Older mothers and their difficult adult children: a life course exploration

Adult child to parent violence is a growing international social problem that needs to be better understood to develop clinical interventions. An exploratory study on the antecedents of early life adversity on adult child to parent violence/elder mistreatment was carried out using secondary analysis. Directed content analysis was used based on life course theory with a data set of older mothers all > 57 years old (J. R. Smith 2021, 2022). Measurement of instances of child abuse, domestic violence, and birth trauma among abused older mothers was conducted. All the older women had reported being negatively affected by their adult children's problems and 56% reported being physically attacked. A case example is presented to illustrate how repeated incidents of abuse or neglect in early life might explain an older woman's inability to take actions for her own safety.

Caregiving Stress Experienced by Parents of Adult Children with Intellectual Disabilities During COVID-19 in Korea

Many of community supports and resources were shattered in the COVID-19 pandemic, leaving parents to navigate caring for their adult child with intellectual disabilities with little support. This study explored caregiving stress experienced by parents of adult children with intellectual disabilities during the COVID-19 pandemic in Korea. In-depth interviews were conducted with 19 parents of an adult child with intellectual disabilities. Thematic analysis yielded two themes: caregiving burden and deteriorating health. Parents bore the brunt of the caregiving burden, spending much of their time helping their adult child with daily activities and managing their challenging behaviors, leaving the caregivers struggling physically and mentally. The heightened caregiver burden and associated deteriorating health among these parents raise serious concerns, indicating a need for immediate support to alleviate these issues and help parents navigate caring for their adult child with intellectual disabilities during the COVID-19 pandemic.

The Association of Children and Their Educational Attainment With Diabetes-related Complications and Mortality Among Older Adults With Type 2 Diabetes: A Nationwide Cohort Study

OBJECTIVE

Socioeconomic resources and family support have been shown to improve adherence to treatment in people with type 2 diabetes (T2D) and are associated with a lower risk of diabetes-related complications and death. We investigated the associations of having children and their educational level with diabetes-related complications and death among older adults with T2D.

METHODS

We included 74,588 adults who were at least 65 years of age at the time of T2D diagnosis over the period from 2000 to 2018 in Denmark and grouped them based on having children (yes [reference]/no), and their children's highest educational level (low/medium/high [reference]). Multistate models were performed with 3 states: T2D diagnosis, diabetes-related complications, and death. All models were stratified by other chronic diseases at baseline (yes/no).

RESULTS

During follow-up (mean, 5.5 years), 14.6% of the adults developed a complication and 24.8% died with or without complications. Not having children was associated with a higher hazard of death without complications among adults without (hazard ratio [HR], 1.25; 95% confidence interval [CI], 1.17 to 1.33) and with (HR, 1.10; 95% CI, 1.02 to 1.18) other chronic diseases and after complications among adults without other chronic diseases (HR, 1.25; 95% CI, 1.12 to 1.38). Having children with a lower educational level was associated with a higher hazard of complications (HRlow, 1.14; 95% CI, 1.05 to 1.24; HRmedium, 1.11; 95% CI, 1.05 to 1.17), death without complications (HRlow, 1.26; 95% CI, 1.17 to 1.36; HRmedium, 1.07; 95% CI, 1.02 to 1.14), and after complications (HRlow, 1.22; 95% CI, 1.07 to 1.39) among adults without other chronic diseases.

CONCLUSIONS

Among adults without other chronic diseases, having no children or having children with lower educational levels was associated with a higher hazard of death. Among these adults, having children with lower educational levels was also associated with a higher hazard of diabetes-related complications.

What we learnt from parents' death experience: A cross-sectional study of death literacy and parent's death quality among adult children in China

OBJECTIVES

This study aims at investigating the current status of death literacy and parent's death quality among adult children in China. A cross-sectional survey was conducted to explore the associations between death literacy and parent's death quality and to provide evidence for developing public policies for improving the quality of death and end-of-life care for the population in the Greater Bay Area (GBA) of China.

METHODS

A cross-sectional design was adopted. Participants who experienced their father's and/or mother's death were recruited from 5 cities in the GBA of China in 2022. The Good Death Inventory (GDI) and the Death Literacy Index (DLI) were used to investigate the perceived quality of death of the parents of the participants and the death literacy of the participants.

RESULTS

A total of 511 participants were recruited. Participants with higher GDI scores were positively associated with DLI scores (p < 0.001). Adult children who had close relationships before their parents' death also had higher levels of DLI.

SIGNIFICANCE OF RESULTS

This study investigated death literacy among bereaved adult children in China, filling a gap in the investigation of death literacy among Chinese residents. It found that parents' death experience can have a significant impact on the death literacy of adult children, which may affect their understanding and preparation for their own eventual death. Promotion of family discussion on death, development of community palliative care, and improving public death literacy are urgently needed in China.

What About the Sexual Orientation of the Offspring of Lesbian and Gay Parents? A Multidimensional, Time and Gender-Based Answer

This study examined the sexual orientation of 30 young adult children of lesbian and gay parents, analyzing three dimensions (sexual behavior, sexual attraction and sexual self-identification), their evolution over time and the possible influence of gender (19 women and 11 men). Sexual orientation was measured using KSOG. The results revealed that most participants defined themselves as heterosexual only, although percentages varied between 87% for sexual behavior to 67% for sexual attraction and 60% for sexual self-identification. Gender differences were found for sexual attraction and self-identification, with men having a polarized profile (responses at both ends of the scale) and women reporting a less exclusive and more fluid sexuality. These findings are discussed in light of the complex nature of sexual orientation, the freedom of these young adults for defining their sexual orientation, and the role played by gender and family experiences.

Adult children and older people's demand for community care services in urban China

OBJECTIVES

This paper has two objectives. First, it assesses whether the existing informal care provided by adult children has an impact on older people's propensity to demand community care services. Second, it compares the different statuses of sons and daughters in the formal/informal support trade-off.

METHODS

The paper is based on an analysis of data from the 2018 wave of the China Longitudinal Ageing Social Survey, within the framework of a revised version of Andersen's model, and applies multilevel models to analyse the effects of adult children's gender, numbers and the quality of their support, on older people's willingness to purchase community care services.

RESULTS

Older people who had sons as well as daughters demanded fewer services, while the number of sons increased service demand. Regarding sons, community care services compensated for economic support, daily life care and spiritual consolation, but did so only in respect of daily life care from daughters.

CONCLUSIONS

Many families have only one son or one daughter as a result of the one-child policy and therefore often require support from formal care services. Moreover, there is a distinct gender division and an influential filial culture governing the impact of services on the support provided by adult children. Because ageing in place depends on both informal family support and formal services, this key policy goal is at risk if the latter provides insufficient support to the former.

