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Cha SE, Kim K, Lee S. Gendered Trends in Formal and Informal Care Utilization Among Older Adults in South Korea. J Aging Soc Policy 2024:1-16. [PMID: 38701195 DOI: 10.1080/08959420.2024.2349495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 04/10/2024] [Indexed: 05/05/2024]
Abstract
Drawing on data from two waves of the Korean Longitudinal Study of Ageing (2010 and 2018), this study examined how community-dwelling older men and women (65+) with functional limitations utilized formal and informal sources of care and how their patterns of care utilization changed over time. The usage patterns of formal and informal caregiving services were categorized into three groups: (a) informal help only, (b) formal-informal mix, and (c) no help from either. More men and women used both formal and informal help for their care needs in 2018 than in 2010 (15% compared to 7%). The proportion of older men who relied on informal help only remained similar across survey years, whereas a smaller proportion of older women relied on informal help only in 2018. Although formal care use has been expanded in South Korea, older men continue to utilize help from their families. However, for older women, the proportion who did not receive any help increased - despite an increase in formal care utilization. These findings highlight the importance of considering gendered resources in caregiving in Korea.
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Affiliation(s)
- Seung-Eun Cha
- Department of Child and Family Welfare, The University of Suwon, Hwaseong-si, Republic of Korea
| | - Kyungmin Kim
- Department of Child Development and Family Studies, Seoul National University, Seoul, Republic of Korea
| | - Seoyeon Lee
- Department of Home Economics Education, Chonnam National University, Gwangju, Republic of Korea
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Swinkels JC, van Tilburg TG, Broese van Groenou M. Why do spouses provide personal care? A study among care-receiving Dutch community-dwelling older adults. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e953-e961. [PMID: 34245192 PMCID: PMC9291597 DOI: 10.1111/hsc.13497] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 05/31/2021] [Accepted: 06/05/2021] [Indexed: 06/13/2023]
Abstract
This study investigates under what conditions older spouses receive personal care from their spouse. Whether spousal care is provided is determined by individual and societal factors related to informal and formal care provision. Individual factors concern the need for care (the care recipient's health status), the spouse's ability to provide care (the spouse's health status) and the quality of the marital bond. Societal factors reflect changing policies on long-term care (indicated by the year in which care started) and gender role socialisation (gender). From the Longitudinal Aging Study Amsterdam, which completed eight observations between 1996 and 2016, we selected 221 independently living married respondents, aged 59-93, who received personal care for the first time and had at least one previous measurement without care use. The results show that if an older adult received personal care, the likelihood of receiving that care from the spouse decreased over the years: from 80% in 1996 to 50% in 2016. A husband or wife was less likely to receive spousal care when the spouse was unable to provide care or the quality of the relationship was low. No gender differences were found in either the prevalence of spousal care use or in the factors associated with that use. Thus, individual factors and the societal context seem to determine whether one receives personal care from their spouse. The decline in the likelihood of personal care provision from a spouse over the years may indicate a crumbling of family solidarity, an unmeasured and growing inability of the older spouse to provide care or an increasing complexity of care needs that requires the use of formal care. As care-giving can be a chronic stressor and most spouses provide care without assistance from others, attention from policy makers is needed to sustain the well-being of older couples.
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Affiliation(s)
- Joukje C. Swinkels
- Department of SociologyFaculty of Social SciencesVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Theo G. van Tilburg
- Department of SociologyFaculty of Social SciencesVrije Universiteit AmsterdamAmsterdamthe Netherlands
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Jansen L, De Burghgraeve T, van den Akker M, Buntinx F, Schoenmakers B. Supporting an informal care group - Social contacts and communication as important aspects in the psychosocial well-being of informal caregivers of older patients in Belgium. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1514-1529. [PMID: 34288204 PMCID: PMC9292869 DOI: 10.1111/hsc.13482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 05/03/2021] [Accepted: 06/01/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Increasingly, informal caregivers in Belgium care in group for an older patient. This study aimed to decrease the caregiver burden and to increase the well-being of caregivers and patients by supporting the needs of informal care groups of older patients (≥70 years). METHOD Through an online self-management tool, the groups were supported to make informed choices concerning the care for the older patient, taking into account the standards, values, concerns and needs of every caregiver and patient. A pre-post study was performed. RESULTS Although patients and caregivers considered the self-management tool as useful and supportive, no clear evidence for decreased caregiver burden was found. There was a positive trend in group characteristics such as the distribution of tasks, communication and prevalence of conflicts. Caregivers also stated that they took more time for themselves, had less feelings of guilt and experienced less barriers to ask help. CONCLUSION Tailor-made support of informal care groups starts with facilitating and guiding a process to achieve consent within the group to optimise the care for the patient and also for the caregivers. With a shared vision and supported decisions, caregivers can enter into conversations with the professional caregiver to coordinate adjusted support regarding the care needs.
