Compassion fatigue in adult daughter caregivers of a parent with dementia

Impact of care-recipient relationship type on quality of life in caregivers of older adults with dementia over time

BACKGROUND

Dementia caregiving is a dynamic and multidimensional process. To gain a comprehensive understanding of informal caregiving for people living with dementia (PLWD), it is pivotal to assess the quality of life (QoL) of informal caregivers.

OBJECTIVE

To evaluate whether the care-recipient relationship type predicts changes in the QoL of informal caregivers of PLWD over a two-year period.

METHODS

This was a secondary analysis of longitudinal data. The data were drawn from two waves of linked data from the National Health and Aging Trends Study (NHATS) and the National Study of Caregiving (NSOC) (2015: NHATS R5 & NSOC II; 2017: NHATS R7 & NSOC III). Caregivers were categorized into spousal, adult-child, "other" caregiver and "multiple" caregivers. QoL was assessed through negative emotional burden (NEB), positive emotional benefits and social strain (SS). Generalized estimating equation modelling was used to examine changes in caregivers' QoL outcomes across types of relationship over time.

RESULTS

About, 882 caregivers were included who linked to 601 PLWD. After adjusting caregivers' socio-demographics, "other" caregivers had lower risk of NEB and SS than spousal caregivers (OR = 0.34, P = 0.003, 95%CI [0.17, 0.70]; OR = 0.37, P = 0.019, 95%CI 0.16, 0.85], respectively), and PLWD's dementia status would not change these significance (OR = 0.33, P = 0.003, 95%CI [0.16, 0.68]; OR = 0.31, P = 0.005, 95%CI [0.14, 0.71], respectively).

CONCLUSIONS

The study demonstrates that spousal caregivers face a higher risk of NEB and SS over time, underscoring the pressing need to offer accessible and effective support for informal caregivers of PLWD, especially those caring for their spouses.

The relationship at the heart of the experience of daughter caregivers of a parent with dementia: An interpretative phenomenological analysis

BACKGROUND

Parents with dementia require emotional, physical, psychological and financial support from their child caregivers to continue living at home. Daughter caregivers have been shown to be more involved in self-care and household tasks and to experience higher levels of distress than son caregivers.

OBJECTIVE

The aim of this study was to investigate the experience of daughter caregivers who provide informal care for a parent with dementia living in their own home.

METHOD

Semi-structured interviews were conducted with 11 daughter caregivers of a parent with Alzheimer's disease. Interviews were analysed using Interpretative Phenomenological Analysis.

RESULTS

Three axes emerged from the analyses: [1] the before conditions the after: the quality of the previous relationship with the parent with Alzheimer's disease is a determining factor and allows the identification of three profiles of daughter caregivers: 'the grateful', 'the resentful' and 'the ambivalent', [2] when the relationship protects against the sense of burden: the feeling of being invaded by the caregiving situation is influenced by the quality of the relationship with the parent with Alzheimer's disease, and [3] alone or almost: the support network is desired when it is absent but kept at arm's length when it is present.

DISCUSSION

The results underline the importance of assessing the quality of attachment and supporting the relationship with the parent (especially when the relationship prior to the disease was difficult). Daughter caregivers should also be encouraged to delegate tasks and refocus their actions related to their values. Family mediation sessions may be planned to improve the organisation of care and set up an efficient collaboration.

Unknown Aspect of Compassion Fatigue in Family Caregivers of Elderly: A Phenomenological Study

The study aims to evaluate caregiving emotional state of caregiver family members, their state of experiencing compassion fatigue, and their opinions about effect of compassion fatigue on care. The study was designed using a phenomenological pattern, and 10 volunteer family caregivers were included in the study group. Individual interview technique was used in data collection. Data was analyzed through content analysis with an inductive method and gathered under three themes: (1) opinions of caregivers about emotional status of caregiving to their patients, (2) symptoms of compassion fatigue, and (3) relationship of compassion fatigue and care process. In content analysis conducted on expressions of caregivers about their caregiving to their patients, 8 categories were created under Theme 1, 11 categories are established in the theme of symptoms of compassion fatigue, and 15 categories are created in the theme of relationship of compassion fatigue and care process. Caregivers used codes such as "to the best of my ability, sufficiently, as far as possible, remorse."