Factors Associated with Severe Adenovirus Pneumonia in Children: A Retrospective Study from Guangzhou, China (2017-2019)

BACKGROUND Adenovirus infections are prevalent in children, typically presenting with mild or asymptomatic symptoms. However, some children develop severe pneumonia necessitating hospitalization. This retrospective study aimed to identify risk factors associated with severe adenovirus pneumonia in children. MATERIAL AND METHODS We screened consecutive children admitted for community-acquired pneumonia at the Emergency Department of Guangzhou Women's and Children's Medical Center between 2017 and 2019. Adenovirus infection was confirmed through rapid respiratory virus assay, RT-PCR assay from respiratory secretions, or serum IgM antibodies. According to Chinese guidelines, patients with pneumonia were classified into severe and mild groups. We assessed risk factors for severe adenovirus pneumonia by comparing clinical features and laboratory indicators, then included differing factors between the 2 groups in a logistic regression analysis. Data analysis was performed using SPSS 26.0 software. RESULTS Our study included 173 children diagnosed with adenovirus pneumonia (117 severe, 56 mild). The median age was 40 months, with 64 male patients. Univariate analysis and binary logistic regression analysis revealed that pleural effusion (13.449 [1.226-147.510], p=0.033), electrolyte disturbances (15.149 [2.724-84.246], p=0.002), oxygen therapy (258.219 [20.684-3223.548], p<0.001), bronchoscopy (26.781 [6.088-117.805], p<0.001), and steroid administration (6.584 [1.497-28.953], p=0.013) were associated with the severity of adenovirus pneumonia. CONCLUSIONS This single-center retrospective study identified pleural effusion, the need for bronchoscopy, oxygen therapy, and steroid treatment, along with impaired serum electrolytes, as factors associated with severe adenovirus pneumonia in children.

A Systematic Review of Literature on Caregiving Preparation of Adult Children

With the increasing life expectancy and ageing population, long-term care has become an urgent policy issue worldwide. The informal care provided by family members, particularly adult children, is a key aspect of long-term care. However, socioeconomic transformations have resulted in changing family and demographic structures and increased geographic mobility, reducing the capacity of families to provide informal care and meet the caregiving needs of older adults. For ageing families, care preparation can be an effective method for coping with eldercare challenges, and care preparation is attracting increasing attention from researchers. This study seeks to conduct a systematic review for studies on caregiving preparation by adult children that were retrieved from six databases, to synthesise the available evidence, and to identify knowledge gaps and opportunities for future investigations. The characteristics and main themes of eighteen reviewed articles were identified and analysed. This study discussed various conceptualisations of caregiving preparation by adult children, the prevalence of caregiving preparation, the factors related to caregiving preparation, and the related consequences. On the basis of the systematic review findings, several limitations of the literature and directions for future research were proposed to promote care preparedness and the well-being of ageing families.

Comparing Older Parents' and Adult Children's Fear of Falling and Perceptions of Age-Friendly Home Modification: An Integration of the Theories of Planned Behavior and Protection Motivation

This study investigated how a fear of falling affects perceptions and behavioral intentions toward age-friendly home modification (AFHM) in older parents and adult children by integrating the theory of planned behavior (TPB) to explain AFHM decision-making processes and the protection motivation theory to explain the impact of a fear of falling on AFHM intention. The target population comprised older parents (≥75 years old) and adult children (45-64 years old) in Busan, South Korea (N = 600). The participants completed a self-administered questionnaire in March 2022. Independent t-test and path model analyses were conducted to compare primary constructs between older parents and adult children and analyze the relationships among a fear of falling, TPB components, and AFHM intention. Results showed that both groups had positive attitudes toward AFHM. However, adult children showed significantly higher rates of having a fear of falling, lower perceived behavioral control, and higher AFHM intention than older parents. The proposed research models were partially supported in the older-parent group and fully supported in the adult-children group. Adult children play a critical role in AFHM, along with older adults who are directly involved in an aging society. AFHM-supporting programs, including monetary and human-force assistance, education, related public advertisements, and an active AFHM market, should be expanded.

A 16-Year-Old Ukrainian Boy Shot at Close-Range to the Back of the Neck with a Handgun Who Required Surgical Removal of a 9×18-mm Bullet Shell from the Left Posterior Maxilla and Recovered Following Physical Therapy

BACKGROUND The conflict in Ukraine during the past year has resulted in increased deaths and injuries to soldiers and civilians from military weapons and large and small caliber firearms. Unlike clinicians in some Western countries, until recently, clinicians working in Ukraine hospitals had little experience managing patients with gunshot wounds. CASE REPORT A 16-year-old boy was admitted as an emergency following a gunshot wound to the back of the neck from a Makarov pistol. The gun was reported to have been fired at a distance of more than 15 cm. Imaging showed the 9-mm bullet hit the cervical spine, causing nerve root involvement at C4 to C7, traveled upwards, and lodged in the left posterior maxilla. On examination, the patient had facial asymmetry and paralysis of the left shoulder, arm, hand, and wrist and was in pain and shock. Intubation and emergency surgery were performed, with the removal of a 9×18-mm bullet shell from the pterygopalatine fossa, deep to the infratemporal fossa, and posterior to the maxilla. The patient underwent postoperative physical therapy and continues to improve his physical function. CONCLUSIONS This report has shown the importance of immediate evaluation of gunshot wounds so that surgery can be planned and performed rapidly, with a view to postoperative recovery and active physical therapy.

'She Can't Support Me Because She's so Old': A Mixed-Methods Study of Support Experiences and Needs in Adult Child-Parent Dyads at the End of Life

Little is known about support experiences and needs in the dyads of (1) terminally ill adult children and their parent caregivers and (2) terminally ill parents and their adult child caregivers. The current study aimed at investigating the experiences and needs of adult children and parents in end of life situations regarding their provision and receipt of support. The study employed a convergent parallel mixed-methods design, combining explorative qualitative interviews with the quantitative self-report Berlin Social Support Scales. Sixty-five patients (dyad 1: 19; dyad 2: 46) and 42 family caregivers (dyad 1: 13; dyad 2: 29) participated in the study (02/2018-11/2019). Results show that ill adult children felt less (well) supported than ill parents. Parent caregivers were often limited in the support they could provide, due to their age and health conditions. Hypotheses were deduced from patients' and family caregivers' notions to inform dyad-specific recommendations for support interventions.

The generational impact of household clutter

OBJECTIVES

Hoarding disorder can create long-term problems for adult children of individuals with hoarding symptoms; however, the extent of the psychosocial consequences of growing up in a cluttered household are not yet fully understood. This study investigated the extent to which generational clutter (i.e., parent/caregiver and grandparent) influenced individuals' self-reported hoarding severity and psychiatric and psychosocial functioning.

METHODS

A total of 1306 adults completed an online survey that included measures of hoarding, anxiety, depression, companionship and emotional support. A subsample (n = 198) reported on parent and grandparent household clutter, as well as family impact from hoarding. We used correlations, t-tests, linear and hierarchical regressions and mediation analyses to investigate whether hoarding symptoms were predicted by parent or grandparent hoarding.

RESULTS

Parent clutter level significantly predicted participant hoarding symptoms. For participants who reported having caregivers with elevated clutter, self-reported psychosocial functioning was lower overall. Self-reported behaviour modification due to family hoarding symptoms (accommodation) was a significant predictor of participant hoarding symptoms.

CONCLUSIONS

Parent clutter and family accommodation behaviours may be a risk factor for future clutter in adult children. Further comparisons between parents and children are needed to determine whether this association increases children's risk for future hoarding symptoms.

