee, USA
| | - Fayron Epps
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, Georgia, USA
| | - Karen M Rose
- College of Nursing, University of Tennessee, Knoxville, Tennessee, USA
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Skirbekk V, Potancoková M, Hackett C, Stonawski M. Religious Affiliation Among Older Age Groups Worldwide: Estimates for 2010 and Projections Until 2050. J Gerontol B Psychol Sci Soc Sci 2018; 73:1439-1445. [PMID: 28329786 DOI: 10.1093/geronb/gbw144] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 10/11/2016] [Indexed: 11/14/2022] Open
Abstract
Objectives The religious landscape of older adults around the world is changing profoundly. Yet until now, no study has chronicled these changes or compared expected aging patterns of religious groups. Differential aging among religious groups can have important economic and social consequences. This study estimates and projects the future religious composition by age at the global and regional levels. Method This study presents estimates of age structures by religion for 2010 and projections until 2050. It is based on analyses of more than 2,500 censuses, registers, and surveys from 198 countries. Regional and global results are the aggregate of demographic projections carried out at the country level. Results In 2010, Muslims were least likely to be aged 60 or older (7% of all Muslims), and Jews were most likely to be in this age group (20% of all Jews). By 2050, we project that Buddhists and the religiously unaffiliated will have the oldest populations (both will have 32% above the age of 60), whereas Muslims will remain the youngest religious group (with only 16% above the age of 60). Christians will, globally, age relatively slowly, from 14% to 21% above the age of 60 from 2010 to 2050. Discussion The religious landscape among the world's seniors will change fundamentally in the coming years, due to the combination of rapid aging among the religiously unaffiliated and Buddhist populations and the persistence of relatively young age structures among Muslims and Christians, which are the dominant religions in Africa.
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Affiliation(s)
- Vegard Skirbekk
- Columbia Aging Centre, Columbia University, New York.,Norwegian Institute of Public Health, Oslo, Norway
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Abstract
The growing elderly population is creating record numbers of individuals with Alzheimer's disease (AD) and other dementias. Nursing has an unprecedented opportunity to rethink how we care for adults with dementia, reduce the burden of caregivers, and preserve the personhood of patients. This article reviews AD and dementia pathophysiology, history, screening, stigma, treatments and interventions, and caregiver support. A nurse's journey with her mother with AD imparts the meaning of patient dignity.
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Hendricks-Lalla A, Pretorius C. The male familial caregiver experience of caring for persons with Alzheimer's disease from low socio-economic status: A South African perspective. DEMENTIA 2018; 19:618-639. [PMID: 29909650 DOI: 10.1177/1471301218781372] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The aim of this study was to explore the experiences of male familial caregivers of persons with Alzheimer’s disease from low socio-economic status using the ecological systems theory perspective. The data were obtained from 11 semi-structured interviews that were conducted with the familial caregivers of persons with Alzheimer’s disease. Data were analyzed using thematic analysis, where four main themes emerged, namely, relationship difficulties, understanding Alzheimer’s disease, support networks, and finding meaning and satisfaction in the caregiving role. Behavioral problems, erosion of the relationship with the significant other, familial conflict, experience of diagnosis, lack of information, lack of free time, and financial concerns were identified challenges facing caregivers. Provision of information, support groups, social support, community-based support, and finding meaning and satisfaction in the caregiving role were reported as resources that assist in caregiver coping. Men seem to be capable of providing effective care and are able to successfully manage in their caregiving role. Culture seems to play a significant role in help-seeking behavior and the approach to caregiving. The findings provide the basis for the specific needs of male caregivers that should be focused on in order to provide culturally appropriate services to enhance caregiver coping amongst male caregivers in similar settings.
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Affiliation(s)
- Abeedah Hendricks-Lalla
- Department of Psychology, Stellenbosch University, South Africa.,Department of Psychology, Stellenbosch University, South Africa
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Hansen BR, Hodgson NA, Gitlin LN. African-American caregivers' perspectives on aggressive behaviors in dementia. DEMENTIA 2018; 18:3036-3058. [PMID: 29578357 DOI: 10.1177/1471301218765946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Purpose Although African-American dementia caregivers report less upset and more confidence managing aggressive behaviors when compared to whites, their contextual experience remains unclear and this study explores that context. Methods Semi-structured interviews with 13 African-American family caregivers were analyzed using content analysis. Results Two themes emerged, “It’s the disease…not the person” and “You got to pick your battles.” “It’s the disease…not the person,” reframing aggressive behavior, included three sub-themes. Sometimes the person with dementia seemed like a stranger but caregivers remembered “In there somewhere is that person.” Aggressive behavior made this perspective difficult as they reported, “Sometimes it’s hard not to take it personal.” Premorbid dyadic conflict made caregiving difficult but caregivers remembered they were “Not who they were then.” “You got to pick your battles,” reflecting cognitive and behavioral strategies, also included three sub-themes. Participants prioritized caregiving over other commitments by reminding themselves “I got to do what I gotta do.” Preventing aggressive behaviors was most successful when “We didn’t argue…we didn’t insist” and caregivers remembered “Don’t put her in a position to fail” when involving the person with dementia in activities. Implications African-American caregivers described substantial challenges when confronted by aggressive behaviors. Strategies employed by caregivers enabled them to maintain a caring perspective and the person with dementia to maintain calm. Interventions that help caregivers manage aggressive behaviors may benefit by considering the challenges, cultural values, and effective strategies used by African-Americans.