Gender Differences in Adverse Psychosocial Outcomes among Family Caregivers: A Systematic Review

This systematic review explores gender differences in adverse psychosocial and role-related outcomes of family caregivers of older adults with chronic illnesses. Data sources for the systematic review included CINAHL, PubMed, PsycINFO, and Google Scholar. Eligible primary research focused on examining gender-based differences in psychological and emotional outcomes (e.g., burden, depression, stress) among family caregivers of an older adult with chronic illness. In total, 16 studies were included in the review with most studies using a cross-sectional design and conducted outside of the United States. Studies reported on gender differences in health outcomes such as burden, stress, and anxiety. Women caregivers had overall higher negative outcomes, but men may have more intense difficulty during the initial caregiver transition phase. Resources to address caregiver health should consider the caregiver's gender. As the older adult population grows, more caregiver research is needed and future studies to include more male caregivers.

Compassion Fatigue in Informal Caregivers of Children with Cancer; a Section from Turkey

Compassion fatigue is the natural stress caused by the strong desire to help a valued person and alleviate the pain he/she suffers after he/she undergoes a traumatizing event. That caregiver who witnesses the physical suffering of the patient, who makes intense effort during the process deprived of the social, psychological, or economic support they need is among the reasons causing compassion fatigue. In this study, the aim was to test and describe the effects of compassion fatigue on informal caregivers of children with cancer. The study is phenomenological, a form of a qualitative study. The participants were the relatives of children with cancer. The data were obtained through in-depth interviews. The audio-recorded interviews were analyzed through the inductive thematic analysis to obtain answers to the questions. The findings were categorized under four headings which compassion fatigue was addressed: Empathy ability, compassion stress, problems experienced by the participants as components of compassion fatigue. The results of this study demonstrated that mothers were at risk of compassion fatigue. Those who give care to their relatives are faced with problems more than professionals. It is recommended that the implementation of multidisciplinary interventions that will improve caregivers' well-being, and preventive social work interventions, will prevent them from compassion fatigue.

Supporting and sustaining care at home: Experiences of adult daughters who support a parent with dementia to remain in their own home

Supporting a parent with dementia living in their own home is a challenging care issue which has potential for negative physical, emotional and psychosocial impacts. This research explores the experiences of adult daughters who sustain this arrangement as well as managing the competing demands of their lives. Using a qualitative approach, semistructured interviews were conducted between March and October 2017. Eight adult females in the United Kingdom who were supporting a parent with dementia to remain living in their home were interviewed. Photo-elicitation was used as an aid to data collection and complemented the use of Thematic Analysis (TA) to analyse verbatim transcripts. Four themes were identified: (a) Impact on identity: impact of the participants' experience on their sense of identity; (b) Continuity and change: relationship redefinition and duality of roles; (c) Stepping up to the challenge: adjustment to and coping with competing demands and ethical dilemmas; and (d) Finding help: 'It is just a minefield': experiences of help-seeking and service provision. This study highlights the experiences and challenges for adult daughters who support a parent with dementia. Ethical dilemmas regarding autonomy and safeguarding concerns figure large along with the competing demands of multiple roles. Service providers should aim to be more proactive in offering timely practical and psychosocial support and guidance to avoid compassion fatigue and acknowledge the valuable unpaid service provided by these 'women in the middle'.

A factorial randomized controlled trial to examine separate and combined effects of a simulation-based empathy enhancement program and a lecture-based education program on family caregivers of people with dementia

OBJECTIVES

The present study was a 2 × 2 factorial randomized controlled trial that examined if a simulation-based empathy enhancement program and a lecture-based education program, together or separately, improved outcomes of family caregivers of people with dementia.

METHOD

A total of 101 participants were randomly assigned to simulation-based education only, lecture-based education only, simulation-based education plus lecture-based education, or treatment as usual. Data were analyzed using a two-way analysis of covariance while controlling for pretest results, kinship, and gender.

RESULTS

Statistically significant interaction effects between the simulation program and the lecture program were found in the levels of well-being and helplessness. The lecture program accompanied by the simulation program led to higher level of well-being in terms of happiness and lower level of helplessness than the lecture program alone. Caregivers with the lecture program provided led to less frequent use of dysfunctional coping strategies than those with no lecture program provided. Caregivers with the simulation program provided led to more frequent use of emotion-focused coping strategies than those with no simulation program provided.

CONCLUSIONS

Findings of the present study support benefits of combined of and separate simulation-based and lecture-based programs on family caregivers of people with dementia in important outcomes affecting quality of care and quality of lives in families of people with dementia. Further studies are needed to identify intervention components that can improve empathy of family caregivers of people with dementia and be embedded into a multicomponent program tailored better to families in different needs.