Drug-Induced Cardiotoxicity in Children During the Past 30 Years: A Bibliometric Study and Visualization Analysis

BACKGROUND Drug-induced cardiotoxicity (DICT) is one of the most serious adverse drug reactions, which is an important safety issue in drug development and clinical practice. This study aimed to summarize the knowledge structure and to detect emerging trends, and provide ideas for future research on DICT in children using bibliometric methods. MATERIAL AND METHODS All publications on DICT in children were retrieved through the Web of Science Core Collection up to April 20, 2022. The document type was restricted to articles with the language set to English. CiteSpace and VOSviewer were used to conduct this bibliometric analysis. RESULTS A total of 298 articles were included, and the annual publications decreased since 2021. The United States was the leading country with the most publications (117), the highest centrality (0.39), and total citations (4055). The most influential institution was the University of British Columbia, while Carleton BC and Rassekh SR, both from Canada, were the most productive authors, but there was no leader in this field. The keywords with both high frequency and high centrality after excluding "cardiotoxicity" and "children" were acute lymphoblastic leukemia (Freq=43, Central=0.15), childhood cancer (Freq=42, Central=0.13), toxicity (Freq=33, Central=0.16), and breast cancer (Freq=29, Central=0.19). "Adriamycin cardiotoxicity" was the first burst keyword, while "childhood cancer", "oxidative stress", and "cardiac dysfunction" were emerging research hotspots. CONCLUSIONS Attention to DICT in children was insufficient. This study serves as a breakthrough point, providing a comprehensive overview of the knowledge structure, development landscape, and future opportunities in this field.

The Challenges of Caring for an Adult Child with Schizophrenia in the Family: An Analysis of the Lived Experiences of Older Parents

The present study aimed to investigate the lived experiences of older parents regarding the challenges in caring for adult children with schizophrenia. The current study was conducted on 16 parental (mother or father) caregivers of adult children with schizophrenia using a descriptive phenomenological qualitative approach and Colaizzi's seven-step method. This study follows the Qualitative Research Checklist (COREQ). The findings showed that the parent caregivers' experiences could be classified into two main themes: "burden of care" and "Negative attitude and inefficient performance." The former consisted of three sub-themes including "disrupted social and family interactions," "helplessness and inefficient support," and "challenges of the healthcare system," while the latter had two sub-themes including "Negative attitude and inefficient performance of the caregivers" and "Negative attitude and inefficient performance of families and society." Older parents have to tolerate a significant burden of care due to their age and physical conditions. Improving the knowledge of specialists, the government's redoubled efforts in multifaceted support for patients and caregivers, creating an integrated team of specialists, and accepting and improving public attitudes against stigma and obvious discrimination in society as important priorities in improving the condition of caregivers and patients with schizophrenia were considered.

Parenting style in childhood and attitudes toward caregiving in adulthood: a qualitative study

This study aims to explore how relationships with parents during childhood can influence an individual's attitude toward caregiving later in life. The qualitative data came from 47 respondents who care for adult loved ones, with a caregiver mean age of 46.7. The respondents reflected on their recent experience of providing care for their loved ones and how experiences with their caregivers growing up may have influenced their caregiving attitudes. Using a codebook thematic analysis, themes were generated linking childhood experiences to current attitudes toward caregiving. Themes included reciprocating good care, performing obligatory care, and stopping the generational transference of negative care. For most participants, providing quality care for adult loved ones happened regardless of whether the one's childhood experiences with caregivers were positive or negative. Knowledge about the impact of childhood experiences can help health professionals develop interventions to support family caregivers that consider childhood experiences with parents.

Connecting Fathers: Fathers' Impact on Adult Children's Social Networks

We examine the relationship between having an emotionally close and active father in an adult child's social network compared to having a father who is not close, or a father who was not named. We hypothesize that fathers provide both essential and important contributions to their children's psychosocial development, and those contributions continue into active adulthood. Using the 2015 UC Berkeley Social Networks Study (UCNets), we find that adult children who name an emotionally close father in their network tend to have more males as social ties, but not more female ties. We conclude that fathers continue to play an important and active role in their children's lives long after childhood.

"Parenting my parents": Perspectives of adult children on assuming and remaining in the caregiver's role

Background

Family caregivers are essential when responding to the long-term care needs of aging societies. The complex and multifaceted caregiver's role encompasses a unique set of challenges and strains, however, it can be a rewarding experience with many benefits and positive outcomes. Moreover, there is a link between the caregiver's wellbeing, quality of care, and the quality of life of the care recipient. Thus, the current study aimed to explore why adult children are assuming and remaining in the caregiver's role despite its challenges.

Methods

Research data was collected through the use of qualitative semi-structured interviews from September 2021 to July 2022. In total 16 Lithuanian and Italian caregivers were recruited through convenience/snowball sampling. The study utilized the constructivist grounded theory for data analysis and self-determination theory for data interpretation.

Results

Adult children's caregiving experiences revealed three themes related to the motivation to assume and continue with family care: (1) believing in the inherent value of family care; (2) making sense of the changing nature of caregiving; and (3) "making the best of it". Key motivational drivers of these decisions were associated with the satisfaction of the three basic psychological needs - autonomy, competence, and relatedness. Results show that finding meaning and making sense of the caregiving role when responding to a parent's increased care needs may result in positive caregiving experiences and outcomes even at rather low levels of the care recipient's autonomy.

Conclusion

Caregivers were able to experience family care as a meaningful and rewarding experience while acknowledging its challenges and limitations. Implications for family caregiving decisions and experiences, social policy, and future research are discussed in more depth in the paper.

Caring for parents with end-stage renal disease: What do adult children face and how do they cope?

AIM

This study aimed to explore the stressors and coping strategies of adult children who care for their parents with end-stage renal disease (ESRD) undergoing in-centre haemodialysis.

BACKGROUND

Given the growing number of older patients with ESRD, adult children are increasingly providing more care and assistance to their parents with this condition. However, little is still known about the experiences of caring for a parent undergoing haemodialysis.

DESIGN

A qualitative exploratory study was conducted in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.

METHODS

Semi-structured face-to-face interviews with nineteen adult children (44.9 ± 11.7 years old) were carried out. Data were transcribed verbatim and subjected to thematic analysis.

RESULTS

Four stressors (managing disease and treatment-related requirements, patients' reaction to treatment, lack of support from family members, and additional challenges to personal and family life) and five coping strategies (active coping and planning, seeking social support for emotional use, accepting the situation as it is, venting emotions, and maintaining interests outside caring) were identified.

CONCLUSION

Caring for a parent undergoing haemodialysis is an experience with several challenges, marked by educational needs, emotional distress, lack of support from close relatives and the need to manage multiple responsibilities.

RELEVANCE TO CLINICAL PRACTICE

Findings highlight the importance of developing interdisciplinary educational and supportive interventions to support this group of caregivers. These interventions should facilitate access to disease and treatment-related information, provide emotional support, and train coping skills to prevent burden and promote healthy adjustment to the demands of ESRD care.

Family' members experiences of their older relative's alcohol and substance misuse

BACKGROUND

Alcohol consumption in Norway and much of the western world has increased during the past decades, in particular among older adults (> 65 years). Although living with a family member's alcohol misuse has been shown to have a significant deleterious health impact, research on this topic is both lacking and urgently needed to develop targeted health services.

AIM

To generate knowledge of how family members are affected by their older relatives' alcohol and other substance misuse problems.