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Affiliation(s)
- Leontien Jansen
- Academic Center for General PracticeDepartment of Public Health and Primary CareKU LeuvenLeuvenBelgium
- Public Health PsychiatryDepartment of NeurosciencesKU LeuvenLeuvenBelgium
| | - Tine De Burghgraeve
- Academic Center for General PracticeDepartment of Public Health and Primary CareKU LeuvenLeuvenBelgium
| | - Marjan van den Akker
- Academic Center for General PracticeDepartment of Public Health and Primary CareKU LeuvenLeuvenBelgium
- Department of Family MedicineSchool CAPHRIMaastricht UniversityMaastrichtThe Netherlands
- Institute of General PracticeGoethe UniversityFrankfurt am MainGermany
| | - Frank Buntinx
- Academic Center for General PracticeDepartment of Public Health and Primary CareKU LeuvenLeuvenBelgium
- Department of Family MedicineSchool CAPHRIMaastricht UniversityMaastrichtThe Netherlands
| | - Birgitte Schoenmakers
- Academic Center for General PracticeDepartment of Public Health and Primary CareKU LeuvenLeuvenBelgium
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Rurka M, Jill Suitor J, Gilligan M. The Caregiver Identity in Context: Consequences of Identity Threat From Siblings. J Gerontol B Psychol Sci Soc Sci 2021; 76:1593-1604. [PMID: 32674158 PMCID: PMC8436691 DOI: 10.1093/geronb/gbaa099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Although siblings represent central members of the networks of caregivers and their parents, there has been limited attention to how siblings affect one another's well-being during caregiving. In this article, we draw from theories of identity and stress to examine the impact that siblings have on caregivers' psychological well-being. Specifically, we employ a mixed-methods approach to explore whether caregivers' perceptions that their siblings are critical of the care they provide their mother are associated with higher depressive symptoms and the mechanisms underlying this association. METHODS Using quantitative data collected from 404 caregivers nested within 231 families as part of the Within-Family Differences Study, we conduct mediation analyses to examine whether perceived sibling criticisms are associated with caregivers' depressive symptoms (a) directly and/or (b) indirectly through sibling tension. We then analyze qualitative data collected from the same caregivers to gain insight into the processes underlying statistical associations. RESULTS Quantitative analyses revealed that there was no direct relationship between perceived sibling criticisms and depressive symptoms; there was, however, an indirect relationship such that perceived sibling criticisms were associated with greater sibling tension, which in turn was associated with higher depressive symptoms. These quantitative findings were corroborated by qualitative analyses, which demonstrated that, in an effort to mitigate the negative impact of sibling criticisms, caregivers often employed strategies that may have fueled sibling tension. DISCUSSION These findings demonstrate how identity processes, as well as the family networks in which caregiving takes place, shape the experiences and consequences of parent care.