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Affiliation(s)
| | - Nancy A Hodgson
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Laura N Gitlin
- College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
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Ejem D, Bauldry S, Bakitas M, Drentea P. Caregiver Burden, Care Recipient Depressive Symptomology, and Social Exchange: Does Race Matter? J Palliat Care 2018. [PMID: 29514553 DOI: 10.1177/0825859718758120] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Informal caregivers play a vital role in supporting seriously ill patients. However, informal caregiving is burdensome and can lead to negative health outcomes for the caregiver and the care recipient. The study's aim was to evaluate relationships among caregiver burden, care recipient depressive symptomology, and race. Guided by the social exchange perspective, we examined cross-sectional dyadic data from the National Long-Term Care Survey (N = 1279). Using ordinal logistic regression, we found that higher caregiver-reported objective burden was associated with higher care recipient depressive symptoms ( P < .05), an association that was stronger for blacks. Interestingly, despite significant levels of objective burden, there was an association between lower depressive symptoms in black care recipients when there was an exchange of the social good "helpful company" with a caregiver. These findings illustrate the importance of supporting reciprocal exchange as a promising component of maintaining balanced caregiver-care recipient relationships among black older adults and their informal caregivers.
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Affiliation(s)
- Deborah Ejem
- 1 School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Shawn Bauldry
- 2 Department of Sociology, Purdue University, West Lafayette, IN, USA
| | - Marie Bakitas
- 1 School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.,3 Department of Medicine, Division of Geriatrics, Gerontology, and Palliative Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Patricia Drentea
- 4 Department of Sociology, University of Alabama at Birmingham, Birmingham, AL, USA
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Yoon KH, Moon YS, Lee Y, Choi SH, Moon SY, Seo SW, Park KW, Ku BD, Han HJ, Park KH, Han SH, Kim EJ, Lee JH, Park SA, Shim YS, Kim JH, Hong CH, Na DL, Ye BS, Kim HJ, Moon Y, Lee SS, Kim DH. The moderating effect of religiosity on caregiving burden and depressive symptoms in caregivers of patients with dementia. Aging Ment Health 2018; 22:141-147. [PMID: 27661263 DOI: 10.1080/13607863.2016.1232366] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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 explored whether religiosity/spirituality has a protective role against negative caregiving outcomes, in a large multicenter nationwide sample of caregivers of patients with dementia in South Korea. Additionally, this study was the first to examine whether religiosity/spirituality could affect caregiving outcomes according to the various religious affiliations of caregivers. METHODS The study was conducted on a sample of 476 caregivers of patients with dementia participated in the Clinical Research Center for Dementia of South Korea (CREDOS). We examined the moderating effect of each of the three dimensions of religiosity/spirituality (organizational religious activity, ORA; non-organizational religious activity, NORA; intrinsic religiosity, IR) on the relationship between activities of daily living (ADL) of patients with dementia and caregiving burden and depressive symptoms of caregivers, using a series of hierarchical regression analyses. In addition, these analyses were conducted according to the religious affiliations of the caregivers. RESULTS ORA, NORA, and IR of religiosity/spirituality alleviated the effect of ADL of patients on caregiving burden. ORA and IR moderated the relationship between ADL of patients and depressive symptoms of caregivers. These moderating effects of religiosity on caregiving outcomes were different according to various religious groups. CONCLUSION We have identified religiosity/spirituality as a protective factor for caregivers of patients with dementia. The sub-dimensions of religiosity as moderators were different by religious affiliations of caregivers. Further studies are needed to investigate the specific religiosity-related factors which could positively impact the mental health of the caregivers of patients with dementia by religions.