METHOD

In 2020, 17 individual interviews were carried out with the wives and adult children of older adults with alcohol and other substance misuse problems. Data were analysed using content analysis.

FINDINGS

Analyses revealed two main themes; the impact of living with psychological stress over time, and the impact over time on family relationships and functioning. Both included four subthemes, representing different dimensions of participants' experiences of the impact of their older relative's alcohol and substance misuse.

CONCLUSION

The challenges family members experienced through ongoing exposure to their relatives' alcohol and/or other substance misuse increased over time. These experiences had significant negative consequences for their health and life situation.

Family experience of young-onset dementia: the perspectives of spouses and children

OBJECTIVES

Although young-onset dementia (YOD) affects the whole family system, this population is still under-represented in literature, and no progress in care provision has been made. Hence, additional evidence is necessary to understand how family and social relationships are affected by YOD and care challenges, as to provide recommendations for clinical practice and service improvement from a family perspective.

METHOD

Family carers were recruited via one memory clinic and the local Alzheimer's Associations in Italy. Semi-structured interviews explored their experiences with YOD, the impact of the condition on their lives, family and social relationships, and the support and care they received. Transcripts were coded by three researchers and analysed using inductive thematic analysis.

RESULTS

Thirty-eight interviews were conducted with 26 spouses and 12 adult children. Three themes emerged: 1) Problems around diagnosis, 2) Lack of post-diagnostic support, and 3) Living with YOD as a family. Overall, problems occurred across the dementia pathway. Without appropriate support, it was difficult for families to adjust to living with YOD and to the associated changes in family roles and relationships.

CONCLUSIONS

Since optimal care depends on good family relationships, better support for families in the adaptation to condition would likely benefit patient care while ensuring social inclusion and health equity for vulnerable groups.

A qualitative meta-synthesis of the caregiving experiences of adult children providing care for cancer patients in China: Implications for multidisciplinary healthcare teams

Qualitative meta-synthesis is a coherent approach to answering an overarching research question by synthesising past qualitative studies so as to create new meanings from their results. We conducted a qualitative meta-synthesis to systematically evaluate and integrate the caregiving experiences of adult children providing care for an elderly parent with cancer. The search was conducted in the databases Web of Science, PubMed, Embase, MEDLINE, Cochrane Library, Grew Literature in the Health Sciences, CNKI, WanFang Data, VIP, SINOMED and China Academic Journals as well as Chinese grey literature databases (China Academic Conference Literature Database/, National Science and Technology Library) from inception to June 9, 2021. Thirteen studies were included in the final synthesis. The caregiver experiences they describe are synthesised into three primary themes: care needs, care burden and care gains, with numerous secondary themes. Besides our findings that seem to align with those from studies focused on other cultures, we have highlighted three main discoveries from the synthesis that stand out in the Chinese context: (1) many sub-themes related to specific caregiving skills; (2) a strong expectation for health professionals to improve their communication skills with family caregivers; (3) the negative and positive influences of filial piety in caregiving experiences. Our findings can help multidisciplinary healthcare teams in China support adult children as caregivers in their emphasis on improving caregiver education and training, ways of making the most of potential care gains, and ways of easing care burdens.

The Role of Contact Care by Adult Children in Relieving Depression in Older Adult Individuals

The purpose of this study is to investigate how contact care by adult children influences the effect of caring for grandchildren on depression in older adult individuals. Studies have shown that caring for grandchildren either increases or decreases the symptoms of depression in older adult individuals, while other studies have shown no effect. The reason for these inconsistent results is that the key control variable, contact care by adult children, has been omitted from these previous studies. An analysis of panel data consisting of observations from 162 older adult respondents in the Korean Longitudinal Study of Aging over the 2008-2016 period confirms that the positive effect of caring for grandchildren on depression in older adults increased as the number of adult children who visited their older adult parents after entrusting their children to them increased. As more of their adult children visited the older adult individuals, the latter were more likely to feel that caring for their grandchildren was healing rather than stressful.

The Effect of Adult Children's Education Attainment on Their Parents' Cognitive Health: An Intergenerational Support Perspective

The purpose of this study is to examine the relationship between adult children's education attainment and their parents' cognitive health, and to further explore the mechanism of intergenerational support. Based on empirical analysis of data from China Health and Retirement Longitudinal Survey, our study finds a positive association between children's educational attainment and parents' cognitive health. This correlation is provided for by emotional communication of informal caregiving, financial support, and healthy behaviors shaped in the parents by adult children. The strength of the effect varied by the adult child's gender. While sons' education attainment significantly improves parental cognitive parameters through informal caregiving, financial support, and development of healthy behaviors, the effect of daughters' education derives from financial support and healthy behaviors, not being related to informal caregiving. The study enriches the evidence on the mobility of children's human capital toward their parents and provides practical insights for advancing children's participation in family caregiving.

"I Grew Up Amidst Alcohol and Drugs:" a Qualitative Study on the Lived Experiences of Parental Substance Use Among Adults Who Developed Substance Use Disorders Themselves

Experiencing parental substance use (PSU) has been associated with a heightened risk of developing substance use disorders (SUDs) in offspring. The primary goal of this study was to explore perspectives of adult children with lived experience of PSU who also developed SUDs themselves through first-hand experience. This study was conducted in Flanders (Belgium). A qualitative exploratory research design was applied. Seventeen semi-structured interviews were conducted with adult children of parents with SUDs (range: 29-48 years) who themselves had developed SUDs. All interviews were audio-taped and transcribed verbatim. Three overarching themes emerged through thematic analysis: 1) loneliness and neglect in childhood; 2) stigma and the self; and 3) the role of social connection in substance use and recovery. The narratives highlighted the central role of feelings of loneliness, isolation and belonging among children of parents with SUDs in childhood and adulthood. Increasing public awareness on the impact of PSU on children and accessible support is needed to overcome stigma and remove barriers to social inclusion for children of parents with SUDs. Findings may prove valuable in informing policy, program and treatment development aimed at breaking maladaptive intergenerational cycles.

Investigating a Potential Causal Relationship Between Maternal Blood Pressure During Pregnancy and Future Offspring Cardiometabolic Health

Observational epidemiological studies have reported that higher maternal blood pressure (BP) during pregnancy is associated with increased future risk of offspring cardiometabolic disease. However, it is unclear whether this association represents a causal relationship through intrauterine mechanisms. We used a Mendelian randomization (MR) framework to examine the relationship between unweighted maternal genetic scores for systolic BP and diastolic BP and a range of cardiometabolic risk factors in the offspring of up to 29 708 genotyped mother-offspring pairs from the UKB study (UK Biobank) and the HUNT study (Trøndelag Health). We conducted similar analyses in up to 21 423 father-offspring pairs from the same cohorts. We confirmed that the BP-associated genetic variants from the general population sample also had similar effects on maternal BP during pregnancy in independent cohorts. We did not detect any association between maternal (or paternal) unweighted genetic scores and cardiometabolic offspring outcomes in the meta-analysis of UKB and HUNT after adjusting for offspring genotypes at the same loci. We find little evidence to support the notion that maternal BP is a major causal risk factor for adverse offspring cardiometabolic outcomes in later life.

