"Being in-Between": Spouses That Cohabit With and Provide Care for Their Partners in Nursing Homes

The social process of involuntary separation and the search for connection

Placing a loved one in care does not relieve informal caregivers' physical and emotional stresses. This study identified the unique psycho-social-spiritual processes of involuntary separation among spouses following long-term care admission. Participants were 17 spouse-caregivers (12 women and 5 men) with a mean age of 84 years who had been involuntarily separated for an average of 20 months. The basic psycho-social-spiritual process of spouse-caregiver involuntary separation was connecting in disconnection, which had three distinct stages: (1) Initial coping, (2) Adjusting to the new situation, and (3) Moving forward. Movement through the three stages was influenced by individuals' capacity and willingness to reach out for connection and by the abilities of others to extend accurate empathy and practical help. The implications of this study highlight spouse-caregivers' needs for connection and support not only during the crisis of separation, but in the months and years that follow.

Lost in Transition: Community-Dwelling Partners' Stories of Losing a Spouse to Cognitive Decline and Long-Term Care Facilities

This qualitative narrative study presents three stories told by older community-dwelling partners to spouses moving into long-term care facilities because of cognitive decline. Applying Alvesson and Kärreman's mystery method to these stories reveals that when spouses' caring needs increase, care partners must take on increasing loads of practical work and responsibilities. These partners become lost in the transitions between care work, extended family, and attending to their couplehood. When their spouses move into long-term care, living apart presents new challenges of care and couplehood, each day presenting new and unforeseen tasks to manage. Our findings suggest that if couplehood is to be maintained, well-established habits and work division between the spousal partners are both drivers and barriers. It necessitates agency, creativity from the community-dwelling partner, as well as a supportive extended family and sufficient economic resources. More knowledge is required regarding the interdependent expectations between the next-of-kin, long-term care residents, and caregiving staff members.

Psychological Well-Being Among Informal Caregivers in the Canadian Longitudinal Study on Aging: Why the Location of Care Matters

Objectives

A caregiving stress perspective suggests that caregiving harms psychological well-being in informal caregivers, whereas a caregiving rewards perspective suggests that provision of care benefits psychological well-being. This research examines whether both perspectives apply to caregiving experiences, but differently by the primary location of caregiving (i.e., in-home, other residence, and institution), as well as by gender.

Methods

We analyzed depression and life satisfaction in the nationally representative Canadian Longitudinal Study on Aging (N = 48,648), first comparing noncaregivers (N = 27,699) to a combined caregiver group (N = 20,949) and then stratifying caregivers by the primary location of care.

Results

When considered as a single group, caregivers suffered relative to noncaregivers in terms of life satisfaction and depression. When stratified by the location of care, only in-home caregivers reported both greater depression and lower life satisfaction. Nonresidential caregivers did not differ significantly in levels of depression from noncaregivers and reported higher life satisfaction. Institutional caregivers reported greater depression than noncaregivers, but did not differ significantly in life satisfaction. These patterns were stronger among women than men.

Discussion

Both the caregiving stress and caregiving rewards perspectives are applicable to the caregiving experience, with the stress perspective more applicable to in-home caregivers and the rewards perspective more relevant to nonresidential caregivers. Recommendations include targeted practice focused on the location of care as well as the gender of the caregiver. Given that nonresidential caregivers actually benefit from providing care, interventions need to focus on identifying and bolstering positive aspects of the caregiving experience.