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Affiliation(s)
- Marissa Rurka
- Department of Sociology, Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana
| | - J Jill Suitor
- Department of Sociology, Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana
| | - Megan Gilligan
- Department of Human Development and Family Studies, Iowa State University, Ames
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Abstract
BACKGROUND Cancer is a family disease, affecting the individual patient and the family. For Chinese patients and their families in Canada, adjusting to cancer may be particularly distressing when culture and language are not congruent with the mainstream model of care delivery. OBJECTIVE In view of the limited research on the cancer experience of Chinese families, this study aims to examine the interrelatedness of patients and family caregivers' distress among a Chinese-speaking cancer population in Canada. METHODS Semi-structured interviews were conducted with a purposive sample of 10 Chinese-speaking cancer patients and 6 family caregivers. Qualitative analysis of the interview data was conducted to construct cross-cutting themes regarding the experiences of distress after a cancer diagnosis. RESULTS Four overarching themes emerged from the analysis: (1) misconception about cancer, (2) tensions in disclosure, (3) patient and family caregiver distress, and (4) concealing emotion in patient and family caregiver. Notably, the interrelatedness of patients and family caregivers' distress was highlighted, as patients and family caregivers both sought to regulate their own emotions to protect one another's mental well-being. CONCLUSION The study provides insights into the distress of living with cancer and the impact on family relationships. Understanding the patients and family members' cultural and social contexts also provides the foundation for patient- and family-centered care. IMPLICATIONS FOR PRACTICE Healthcare professionals can provide culturally appropriate care by recognizing the needs, values, and beliefs of cancer patients and their families. Furthermore, the patient-family-caregiver dyad needs to be considered as the unit of care.
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Resource and Strategic Mobilization Model (RSM) of Productive Aging: Examining Older Americans’ Participation in Various Productive Activities. AGEING INTERNATIONAL 2016. [DOI: 10.1007/s12126-016-9259-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Spouses often serve as the primary caregivers to their ill or disabled partners. Studies have shown that men receive more care from their wives than vice versa, but few studies have focused on how the gender gap in care varies across the later life course. Drawing on data from the Health and Retirement Study, this study examined the moderating effects of age, gender, and full-time employment on married women's and men's receipt of spousal care. This study found that among community-dwelling married adults, the gender gap in care was larger among those in middle age (50-65) than it was among those in older age. As women and men aged, the gender gap decreased primarily because men left full-time work and increased the amount of time that they spent caring for their wives. As gender differences in full-time employment narrowed, the gender gap in spousal care narrowed.
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Abstract
Despite evidence of increasing diversification of family structures, little is known regarding implications of marital and parental status for access to social support in later life. Using data from Statistics Canada's 2007 General Social Survey, this study assessed the impact of marital and parental status intersections on social support among adults aged 60 and older (n = 11,503). Two-stage probit regression models indicated that among those who were currently married or separated/divorced, childless individuals were more likely to report instrumental (domestic, transportation) and emotional support from people outside the household. Conversely, among never-married or widowed older adults, being childless was associated with reduced domestic support but without differences in other support domains. Findings suggest that marital and parental status intersections are not uniformly positive, neutral, or negative regarding implications for extra-household social support. Future work should address complexities of these relationships in order to better understand rapidly changing family structures.
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Dunkle RE, Ingersoll-Dayton B, Chadiha LA. Support for and From Aging Mothers Whose Adult Daughters are Seriously Mentally Ill. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2015; 58:590-612. [PMID: 26098686 DOI: 10.1080/01634372.2015.1054056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This article discusses, from the grandmother's perspective, the ways in which support is exchanged in families coping with serious mental illness. A strengths perspective was utilized to identify ways in which family members help each other. Employing a qualitative approach, this study focuses on interviews obtained from a sample of 22 aging mothers, aged 52-90, who are in contact with their daughters who have a mental illness. Grandmothers provided several kinds of support to their mentally ill adult daughters and to their grandchildren, who also supported the aging mother in numerous ways. As social workers seek to assist individuals with mental illness, it is important to assess the existing strengths of their intergenerational family context.