Role of the Infusion Nurse: Caring for the Family/Lay Caregiver of Older Adults

Approximately 43 500 000 family caregivers provide unpaid care to an adult or child. Most caregivers provide care to older adults, most often parents. Caregivers are often ill-prepared to assist their loved ones, creating or increasing caregiving burden and/or risk of compassion fatigue, potentially leading to critical "caregiving tipping points." Identifying families who are experiencing increased burden or risk of compassion fatigue is a skill that nurses, including infusion nurses, who have unique entrée into the caregiving situation, should develop. The purpose of this article is to describe "impending" tipping points before they occur and to offer solutions for how nurses can help caregiving families identify them and access additional supportive services.

The lived experience of spiritual well-being amongst family caregivers of persons with dementia on palliative care

Family caregivers of persons with dementia are known to experience caregiver burden, anxiety, and social isolation. Spiritual well-being may help ameliorate these characteristics. The meaning of this phenomenon, though, is not known to have been explored previously within this caregiving population. This hermeneutic phenomenological study examined the lived experiences of spiritual well-being in 10 family caregivers. The analysis of semi-structured interviews revealed 5 prominent themes: being connected, strength, presence, hardships, and duty. Phenomenological writing revealed the essence of spiritual well-being in the context of this study. This understanding will help nurses appreciate the importance some family caregivers place on spirituality and recognize when a family caregiver may benefit from a spiritual guidance referral. Further research is recommended to examine associations between spiritual well-being and burden, depression, and social isolation in caregivers of persons with dementia at different stages of receiving palliative care.

The place of family caregivers for older adults with Alzheimer's disease: a literature review in Brazil and the United States

This is a review of the literature on family caregivers of patients with Alzheimer's disease from 2013 to 2017 available in the BVS, Scopus, and PubMed databases. The descriptors used (translated from Portuguese) were Alzheimer's disease, caregivers, elderly health, by combination. Of the 163 papers analyzed, after applying the relevance test, we selected 26 papers presented from five thematic units: 1- Literature reviews; 2- Prevalence profiles of AD caregivers; 3- Qualitative research that analyzes the feelings and sufferings of caregivers; 4- Comparative studies and objective tests; 5- Evaluation studies of intervention programs. The comprehensive and comparative analysis of the investigations highlighted differences and similarities, advantages, and disadvantages of the samples and methodologies adopted in Brazil and the US. The articles analyzed factors that influence family caregivers' impact with Alzheimer's disease, identifying the affective bonds involved, the expected reciprocity, the physical, emotional, and social costs associated with a prolonged chronic illness and requiring increasingly complex care. Family caregivers and older adults with AD require a broad, accessible, or articulated support network inside and outside the family.

Association of care workers' job satisfaction and global happiness with change of functional performance of severely disabled elderly residents in nursing homes: a cohort and questionnaire study in Japan

OBJECTIVES

There is growing concern regarding quality of work life (QWL) among care staff in nursing homes. However, little is known about the impact of QWL on nursing home residents' functional performance. Recent literature suggests that job satisfaction and happiness of healthcare workers reflect their perceived QWL and impact the quality of their care. This study examined the association between job satisfaction and global happiness with change in functional performance of severely disabled elderly residents in nursing homes.

DESIGN

A retrospective cohort study of nursing home residents combined with a questionnaire survey of their care staff.

SETTING

Eighteen nursing homes in Japan.

PARTICIPANTS

Data were collected from 1000 residents with a required care level of 3-5 and from 412 care staff in nursing homes between October 2017 and March 2018.

OUTCOMES AND EXPLANATORY VARIABLES

Functional performance was structurally assessed with ICF (International Classification of Functioning, Disability and Health) staging, composed of 52 items concerning activities of daily life, cognitive function and social participation, at baseline and 6 months later. Deterioration and improvement of functional performance were dichotomously defined as such change in any of the items. QWL of care staff was evaluated with a questionnaire including questions about job satisfaction and global happiness.

RESULTS

Functional performance deteriorated and improved in 23.0% and 12.7% of residents, respectively. Global happiness of care staff was associated with lower probability of residents' deterioration (adjusted OR, 0.61; CI 0.44 to 0.84). There was no significant correlation between job satisfaction or happiness of care staff and improvement of residents' functional performance.

CONCLUSION

These results suggest that QWL of care staff is associated with changes in functional performance of elderly people with severe disabilities in nursing homes.