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Affiliation(s)
- Kyung Hee Yoon
- a Department of Psychiatry, Chuncheon Sacred Heart Hospital , Hallym University College of Medicine , Chuncheon , South Korea.,b Institute for Skeletal Aging, Chuncheon Sacred Heart Hospital , Hallym University College of Medicine , Chuncheon , South Korea
| | - Yoo Sun Moon
- a Department of Psychiatry, Chuncheon Sacred Heart Hospital , Hallym University College of Medicine , Chuncheon , South Korea.,b Institute for Skeletal Aging, Chuncheon Sacred Heart Hospital , Hallym University College of Medicine , Chuncheon , South Korea
| | - Yunhwan Lee
- c Department of Preventive Medicine and Public Health , Ajou University School of Medicine , Suwon , South Korea.,d Institute on Aging , Ajou University Medical Center , Suwon , South Korea
| | - Seong Hye Choi
- e Department of Neurology , Inha University School of Medicine , Incheon , South Korea
| | - So Young Moon
- d Institute on Aging , Ajou University Medical Center , Suwon , South Korea.,f Department of Neurology , Ajou University School of Medicine , South Korea
| | - Sang Won Seo
- g Department of Neurology, Samsung Medical Center , Sungkyunkwan University School of Medicine , Seoul , South Korea.,h Neuroscience Center, Samsung Medical Center , Seoul , South Korea.,i Department of Clinical Research Design and Evaluation , SAIHST, Sungkyunkwan University , Seoul , South Korea
| | - Kyung Won Park
- j Department of Neurology , Dong-A University College of Medicine , Pusan , South Korea
| | - Bon D Ku
- k Department of Neurology , Catholic Kwandong University College of Medicine , Gangneung , South Korea
| | - Hyun Jeong Han
- l Department of Neurology , Myongji Hospital , Goyang , South Korea
| | - Kee Hyung Park
- m Department of Neurology , Gachon University Gil Medical Center , Incheon , South Korea
| | - Seol-Heui Han
- n Department of Neurology , Konkuk University College of Medicine , Seoul , South Korea
| | - Eun-Joo Kim
- o Department of Neurology , Pusan National University School of Medicine , Pusan , South Korea
| | - Jae-Hong Lee
- p Department of Neurology , University of Ulsan College of Medicine, Asan Medical Center , Seoul , South Korea
| | - Sun A Park
- q Department of Neurology , Soonchunhyang University Bucheon Hospital, College of Medicine , Bucheon , South Korea
| | - Yong S Shim
- r Department of Neurology , Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea , Bucheon , South Korea
| | - Jong Hun Kim
- s Department of Neurology , Ilsan Hospital, National Health Insurance Service , Goyang , South Korea
| | - Chang Hyung Hong
- d Institute on Aging , Ajou University Medical Center , Suwon , South Korea.,t Department of Psychiatry , Ajou University School of Medicine , Suwon , South Korea
| | - Duk L Na
- g Department of Neurology, Samsung Medical Center , Sungkyunkwan University School of Medicine , Seoul , South Korea.,h Neuroscience Center, Samsung Medical Center , Seoul , South Korea.,i Department of Clinical Research Design and Evaluation , SAIHST, Sungkyunkwan University , Seoul , South Korea
| | - Byoung Seok Ye
- u Department of Neurology , Yonsei University College of Medicine , Seoul , South Korea
| | - Hee Jin Kim
- g Department of Neurology, Samsung Medical Center , Sungkyunkwan University School of Medicine , Seoul , South Korea.,h Neuroscience Center, Samsung Medical Center , Seoul , South Korea.,i Department of Clinical Research Design and Evaluation , SAIHST, Sungkyunkwan University , Seoul , South Korea
| | - Yeonsil Moon
- n Department of Neurology , Konkuk University College of Medicine , Seoul , South Korea
| | - Sang Soo Lee
- b Institute for Skeletal Aging, Chuncheon Sacred Heart Hospital , Hallym University College of Medicine , Chuncheon , South Korea
| | - Do Hoon Kim
- a Department of Psychiatry, Chuncheon Sacred Heart Hospital , Hallym University College of Medicine , Chuncheon , South Korea
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Spiritual/religious coping and depressive symptoms in informal caregivers of hospitalized older adults. Geriatr Nurs 2018; 39:48-53. [DOI: 10.1016/j.gerinurse.2017.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 05/30/2017] [Accepted: 06/02/2017] [Indexed: 12/13/2022]
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Richardson VE, Fields N, Won S, Bradley E, Gibson A, Rivera G, Holmes SD. At the intersection of culture: Ethnically diverse dementia caregivers' service use. DEMENTIA 2017; 18:1790-1809. [PMID: 29254375 DOI: 10.1177/1471301217721304] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This study used an ethnocultural approach to explore how cultural factors influenced ethnically diverse dementia caregivers’ experiences and use of services. A modified thematic analysis of in-depth interviews with 15 caregivers, ranging in age from 50 to 75 years, including spouses, daughters, sons, cousins, and a friend, from three minority groups—African American, Hispanic, and South Korean caregivers—was conducted by a team of multi-lingual researchers. Caregiver stress was pervasive across all subgroups. Several themes emerged that were qualitatively different across groups, including knowledge about dementia, language barriers, religion and spirituality, and cultural differences in attitudes about caring and formal services. A two-pronged intervention model that includes a generic intervention to reduce caregiver stress along with a culturally targeted intervention tailored to a family’s language, food preferences, religious practices, gender norms, and other values was recommended to more successfully reach and support these caregivers.