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Affiliation(s)
- Ruth E Dunkle
- a School of Social Work , University of Michigan , Ann Arbor , Michigan , USA
| | | | - Letha A Chadiha
- a School of Social Work , University of Michigan , Ann Arbor , Michigan , USA
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Mast ME. To Use or Not to Use: A Literature Review of Factors that Influence Family Caregivers’ Use of Support Services. J Gerontol Nurs 2013; 39:20-8; quiz 29. [DOI: 10.3928/00989134-20121107-02] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Noël-Miller CM. Partner caregiving in older cohabiting couples. J Gerontol B Psychol Sci Soc Sci 2011; 66:341-53. [PMID: 21482588 PMCID: PMC3078761 DOI: 10.1093/geronb/gbr027] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2010] [Accepted: 02/21/2011] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Despite the rapidly increasing prevalence of cohabitation among older adults, the caregiving literature has exclusively focused on formally married individuals. Extending prior work on intra-couple care, this study contrasts frail cohabitors' patterns of care receipt from a partner to that of frail spouses. METHODS Using nationally representative panel data from the Health and Retirement Study (2000, 2002, 2004, and 2006), we estimate random effects cross-sectional times series models predicting frail cohabitors' likelihood of receiving partner care compared with their married counterparts'. Conditional on the receipt of intra-couple care, we also examine differences in marital and nonmarital partners' caregiving hours and caregiving involvement relative to other helpers. RESULTS Net of sociodemographic, disability, and comorbidity factors, we find that cohabitors are less likely to receive partner care than married individuals. However, caregiving nonmarital partners provide as many hours of care as spouses while providing a substantially larger share of disabled respondents' care than marital partners. DISCUSSION Cohabitation and marriage have distinct implications for older adults' patterns of partner care receipt. This study adds weight to a growing body of research emphasizing the importance of accounting for older adults' nontraditional union forms and of examining the ramifications of cohabitation for older adults' well-being.
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Affiliation(s)
- Claire M Noël-Miller
- Center for Demography of Health and Aging, University of Wisconsin-Madison, 1180 Observatory Drive, Madison, WI 53706, USA.
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Chung J, Berkowicz DA, Ho B, Jernigan M, Chueh H. Creating a place for caregivers in personal health: the iHealthSpace copilot program and diabetes care. J Diabetes Sci Technol 2011; 5:39-46. [PMID: 21303623 PMCID: PMC3045238 DOI: 10.1177/193229681100500106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND As America's baby boom generation reaches retirement, the number of elders, and, in turn, the number of lay individuals who support them, will continue to increase. With the important services caregivers provide, it is critical that we recognize and provide assistance to the informal caregivers who play this important role in our society. The network of support provisioned by relatives, partners, friends, and neighbors suggests that the dyadic, unidirectional caregiver-care recipient relationship assumed by caregiver research so far and by resources deployed to assist caregivers may be insufficient to ascertain and meet the needs of the care community. METHODS In this article, we describe the extension of a Web-based personal health record system, iHealthSpace, for explicitly and openly incorporating caregivers into the care community. RESULTS Using this portal, a set of business rules was implemented to support the creation of custodial accounts. These business rules will be used to create modules that support diabetes care in an adult population. CONCLUSIONS We successfully extended an existing patient portal to accommodate the creation of custodial accounts. We will use this portal to assess the impact of custodial access in the care of older patients with diabetes.
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Affiliation(s)
- Jeanhee Chung
- Laboratory of Computer Science, Boston, Massachusetts 02114, USA.
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Feld S, Dunkle RE, Schroepfer T, Shen HW. Does Gender Moderate Factors Associated with Whether Spouses Are the Sole Providers of IADL Care to Their Partners? Res Aging 2010; 32:499-526. [PMID: 21818168 PMCID: PMC3148766 DOI: 10.1177/0164027510361461] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We explored whether gender moderated the influence of other factors on solo spousal caregiving. The subsample (N = 452) from the AHEAD study included elderly care recipients (CRs) receiving IADL assistance and their spouses. Logistic regression modeled the likelihood of solo spousal IADL care. Gender moderation was tested by product terms between CRs' gender and measures of partners' health, potential helpers, and sociodemographic characteristics. As numbers of CRs' IADLs and couples' proximate daughters increased, wives less often received care solely from their husbands, but husbands' receipt of care from their wives was unaffected. Age differences between spouses and CRs affected solo spousal caregiving to wives and husbands in opposite ways. Regardless of gender, CRs' number of ADL limitations and spouses with IADL or ADL limitations reduced the likelihood of solo spouse care. Identifying circumstances influencing solo spouse caregiving differently among couples with frail wives and husbands facilitates gender sensitive services.