Exposure to animal suffering, adult attachment styles, and professional quality of life in a sample of Italian veterinarians

Contextual and individual risk factors of veterinarians’ professional quality of life are being debated. Research suggests that attachment styles are relevant predictors of professional quality of life; however, their role in work-related well-being of veterinarians is yet to be ascertained. In the present study, self-report measures on exposure to animal suffering, adult attachment styles, and professional quality of life were administered to 1,445 Italian veterinarians (70% females) aged 24 to 74 years old; sociodemographic information and information on workload were also collected. Female gender, higher levels of ordinary workload, on-call hours per week, exposure to animal suffering, together with fearful and preoccupied attachment styles were significantly associated with lower levels of veterinarians’ quality of life. This suggests that work-related factors may combine with individual psychological features in promoting or disadvantaging the professional quality of life of veterinarians. Implications of these findings for promoting veterinarians’ quality of life and directions for future research are discussed.

Healing Intergenerational Wounds: An Integrative Relational-Neurobiological Approach

Old resentments and unfinished business from the family of origin can constrain adults in current relationships with parents or siblings and negatively affect relationships with partners or children. This article explores how old wounds get reactivated in current relationships and contribute to the intergenerational transmission of painful legacies and trauma. Building on intergenerational family theory and interpersonal neurobiology, the dynamics of reactivity and pathways for growth are explored. While much of the time the human brain is on autopilot, driven by habits and emotional reactivity, we are capable of bringing prefrontal thoughtfulness and choice to close relationships. Rather than being victims of parents or our past, we can become authors of our own relational life. Interventions are offered to help adult clients "wake from the spell of childhood," heal intergenerational wounds, and "grow up" relationships with family of origin. The damage caused by parent-blaming in therapy is explored and contrasted with Ivan Boszormenyi-Nagy's emphasis on rejunctive action and cultivating resources of trustworthiness in intergenerational relationships. The family is considered both in its cultural context-including stressors and resources for resilience-and in its life cycle context. Aging in the intergenerational family is discussed, focusing on ways adult children and their parents can grow and flourish with the challenges at this time of life. Throughout, the theme of relational ethics-how we can live according to our values and "reach for our best self" in intergenerational relationships-informs the discussion.

Informal Caregiver Burnout? Development of a Theoretical Framework to Understand the Impact of Caregiving

Informal caregiving is a rewarding but demanding role. The present theoretical framework proposes to adapt the tridimensional concept of burnout to informal caregiving as a way to address the potential consequences of caregiving. This adaptation reflects caregivers' reported difficulties, as well as empirical findings on emotional exhaustion, depersonalization, and personal accomplishment as caregiving outcomes. But to understand burnout in informal caregiving contexts, it is also necessary to find ways to model it. The Informal Caregiving Integrative Model (ICIM) is thus proposed. This model is based on the integration of elements from literature on both informal caregiving stress and professional burnout. The goal of the ICIM is to emphasize the importance of every category of determinants of informal caregiver burnout (i.e., relating to the caregiver, the caregiving setting, and the sociocultural context), with a key mediating role for the caregivers' appraisal of their situation and their relationship with the care-recipient. This article is a first integrative step in the consideration of a form of burnout specific to informal caregivers and supports the design of empirical and interventional studies based on the theoretical foundation that the ICIM proposes.

A Long and Winding Road: Dementia Caregiving With Grit and Grace

BACKGROUND AND OBJECTIVES

Many dementia caregivers provide care for numerous years. Exhibiting grit, or commitment and persistence in the face of adversity, may bolster their ability to manage caregiving challenges. We explored grit in relationship to memory and behavior problems and response to stressors among women engaged in long-term dementia care.

RESEARCH DESIGN AND METHODS

Informed by a life course perspective, and guided by stress-process theory, we interviewed 10 women with a spouse or parent initially diagnosed with mild cognitive impairment 4 times over 10 years. Using Charmaz's analysis methods and grit as a sensitizing concept, we employed an unfolding analytic strategy involving (a) thematic analysis to identify expressions of grit in response to caregiving stressors across interviews and (b) case-by-case comparisons to assess associations of grit with the use of care strategies across caregivers over time.

RESULTS

Dementia caregivers experienced unrelenting and changing psychosocial and physical challenges. Over time, most women exhibited a sustained commitment to the relationship through the ways in which they protected the identity of the person with dementia, modified their expectations for emotional intimacy, and managed their financial affairs. They persevered as their roles and relationships fluctuated, often finding purpose and relief through employment and leisure pursuits. As care intensified, women who took charge and consciously made decisions in the best interest of the care recipient and themselves minimized stress.