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Even-Zohar A. The Contribution of a "Supportive Community" Program for Older Persons in Israel to Their Offspring Who Are Primary Caregivers. Curr Gerontol Geriatr Res 2015; 2015:914543. [PMID: 26346881 PMCID: PMC4546745 DOI: 10.1155/2015/914543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 07/07/2015] [Accepted: 07/15/2015] [Indexed: 11/23/2022] Open
Abstract
The "supportive community" programs in Israel provide a basket of services for older persons living in their own homes. This study examined the differences between caregiver burden and quality of life of 55 offspring who were the primary caregivers of their older parents who were members of a supportive community, compared to 64 offspring whose parents were nonmembers. The findings showed that the role stress factor of caregiving burden was lower, and the psychological health domain of quality of life was higher among offspring whose parents were members of supportive communities. Some of the predictor variables of burden were income status of caregiver, sharing with others in caregiving, and membership of the parent in a supportive community. The primary predictor variable of the quality of life was caregiving burden. The practical conclusion of this study is to further develop and market supportive community programs in various communities.
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Affiliation(s)
- Ahuva Even-Zohar
- School of Social Work, Faculty of Social Sciences, Ariel University, 40700 Ariel, Israel
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Unson C, Flynn D, Glendon MA, Haymes E, Sancho D. Dementia and Caregiver Stress: An Application of the Reconceptualized Uncertainty in Illness Theory. Issues Ment Health Nurs 2015; 36:439-46. [PMID: 26241570 DOI: 10.3109/01612840.2014.993052] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The Reconceptualized Uncertainty in Illness Theory (RUIT) was used to investigate antecedents to, appraisals of, and ways of coping with stressful caregiving. Four focus groups with caregivers (8 males and 16 females) of relatives with dementia were conducted; 15 cared for their parents and the remainder cared for their spouses. They were recruited from an adult care center and other community settings in a metropolitan area in New England. The discussions were audiotaped and transcribed verbatim. Two researchers independently coded the transcripts. Thematic analysis was structured according to the RUIT. The study is unique in its application to caregivers as opposed to patients and to all of the elements of the RUIT. Caregivers experience uncertainty in similar ways to patients with life-altering illness. Symptom severity--lack of personal boundaries, repetitive and aggressive behaviors, and the need for constant care--was the most frequent source of stress. The appraisals were mostly negative and included feelings of resentment, a lack of support from family members, financial strains, and loss of freedom. Self-improvement and self-care were important aspects of coping. Spirituality and humor were other coping skills that respondents used. Not all respondents said they were coping and some also reported that support from health care providers was not always helpful. Nurses can help improve coping by explaining the factors that contribute to caregiver strain and uncertainty, and by assisting caregivers to anticipate the effects of the caregiving role.
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Affiliation(s)
- Christine Unson
- Southern Connecticut State University, Department of Public Health , New Haven, Connecticut , USA
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Rathier LA, Davis JD, Papandonatos GD, Grover C, Tremont G. Religious Coping in Caregivers of Family Members With Dementia. J Appl Gerontol 2013; 34:977-1000. [DOI: 10.1177/0733464813510602] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Accepted: 10/06/2013] [Indexed: 11/15/2022] Open
Abstract
The degree of depression experienced by caregivers of individuals with dementia was examined in relation to religious coping strategies, religious practice, and spirituality in the framework of the stress and coping model. Caregivers of 191 persons with dementia completed the Religious Coping Scale, self-report measures of religious practices and spirituality, burden, and depression. There was no evidence that any religious coping strategy or religious practice moderated the relationship between caregiving stress and depression. Certain types of religious coping strategies had a direct effect on depression. Higher levels of religious coping working with God were associated with decreased depression, whereas higher levels of religious coping working through God were associated with increased depression. Higher burden, lower overall caregiver health rating, and worse reactions to memory and behavior problems were associated with higher levels of depression. Frequency of prayer and the importance of spirituality were weakly associated with lower levels of depression.
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Affiliation(s)
- Lucille A. Rathier
- The Miriam Hospital, Providence, RI, USA
- Brown University, Providence, RI, USA
| | | | | | | | - Geoffrey Tremont
- Brown University, Providence, RI, USA
- Rhode Island Hospital, Providence, USA
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