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Noël-Miller C. Longitudinal changes in disabled husbands' and wives' receipt of care. THE GERONTOLOGIST 2010; 50:681-93. [PMID: 20382664 DOI: 10.1093/geront/gnq028] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
PURPOSE OF THE STUDY This study contrasts 2-year adjustments in disabled husbands' and wives' amount of received care following both worsening and recovery in personal (activities of daily living [ADLs]) and routine care (instrumental activities of daily living [IADLs]) disability. DESIGN AND METHODS Using longitudinal data on 789 husbands and 778 wives from the Health and Retirement Study (2000 and 2002), changes in marital partners' monthly hours of spousal and nonspousal care were jointly modeled using bivariate Tobit models. In addition, asymmetry in the magnitude of responses to worsening and improvement of function was examined. RESULTS Disabled husbands receive more hours of spousal and nonspousal care following worsening in ADL function than wives. Conversely, disabled wives lose more spousal and nonspousal care hours following improvements in ADL disability than husbands. Moreover, wives recovering in ADL function lose more hours of spousal care than they receive following worsening in personal care disability. There is no evidence of corresponding gender differences in the dynamics of assistance received following changes in IADL function. IMPLICATIONS Compared with husbands, disabled wives are disadvantaged in the adjustment of their personal care hours. Although disabled married community residents receive more hours of care than their unmarried counterparts, there are important gender differences in the advantages offered by marriage.
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Affiliation(s)
- Claire Noël-Miller
- Center for the Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI 53706, USA.
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Abstract
BACKGROUND In the literature on family caregiving, care receiving and caregiving are generally treated as distinct constructs, suggesting that informal care and support flow in a unidirectional manner from caregiver to care recipient. Yet, informal care dynamics are fundamentally relational and often reciprocal, and caregiving roles can be complex and overlapping. OBJECTIVES To illustrate ways care dynamics may depart from traditional notions of dyadic unidirectional family caregiving and to stimulate a discussion of the implications of complex relational care dynamics for caregiving science. APPROACH Exemplar cases of informal care dynamics were drawn from three ongoing and completed investigations involving persons with serious illness and their family caregivers. The selected cases provide examples of three unique, but not uncommon, care exchange patterns: (a) care dyads who are aging, are chronically ill, and who compensate for one another's deficits in reciprocal relationships; (b) patients who present with a constellation of family members and other informal caregivers, as opposed to one primary caregiver; and (c) family care chains whereby a given individual functions as a caregiver to one relative or friend and care recipient to another. CONCLUSIONS These cases illustrate such phenomena as multiple caregivers, shifting and shared caregiving roles, and care recipients as caregivers. As caregiving science enters a new era of complexity and maturity, there is a need for conceptual and methodological approaches that acknowledge, account for, and support the complex, web-like nature of family caregiving configurations. Research that contributes to, and is informed by, a broader understanding of the reality of family caregiving will yield findings that carry greater clinical relevance than has been possible previously.
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Brown J, Chen SL. Help-seeking patterns of older spousal caregivers of older adults with dementia. Issues Ment Health Nurs 2008; 29:839-52. [PMID: 18649210 DOI: 10.1080/01612840802182854] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This qualitative, descriptive, secondary analysis of spousal caregivers (n = 20) examined similarities and differences in help-seeking patterns to understand the processes underlying decisions regarding resource use. Husbands were comfortable with letting others assume care or getting others to provide care while wives felt responsible for providing care. Both groups underutilized available services. Gender, role expectations, past coping, and family relationships contributed to differences between groups. An important implication is that services should be gender-specific. Understanding spousal help-seeking patterns may enable health professionals to better provide assistance for elder spousal caregivers so that they continue to provide care and reduce burden.
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Affiliation(s)
- Janet Brown
- The University of Tennessee, College of Nursing, Knoxville, Tennessee 37996-4180, USA.
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