Care Received and Unmet Care Needs Among Older Parents in Biological and Stepfamilies

OBJECTIVES

Increased likelihood of having stepchildren among more recent cohorts of older adults, alongside lower levels of assistance from stepchildren, have led to concerns about greater unmet needs for older parents in stepfamilies. However, few studies have directly examined family structure and unmet needs. We examined the associations between having stepchildren (vs. only biological children) and receiving care from adult children, and unmet needs for assistance.

METHODS

Using the 2015 National Health and Aging Trends Study, we investigated among older parents with care needs whether levels of care received from adult children and unmet needs differed between those with biological versus step families. We also explored whether partner or paid care compensated for observed differences.

RESULTS

Older parents in need of care were more than twice as likely to receive care from their adult children if they had biological instead of step families. Unmet needs among older parents did not differ by family structure, nor did levels of partner or paid care.

DISCUSSION

Results illustrate that concerns about the implications of the rising prevalence of stepfamilies for care parents receive from their children may be warranted. However, there is a lack of evidence of greater unmet need for care for older parents in stepfamilies, as risks of unmet needs are high for older parents regardless of family type.

Mothers' Functional Limitations and Relationship Quality With Adult Children: Exploring the Moderating Roles of Race and Gender

Theory and research on intergenerational relations emphasize the salient role that mothers and their adult children play in one another's lives. However, little is known about how mothers' health may shape mother-child relationship quality in later-life. We utilized data from the Within Family Differences Study to explore how mothers' functional limitations affect multiple dimensions of mother-child relationship quality, as reported by mothers and their offspring, with particular emphasis on whether race, child's gender, or generational position moderated these associations. Although mothers' reports of relationship quality were not predicted by their functional limitations, adult children reported higher ambivalence when they perceived their mothers had limitations. Further, adult children in White families reported higher ambivalence when mothers had limitations than did those in Black families. This study highlights the importance of considering the roles of structural factors in shaping the conditions under which health limitations affect mother-child ties.

Communication in dyads of adult children at the end of life with their parents and parents at the end of life with their adult children: Findings from a mixed-methods study

OBJECTIVE

Patient-family member communication plays a decisive role in coping with an end-of-life situation and is strongly influenced by the dyadic relationship. There is a lack of research exploring and comparing the specifics of communication between (1) terminally ill adult children and their parents and (2) terminally ill parents and their adult children. The present study aimed at describing and comparing communication specifics within these two dyads.

METHODS

As part of the research project Dy@EoL on parent-adult child interactions, this mixed-methods study combined qualitative interviews and the Berlin Social Support Scales self-report questionnaire. Participants in both dyads were recruited via 12 inpatient and ambulatory palliative/hospice care providers between February 2018 and September 2019.

RESULTS

Participants included 65 patients (dyad 1: 19; dyad 2: 46) and 42 family members (dyad 1: 13; dyad 2: 29). Qualitative interviews revealed communication changes in the terminal illness situation and provided insight into each dyad partner's perception of openness and avoidance in the dyadic communication. The quantitative results showed that patients in both dyads provided significantly less informational support relative to family members. A strong similarity present in both dyads was the central motivation for limiting information sharing.

CONCLUSIONS

Individual preferences for information sharing suggest that the divergent needs of dyad partners must be carefully negotiated to ensure that patients are able to address important topics without putting too great an emotional burden on their family members. Tailored psychosocial support measures are needed to achieve this goal. The study was registered prospectively in the German Clinical Trials Register (registration N° DRKS00013206).

The experiences of family resilience from the view of the adult children of parents with bipolar disorder in Chinese society

AIMS

This study explored how adult children perceived family resilience, barriers to develop family resilience and how cultural values influence their experience of parents with bipolar disorder in Chinese society.

DESIGN

A qualitative design with an interpretive phenomenological analysis of data was employed.

METHODS

Twenty adults who had lived with parents with bipolar disorder during childhood were recruited from the acute psychiatric ward when their parents were admitted to the hospital. They described their experiences of perceived family resilience and barriers to resilience (October 2013-September 2015). Semi-structured interviews were conducted in the hospital meeting room or at a convenient location.

FINDINGS

Six themes were identified in family resilience: ill parents try to be good parents, parents' personal strengths, parents' positive attitudes towards mental illness, flexibility of family role, cohesive relationships between family members, and families' social connections. Three themes were identified in the barriers to develop family resilience: poor parenting/family function, conflict between parents and poor mental health literacy.

CONCLUSION

Children's views of family resilience could transform their suffering from lived experiences with a mentally ill parent to a positive growth experience. Family resilience includes well and ill parents' efforts and social network's help to maintain family function. However, the conflicts between well and ill parents and poor family function result in a traumatic growth experience.

IMPACT

To enhance a positive growth experience, family resilience programs for a parent with bipolar disorder aiming to cultivate both the ill and well parents' inner strength and their competence of parenting skills with connecting their social network to maintain family function is needed. Moreover, early stress-reduction intervention needs to be developed for children who did not experience family resilience.

Regret and Repair: Experiences of Adult Children and Parents When a Father Remarries Soon After the Death of a Spouse

The purpose of this study is to better understand what happens to families when a parent remarries quickly after the death of a long-term partner. Men typically re-partner much more rapidly than women do after the death of a spouse. We used a qualitative, grounded-theory method to interview six parents (all men) and their adult children (12 participants total) about their experiences when fathers lost their spouse and re-partnered quickly. We found a variety of reasons for rapid remarriage, and a number of implications for parent-child relationships, including feelings of losing one parent in body and another in relationship, different expectations between parents and children related to holding on to memories of the deceased and finding ways to let go, remaining parents looking back with unexpressed regret, and finally experiences of repair. Clinical recommendations for therapists are provided.

Children and young people's experience of parental dementia: A systematic review

OBJECTIVES

Most studies have been concerned with the experiences and needs of spouses/partners and adult children of people with dementia. In this review, children and young people's lived experience of parental dementia was investigated. Findings will inform both researchers and professionals in the area of dementia care.

DESIGN

A systematic literature search was performed in CINAHL, PsychINFO, PubMed, Scopus, and Web of Science. A rigorous screening process was followed, and a checklist for qualitative and observational studies was used to evaluate the methodological quality of the studies. Narrative synthesis of the selected articles was carried out.

RESULTS

Twenty-one studies were included and a synthesis of the literature revealed six themes. The first theme concerned the difficulties in dealing with the diagnosis which was often preceded by a long period characterized by uncertainty, confusion, family distress, and conflicts. The second theme discussed changes in family relationships in terms of the role of children and young people in supporting both parents and keeping family together. The third theme described the impact of caring on children and young people who struggled to balance caring tasks and developmental needs. The fourth theme showed consequences on children and young people's personal lives in terms of education/career and life planning. The fifth theme illustrated main adaptation models and coping strategies. The last theme discussed the need for appropriate support and services based on a "whole family" approach.

CONCLUSIONS

The included studies provide the basis for knowledge and awareness about the experience of children and young people with a parent with dementia and the specific needs of support for this population.