DISCUSSION AND IMPLICATIONS

While some caregivers exhibited grit from the outset, all showed enhanced perseverance and commitment to the ways they managed memory-related changes over time. Developing confidence in their ability to manage and provide care helped the caregivers respond to stressors with purpose and sustain their roles and responsibilities. Enhancing grit in long-term dementia caregivers may result in better individual and relational outcomes.

Family caregiving for persons with advanced heart failure: An integrative review

Objective

The unique needs of caregivers of those with advanced heart failure (HF) are not effectively being met, and reports of physical and mental health challenges are common. The objective is to identify the current state of the literature related to family caregivers of persons with advanced HF, ascertain gaps that require further exploration, and provide preliminary practice recommendations based on the results.

Method

Systematic review of quantitative and qualitative literature. A search of CINAHL, Medline, EMBASE, and PubMed identified 24 articles that met inclusion criteria. Data were analyzed using the constant comparison method and coded. Thematic analysis was used to develop themes.

Result

Sixteen qualitative and seven quantitative studies met inclusion criteria. Analysis of these studies identified six key areas: (1) undertaking a journey in a state of flux, (2) gaining strength, (3) forgetting oneself along the way, (4) seeking out sources of support, (5) preparing for end of life, and (6) finding closure.

Significance of results

The healthcare system currently struggles to meet the care demands of patients with chronic conditions such as advanced HF; as such, informal caregivers are undertaking key roles in the management of symptoms and promotion of the health of those with advanced HF. When caregivers are not adequately prepared for their role, both patient and caregiver well-being is compromised; therefore, a deeper understanding of the caregiving experience could assist in identifying the cause of caregiver anxiety and result in the development of strategies to minimize its effects. Overall, this review will also contribute to improving the current practice when working with caregivers of persons with advanced HF and serve as a basis for development of evidence informed interventions in the future.

Improving Retention Among Certified Nursing Assistants Through Compassion Fatigue Awareness and Self-Care Skills Education

Background: Retention of certified nursing assistants (CNAs) is an ongoing challenge for nursing homes. Purpose: To combat the effects of providing complex care needs to residents, this quality improvement project explored a 90-minute evidence-based education program on compassion fatigue awareness and multiple self-care skill strategies for CNA retention. Design: A single-group pre- and posttest design, mixed-methods approach. Method: A preintervention demographic survey, a postexperience survey, and the ProQOL (Professional Quality of Life; Version 5) tool measured the CNAs' level of compassion satisfaction, burnout, and secondary traumatic stress at three time points: preintervention, 1 month postintervention, and 3 months postintervention. Results: Forty-five CNAs participated. After 1 month, CNA retention increased by 43%, and at the end of the fourth month, the facility's retention rate was 100%. Forty-four percent of the full-time supplemental agency CNAs became full-time facility employees. The use of supplemental agency staff decreased to less than 5% of the total CNA hours worked. CNAs improved their compassion satisfaction, burnout, and secondary traumatic stress scores. Conclusion: This education program proved to be an effective, low-cost intervention. The quality improvement project highlighted the need for additional study on holistic interventions such as workplace education programs addressing compassion fatigue awareness and self-care skill strategies in this understudied group of formal caregivers.

Impact of Aging on Empathy: Review of Psychological and Neural Mechanisms

Empathy in aging is a key capacity because it affects the quality of older adults' relationships and reduced levels are associated with greater loneliness. Many older adults also find themselves in the role of a caregiver to a loved one, and thus empathy is critical for the success of the caregiver-patient relationship. Furthermore, older adults are motivated to make strong emotional connections with others, as highlighted in the socioemotional selectivity theory. Consequently, reductions in empathy could negatively impact their goals. However, there is growing evidence that older adults experience at least some changes in empathy, depending on the domain. Specifically, the state of the research is that older adults have lower cognitive empathy (i.e., the ability to understand others' thoughts and feelings) than younger adults, but similar and in some cases even higher levels of emotional empathy (i.e., the ability to feel emotions that are similar to others' or feel compassion for them). A small number of studies have examined the neural mechanisms for age-related differences in empathy and have found reduced activity in a key brain area associated with cognitive empathy. However, more research is needed to further characterize how brain changes impact empathy with age, especially in the emotional domain of empathy. In this review, we discuss the current state of the research on age-related differences in the psychological and neural bases of empathy, with a specific comparison of the cognitive versus emotional components. Finally, we highlight new directions for research in this area and examine the implications of age-related differences in empathy for older adults.