Does Parental Investment Shape Adult Children's Fertility Intentions? Findings From a German Family Panel

Parents can play an important role in the childbearing plans of adult children. However, studies testing whether changes in parental investment are associated with subsequent changes in fertility intentions over time are lacking. We investigated whether parental investment, measured as contact frequency, emotional closeness, financial support, and childcare, is associated with adult children's intentions to have a first and a second, or subsequent, child within the next 2 years. These associations were studied in four different parent-adult child dyads based on the sex of parents and adult children (i.e, mother-daughter, mother-son, father-daughter, father-son). The participants are from the German Family Panel, which is a longitudinal survey of younger and middle-aged adults with eight follow-up waves. We exploited within-person (or fixed-effect) regression models, which concentrated an individual's variation over time (i.e., whether changes in parental investment frequencies are associated with subsequent changes in adult children's fertility intentions). It was detected that increased emotional closeness between fathers and daughters was associated with increased adult daughter's intentions to have a first child but father-daughter contact decreased daughter's intentions to have another child, and maternal financial support decreased son's intentions to have a first child. Overall, statistically nonsignificant associations outweighed significant ones. Although it is often assumed that parental investment is an important factor influencing the childbearing decisions of adult children, the present findings indicate that parental investment may not increase adult children's intentions to have a/another child in Germany.

Methodological Reflections on the Recruitment of Adult Child-Parent Dyads for End-of-Life Research in Germany: Experiences From the Dy@EoL Study

CONTEXT

Although high-quality research with patients and family members is needed to improve palliative care, difficulties in recruitment are often reported.

OBJECTIVES

The present article analyzes the authors' experiences in recruiting participants of two types of dyads for the study "Dy@EoL-Interaction at the end of life in dyads of parents and adult children". Recruitment challenges and factors found to improve recruitment are examined.

METHODS

Between February 2018 and November 2019, the research team cooperated with diverse inpatient and ambulatory palliative and hospice care providers to recruit both dyads. Cooperation strategies and adaptations were protocolled. Data on (non-)participation were recorded and analyzed using descriptive statistics.

RESULTS

The recruitment rate was 34.6% (dyad 1, terminally ill adult children with parents: 36.4%; dyad 2, terminally ill parents with adult children: 33.9%). In total, 82.2% of participants were recruited from inpatient settings. The research team has applied various strategies, such as public outreach activities and the extension of recruitment partners. The study protocol was adapted at an early stage to include single participants. Of all patients, 47.7% participated without their dyad partner. The main reason to exclude their family member was the patients' wish to protect them from extraburden.

CONCLUSION

The recruitment was more successful in inpatient than in ambulatory settings. The extension of recruitment partners was beneficial to recruit participants from ambulatory contexts. The inclusion of single participants was conducive as a great number of patients participated without their dyad partner. Sharing the obtained experiences can be helpful for future research planning.

Parental long working hours and adult children's depression in South Korea: a cross-sectional study

This study investigated the association between parental long working hours and the depression of children living with their parents even after becoming adults in South Korea. Data from two years of the Korean National Health and Nutrition Examination Survey (KNHANES) in 2014 and 2016 were analyzed using a cross-sectional study. Logistic regression analyses were performed to determine the association between parental long working hours and their adult children's depression. Adult children of mothers who worked more than 60 hours per week were more likely to have depression than 40 hours or less per week. Comprehending aging mothers' weekly working hours is an important factor for understanding the reason of adult children's depression.

What are the shared decision-making experiences of adult children in regard to their parent/s' health care in residential aged care facilities?

AIM

This scoping literature review aimed to answer the question: What are the shared decision-making experiences of adult children in regard to their parent/s' health care in residential aged care facilities?

BACKGROUND

Shared decision-making has been an important patient-centred approach to nursing care since the 1990s, yet it is becoming increasingly evident that it is still not the reality in aged care facilities fifty years on. Currently, it is not well understood how adult children participate in shared decision-making and the types of decisions they are required to make.

DESIGN

A review of original research papers using Kable, Pich and Maslin-Prothero 12-step systematic approach to documenting a search strategy.

METHOD

The researcher screened 597 articles from four databases, published in the English language, during the period 1985-2019. The researcher used the Mixed Methods Appraisal Tool version 2011 to determine the methodological quality of the included studies. The Joanna Briggs Institute QARI data tool was used to appraise the seven selected articles and thematically analyse findings, respectively.

RESULTS

Four themes were highlighted: communication; staffing; being involved; and staff-family relationships. Despite these themes being apparent, families have limited opportunities to participate in shared health decision-making in regard to their parents' care.

CONCLUSION

The findings from this literature show how shared decision-making is affected by the RACF environment. There is a need to find out and understand what is important from a family member's point of view to optimise shared decision-making and nursing care of the family member in residential aged care settings.

RELEVANCE TO CLINICAL PRACTICE

The limited findings specific to the SDM experiences of adult children of parents in RACFs in this review could help staff and RACFs to develop strategies and staff training to encourage and facilitate the implementation of shared health decision-making with staff and families on older people's care.

Helpful resources recognized by adult children of parents with a mental illness in Japan

AIM

This study aimed to identify the resources recognized as helpful by children of parents with a mental illness (COPMI) to cope with the difficulties they experienced in their lives.

METHODS

A qualitative descriptive design was employed. Semi-structured interviews were conducted with 10 adults who experienced parental mental illness in their childhood. Participants were asked to discuss resources that were beneficial to them. Text segments from the verbatim transcriptions were identified with summarizing codes, and the codes were compared and contrasted to generate subcategories and categories. The case characteristics and subcategories were reorganized to retest the validity of the categories.

RESULTS

Parental mental illness onset occurred before birth or in early childhood for four participants and during elementary or junior high school for six participants. Six categories emerged: protection from the harmful influences of parents' symptoms; care received from adults at home and school; occasional experience of mutual affection and support within the family; emotional validation and sustained support by others; understanding how to cope using information on mental illnesses; and time for oneself and experiences away from the parent.

CONCLUSIONS

Helpful resources recognized by COPMI involved not only emotional connections, but also resources related to their daily lives and time for themselves. Understanding the gaps in COPMI's resources can facilitate effective support. Emotional validation by others and time for themselves and away from the parent are important for promoting their development. Society needs to better understand mental illness.

Childhood experiences pursue adulthood for better and worse: a qualitative study of adults' experiences after growing up with a severely mentally ill parent in a small-scale society

Background

Growing up with a severely mentally ill parent can impact on subsequent adult life, and it can be extra challenging in a society with a small population, known as a small-scale society. Life in a small-scale society is characterised by multiple close relationships, lack of anonymity and a conservative attitude towards normal behaviour.

Aims

To look at the impact of growing up with a mentally ill parent on adult life in a small-scale society.

Methods

Data from semistructured interviews with 11 adult children of severely mentally ill parents were reanalysed and subjected to secondary analysis.

Results

The additional analysis resulted in four central themes: 'becoming open and courageous', 'seeking and giving help', 'feeling uncertain and different' and 'being resilient and sensitive'. These were conflated into an overarching theme: 'childhood experiences track into adulthood for better and worse'. The themes elucidate a diverse big picture and encompass positive and challenging features of adult life in a small-scale society.

Conclusions

The study ends with recommendations for the early establishment of collaboration and family-focused interventions with mentally ill parents and their children.

Do Older Adults with Parent(s) Alive Experience Higher Psychological Pain and Suicidal Ideation? A Cross-Sectional Study in China

Elderly mental health promotion is an important task in the current "Healthy China Action". This study aims to (a) clarify the psychological pain and suicidal ideation of the Chinese elderly with different parental states, (b) examine the associated factors of psychological pain and suicidal ideation, and (c) examine the relationship between psychological pain and suicidal ideation. A sample of 4622 adults aged 60 years and older were included in this study, from the China's Health-related Quality of Life Survey for Older Adults 2018. Participants with both parents alive demonstrated the heaviest psychological pain, and those with one parent alive observed significantly lowest psychological pain and suicidal ideation. Participants who were single, divorced, or widowed, live in rural areas, had higher education level, had lower family income, suffered from two or more chronic diseases, and had no self-care ability were more likely to experience psychological pain and suicidal ideation. In addition, higher psychological pain significantly associated with the occurrence of suicidal ideation. In China, much more attention should be paid to the mental health condition of the elderly, especially for those with both parents alive. Moreover, the associated factors above should be considered to develop targeted health interventions.

Parental Proximity and Earnings after Job Displacements

The earnings of young adults living in their parents' neighborhoods completely recover after a job displacement, while the earnings of those living farther away permanently decline. Nearby workers appear to benefit from help with childcare. Earnings improvements are larger in states with expensive childcare and among workers in inflexible occupations, and workers' parents do less market work following their child's displacement. Differences in job search durations, transfers of housing services, and geographic mobility are too small to explain the result. Our results are also consistent with workers benefiting from parental employment networks.

A phenomenological-hermeneutic study exploring caring responsibility for a chronically ill, older parent with frailty

Aim

To provide lifeworld insights into experiences of adult children with caring responsibility for an 80+-year-old chronically ill parent with frailty.

Background

Informal care is common in Nordic welfare countries; however, little is known about adult children's experience of caring responsibility in this setting.

Design

A phenomenological-hermeneutic study based on Reflective Lifeworld Research.

Methods

Diaries and semi-structured interviews with 12 adult children.

Results

Caring responsibility is identified as "a condition of life, filled with uncertainty." Three constituents contribute to this phenomenon: (a) balancing love, duty and reciprocity; (b) being the parent's advocate and manager; and (c) experiencing concerns and bodily strain.

Conclusion

Adult children work hard to provide care and enhance the well-being of their parent. Heidegger's concept 'Fürsorge' may help us understand how by showing how caring responsibility means balancing different roles vis-à-vis the parent, one's own life and the health and social systems. Caring responsibility changes the relationship between parent and child.

Psychological well-being of Chinese Immigrant adult-child caregivers: how do filial expectation, self-rated filial performance, and filial discrepancy matter?

Background: Given the importance of ethnic culture in family caregiving and recent Chinese immigrant population growth, this study explored effects of multiple filial piety traits-filial expectation, self-rated filial performance, and filial discrepancy-on psychological well-being of Chinese immigrants who care for older parents (adult-child caregivers) in the United States.Methods: This study used cross-sectional data from 393 Chinese immigrant adult-child caregivers in the Greater Chicago area from the 2012-2014 Piety study. Multivariate negative binomial and linear regression analyses tested effects of filial expectation, self-rated filial performance, overall filial discrepancy, and discrepancies in six filial domains (respect, bringing happiness, care, greeting, obedience, and financial support) on psychological well-being indicators: depressive symptoms and stress.Results: Adult-child caregivers reported high filial expectation and self-rated performance, and expectation was higher than performance. High filial expectation and self-rated performance were significantly associated with better psychological well-being; Overall filial discrepancy and two emotional-support domain discrepancies (respect, greeting) were associated with poor psychological well-being.Conclusions: Findings suggest that filial expectation, self-rated filial performance, and filial discrepancy are important in shaping Chinese adult-child caregivers' psychological well-being. Researchers and practitioners should incorporate these aspects of filial piety in future research and intervention development for this population.

Why I Brought My Mother Home

Background According to the Alzheimer's Association, in the United States more than 16 million adult family members provide care for a relative with Alzheimer's disease or other dementia. The economic value contributed by unpaid caregivers is $234 billion dollars. Such caregivers are vital to the ability of the U.S. to meet caretaking needs, as the projected number of individuals suffering from dementia will nearly triple over the next 30 years. A meta-analysis found that decisions to provide family caretaking are rooted in long-standing family relationships. This essay explores one family's decision to move from long-term institutional care back to family-based care in the home setting. https://www.alz.org Greenwood N, Smith R. Motivations for being informal carers of people living with dementia: a systematic review of qualitative literature. BMC Geriatr. 2019;19(1):169. Published 2019 Jun 17. https://doi.org/10.1186/s12877-019-1185-0.

Perspectives of elders and their adult children of Black and minority ethnic heritage on end-of-life conversations: A meta-ethnography

BACKGROUND

People of Black and minority ethnic heritage are more likely to die receiving life supporting measures and less likely to die at home. End-of-life care decision making often involves adult children as advance care planning is uncommon in these communities. Physicians report family distress as being a major factor in continuing with futile care.

AIM

To develop a deeper understanding of the perspectives of elders of Black and minority ethnic heritage and their children, about end-of-life conversations that take place within the family, using a meta-ethnographic approach.

DESIGN

Systematic interpretive exploration using the process of meta-ethnography was utilised.

DATA SOURCES

CINAHL, MEDLINE, PubMed and PsycINFO databases were searched. Inclusion criteria included studies published between 2005 and 2019 and studies of conversations between ethnic minority elders and family about end-of-life care. Citation snowballing was used to ensure all appropriate references were identified. A total of 13 studies met the inclusion criteria and required quality level using Critical Appraisal Skills Programme.

RESULTS

The following four storylines were constructed: 'My family will carry out everything for me; it is trust'; 'No Mum, don't talk like that'; 'I leave it in God's hands'; and 'Who's going to look after us?' The synthesis reflected the dichotomous balance of trust and burden avoidance that characterises the perspectives of Black and minority ethnic elders to end-of-life care planning with their children.

Vietnamese Adult-Child and Spousal Caregivers of Older Adults in Houston, Texas: Results from the Vietnamese Aging and Care Survey (VACS)

Vietnamese are the largest Asian ethnic group in Houston, Texas; however, research on this population is scarce. To address this dearth of knowledge, we developed the Vietnamese Aging and Care Survey. The objective of the study was to explore the sociodemographic and health characteristics of Vietnamese adults aged 65 years and older (n = 132) and their family caregivers (n = 64). Adult-child caregivers (n = 41) were aged between 21 and 65 years old. The majority were married, working, female, and in good to excellent health. Spousal caregivers (n = 23) were between 57 and 82 years old, retired, female, and in fair to good health. Adult children received more caregiving-related help from others compared to spousal caregivers; however, they felt more caregiver burden, had more perceived stress, and were in challenging relationships with care recipients. Differences in life stages of adult-child versus spousal caregivers may contribute to these results. Implications are discussed.