"I Would Like to Be Heard." Communicating With Singaporean Chinese Patients With Dementia: A Focused Ethnography Study

INTRODUCTION

Although first-generation Singaporean Chinese were mainly immigrants from Mainland China, the communication patterns of Singaporean Chinese in the present-day context differs from Mainland Chinese. This difference could be attributed to the subculture but is not conclusive. This study aimed to explore the experiences of nursing staff communicating with Singaporean Chinese with dementia in Singapore.

METHOD

A focused ethnographic study was conducted in a long-term care setting for people with dementia, where data were obtained using nonparticipant observations and semistructured interviews. Data analyses were conducted using Braun and Clarke's thematic analysis.

RESULTS

Nineteen nursing staff were interviewed. The central theme of "embracing diversity and accepting differences" was supported by three subthemes: acknowledging cultural differences, understanding the patients, and overcoming communicative challenges.

CONCLUSIONS

This study highlighted the need for nurses to understand cultural characteristics among Singaporean Chinese with dementia especially on emotional expressions when they are not understood by others.

Ventromedial Prefrontal Cortex Is Critical for Helping Others Who Are Suffering

Neurological patients with damage to the ventromedial prefrontal cortex (vmPFC) are reported to display reduced empathy toward others in their daily lives in clinical case studies. However, the empathic behavior of patients with damage to the vmPFC has not been measured experimentally in response to an empathy-eliciting event. This is important because characterizing the degree to which patients with damage to the vmPFC have lower empathic behavior will allow for the development of targeted interventions to improve patients’ social skills and in turn will help family members to better understand their impairments so they can provide appropriate supports. For the first time, we induced empathy using an ecologically-valid empathy induction in neurological patients with damage to the vmPFC and measured their empathic emotional responses and behavior in real time. Eight neurological patients with focal damage to the vmPFC were compared to demographically-matched brain-damaged and healthy comparison participants. Patients with damage to the vmPFC gave less money in the empathy condition to a person who was suffering (a confederate) than comparison participants. This provides the first direct experimental evidence that the vmPFC is critical for empathic behavior toward individuals who are suffering.

Keeping the person with dementia and the informal caregiver together: a systematic review of psychosocial interventions

BACKGROUND

Social support, relationships, and closeness are emphasized as important by both people with dementia and their informal caregivers. Psychosocial interventions might be helpful to reinforce the relationship between a person with dementia and his or her informal caregiver. Therefore, this review explores what types of psychosocial interventions have been provided for people with dementia and their informal caregivers together, and the effectiveness of these interventions.

METHODS

PubMed, PsychInfo, Cinahl, and references of key papers were searched for studies describing a psychosocial intervention for people with dementia and their informal caregivers together. Psychosocial interventions were defined as focusing primarily on psychological or social factors.

RESULTS

A total of seven publications describing six studies were identified as eligible for inclusion in this review. Interventions ranged in focus from skills training to viewing/making art. The methodology of the studies varied, especially regarding the outcome measures used. The results of individual studies were mixed. A narrative synthesis of the included studies is given.

CONCLUSION

Although caregiving dyads emphasize the importance of their relationship, this is mostly not taken into consideration in the design and effect evaluations of the interventions. Improved research is needed on this subject, which focuses on people with dementia living in the community and those living in nursing homes.

Older adults' influence in family care: how do daughters and aging parents navigate differences in care goals?

OBJECTIVE

This study seeks to address how older adults influence their daily care when their preferences conflict with those of their adult daughter caregivers.

METHOD

Using a sample of 10 dyads (N = 20) of an older adult and adult daughter, we utilize content analysis strategies to analyze in-depth, semi-structured interview data with QSR NVIVO to investigate how older adults influence their care, how daughters respond to such efforts of influence, and how dyads navigate differences in care goals.

RESULTS

When there is agreement in goals, dyads report tasks going well and both individuals' requests are honored. When there are differences in care goals, daughters most frequently reason with their older parents, while parents walk away or 'let go' of their requests. Daughters report making decisions for their parents for health or safety-related needs. However, all dyads discuss differences in care goals, whereby parents are perceived as insisting, resisting, or persisting in care.

CONCLUSION

Findings illustrate complex patterns of responses by families when navigating differences in daily care goals that carry important implications for research and the development of dyadic-based family interventions.