Links Between Perceptions of Successes, Problems and Health Outcomes Among Adult Chinese Children: The Mediating Role of Perceptions of Parents' Feelings and Intergenerational Relationships

Several studies have focused on adult children's successes and problems and implications for their own well-being, but few studies have paid attention to their implications for adult children's health outcomes. In the present study, we tested the links between perceptions of successes, problems, and their own health outcomes, as well as the mediating role of perceptions of parents' feelings and intergenerational relationships. Adult children (n = 314; age 18-59) completed surveys on perceptions of successes (compared with counterparts, speculated how parents rate their successes, and compared with same-gender parent); problems (self's, father's, and mother's); parents' feelings (positive and negative); intergenerational relationships (intergenerational ambivalence and instrumental solidarity); and health outcomes [subjective well-being (SWB), psychological distress (PD), and self-rated health (SRH)]. Path analysis was conducted, a bootstrapped test was used. Results showed that perceptions of successes compared with counterparts were positively correlated with SWB and SRH; perceptions of successes compared with counterparts and perceptions of successes compared with same-gender parent were positively correlated with SWB and SRH via parents' positive feelings; perceptions of successes that speculated how parents rate their successes and perceptions of successes compared with same-gender parent were negatively correlated with PD via parents' negative feelings. Self's problems were negatively correlated with SWB via direct ambivalence (DA), and were positively correlated with PD via parents' negative feelings and DA, while mother's problems were positively correlated with PD via parents' negative feelings. There were no significant correlations between father's problems and adult children's health outcomes. This study underscores the importance of considering perceptions of parents' feelings and DA in understanding the mechanisms of an individual's mental health in family systems. This study sheds lights on considering an individual's health in family systems and cultural contexts.

Parents' experiences of abuse by their adult children with drug problems

Aims:

To examine parents’ experiences of abuse directed at them by their adult children with drug problems.

Material and Method:

The material consists of 32 qualitative interviews on child-to-parent abuse with 24 mothers and eight fathers. The interviewees had experienced verbal abuse (insults), emotional abuse (threats), financial abuse (damage to property and possessions) and physical abuse (physical violence).

Findings:

In the parents’ narratives, the parent-child interaction is dominated by the child’s destructive drug use, which the parents are trying to stop. This gives rise to conflicts and ambivalence. The parents’ accounts seem to function as explaining and justifying their children’s disruptive behavior in view of the drug use. The fact that an external factor - drugs - is blamed seems to make it easier to repair the parent-child bonds. The parents differentiate between the child who is sober and the child who is under the influence of drugs, that is, between the genuine child and the fake, unreal child. The sober child is a person that the parent likes and makes an effort for. The child who is on drugs is erratic, at times aggressive and self-destructive.

Conclusions:

The interviewed parents’ well-being is perceived as directly related to how their children’s lives turn out. The single most important factor in improving the parents’ situation is to find a way for their adult child to live their lives without drug problems.

"We Are More than Our Parents' Mental Illness": Narratives from Adult Children

Although research on children of parents with mental illness is growing, few researchers have examined the long-term impact of parental mental illness on adult children. This study explored the potential impact of growing up with a parent with a mental illness on the parenting role assumed by adult children. The qualitative study included ten participants, who were individually interviewed using a semi-structured interview schedule. Interpretative phenomenological analysis (IPA) along with member checks were utilised to derive themes from participants' narratives. Three main themes were identified, including: 'this is me', 'a whole new world', and 'because of you'. 'This is me' consisted of narratives highlighting how adult children intentionally went about parenting in ways different from their parents, and 'a whole new world' captured the salient identity that parenthood served for adult children. The third theme, 'because of you' highlighted the challenges adult children faced in their parenting roles as a result of their childhood experience living with a parent with mental illness. Participants highlighted the main challenges to be an absence of a reference point and lack of informal social supports. Recommendations for mental health practitioners and future research are presented in order to develop better ways to support adult children and their families.

Mobile Apps for Caregivers of Older Adults: Quantitative Content Analysis

Background

Informal caregivers of older adults provide critical support for their loved ones but are subject to negative health outcomes because of burden and stress. Interventions to provide information and resources as well as social and emotional support reduce burden. Mobile apps featuring access to information, assistance with scheduling, and other features can automate support functions inexpensively and conveniently and reach a greater proportion of caregivers than otherwise possible.

Objective

The aim of this study was to identify mobile apps geared towards caregivers of older adults, catalog features, and suggest best practices for adoption based on empirical findings of beneficial interventions in the caregiving literature.

Methods

Search for apps focused on ones catered for caregivers of older adults in Google Play and iTunes, compiling their features, and identifying features reflecting categories of support identified in successful intervention studies to negative caregiver outcomes. Intervention research indicates that provision of information and resources, assistance in practical problem solving, coordinating care among multiple caregivers, and emotional support reduce caregiver burden.

Results

Despite approximately over 200,000 mobile health–related apps, the availability of mobile apps for caregivers is relatively sparse (n=44 apps) as of October 2017. Apps generally addressed specific categories of support, including information and resources, family communication, and caregiver-recipient interactions. Few apps were comprehensive. Only 8 out of 44 (18%) had features that addressed three or more categories. Few apps provided specific stress reduction exercises for caregivers, which is important for reducing burden.

Conclusions

Mobile apps have the potential to provide resources, just­-in­-time information for problem-solving, and stress reduction strategies for caregivers. Many apps offer functions that have been shown to reduce burden and improve health outcomes in caregivers, but few provide emotional support. Using an evidence­-based practice approach, mobile apps for caregivers can provide multiple beneficial support functions. Apps can serve a much larger proportion of this highly underserved population in their mobile form than more traditional means, improving their health and quality of life.

Adult children of parents with mental illness: Dehumanization of a parent - 'She wasn't the wreck in those years that she was to become later'

Children who have lived with parental mental illness experience long-standing reduced health and social outcomes, alongside ongoing personal distress. While there has been some dialogue regarding interventions to support children who are living with parental mental illness, there remains a paucity of knowledge regarding adult children's experiences and potential needs. Given this, the aim of the present study was to establish parenting narratives of adult children who had experienced childhood parental mental illness. This included their experiences of being parented alongside their own subsequent parenting roles. Three men and 10 women, ranging from 30 to 78 years old, met individually with a researcher to tell their stories. Narratives were thematically analysed to establish themes. The findings of the study demonstrated that individuals who have lived with childhood parental mental illness dehumanized their parent with mental illness. The authors argue that all mental health services should be underpinned with a whole of family assessment and care philosophy. There is also a need for all mental health services to consider how policies and procedures might inadvertently dehumanize clients who are parents, which could contribute to familial dehumanization. This could prevent the dehumanization of parents who experience mental illness to preserve parental and child relationships.

The Abdication of King Edward VIII: a study of estrangement between an adult son and elderly mother

In this article the Abdication of King Edward VIII of Great Britain and his estrangement from the dowager Queen Mary are reconsidered as prototypes of intergenerational conflict arising from a collision of values between an adult child and an elderly mother. Historical materials on the Abdication and other respected secondary sources, including biographies of key individuals, were consulted, and the limited sociological and clinical literature on estrangement between elderly parents and adult children was referenced. Although estrangement was perpetuated by the rigid and incompatible positions taken up by both the former king and his widowed mother, the elderly Queen Mary, it was the latter who suffered the greater emotional consequences of the permanent separation that followed the Abdication. Most accounts of the Abdication have put forward views of the conflict of values at its centre that emphasise the vulnerability of the elderly mother. The clinical narrative supports a characterisation of estrangement as a subtype of bereavement with particular relevance to the geriatric population.