The Transition to Parent Care: Costs,Commitments, and Caregiver Selection Among Children

This research traced the process of caregiver selection among adult children longitudinally, investigating how transitions to parent care were influenced by previous constellations of caregiving costs and commitments within sibling groups. The authors used data from 6 waves (1998–2008) of the Health and Retirement Study, selecting a sample of families (N = 641 parents comprising N = 2,452 parent–child dyads) in which they observed at least 1 adult child becoming a caregiver to a previously self‐sufficient parent. Among cost‐related factors, this transition was predicted primarily by between‐sibling differences in previous geographical distances to the parent and, to a lesser extent, competing demands in work and family spheres. The indicators for caregiving commitments showed the importance of reciprocity, path dependency, and parental expectations as motivational forces affecting the process of caregiver selection among adult children. Gender effects revealed the primacy of the mother–daughter tie, as daughters were overrepresented only in transitions to mother care.     

Perceived overload as a predictor of physical strain among spousal and adult child caregivers of frail elders in the community

ABSTRACT

Family caregivers of frail elders can experience physical strain associated with caregiving. Identifying correlates of caregiver strain can provide an important impetus for tackling the causes and providing effective interventions. Utilizing data from the 1999 National Long-Term Care Survey, the current study examined correlates of caregiver physical strain among 956 family caregivers, using the stress process model. As multiple regression analyses indicated, the caregiver’s perceived overload predicted greater strain for both spousal and adult child caregivers. For both groups, common correlates of physical strain were caregiving demands, the caregiver’s perceived overload, and limitations placed on the caregiver’s life. The results demonstrate that the family relationship of the caregiver (spouse or adult child) leads to variations and dynamics in caregiver strains, due to qualitatively different relationships.     

“No Matter What I Do They Still Want Their Family”: Stressors for African American Grandparents and Other Relatives

Grandparents and other relatives increasingly assume the role of primary caregiver to minor children. This study interviewed family members caring for children whose parents were not available due to parental incarceration, other involvement in the criminal justice system, and substance abuse-related issues. Interviews with 25 African American women examined the impact of caregiving including stress and depression. Stress included caregiver issues related to finances, time allocation, care responsibilities, and concerns about the absent parent, as well as issues specific to the children related to school concerns, child behavior, and emotional problems. These stresses were examined along with caregiver depression scores using the Center for Epidemiological Studies Depression Scale, which indicated more depression related to caregiver illnesses, older caregivers, and care for older and a larger number of children. This study suggests that caring for these children is both challenging and stressful, and caregivers are at risk for depression and other mental health concerns. Health and service providers should carefully assess the needs of caregivers when determining the needs of families where children are under care of nonparental relatives. Family-based services are needed that include caregiver supports as well as support for children.     

Family support in late life: A review of the literature on aging,disability, and family caregiving

ABSTRACT

For older adults and people with disabilities in the United States, family caregiving is an important part of remaining at home and in the community. As care recipients and caregivers age, family dynamics change, and the health, social, and financial impacts of this (largely unremunerated) work have implications for individuals, families, and social policy. In this review, the authors map the literature across multiple fields related to disability and aging to understand caregiving in late life, what it means to be an older caregiver and/or to care for older people. The authors summarize the findings of 97 articles to address the care, services, and supports family caregivers provide for older adults; negative and positive impacts for caregivers serving in this role; supports that family members use or need; and societal impact of family caregiving. Much of the literature describes the work family caregivers provide and negative impacts of caregiving. Less attention is devoted to caregiving benefits, supports used by family caregivers, and societal impacts. The authors conclude with an agenda for future research that attends to the need for research that includes: more diverse samples, new types of caregivers, longitudinal data, qualitative data and analysis, and comparative research.     

Standby Mothering: Temporalities,Affects, and the Politics of Mobile Intergenerational Care

ABSTRACT

In this paper, I showcase how left-behind mothers in the Philippines use digital communication technologies in delivering care to their overseas adult children in Melbourne, Australia. As part of a broader research project on transnational family life, the findings were drawn upon in-depth interviews, visual methods, a simple participant observation, and field notes taking and analysis. The study deployed a mediated mobilities lens, paying close attention to the different forces that shape the provision of intergenerational care through mobile device use. Building upon a critical analysis of the digitalization of intergenerational relationships in a transnational context, I coin the term ‘standby mothering.’ This conception encapsulates the femininized, ubiquitous, networked, and ambivalent intergenerational care practices that are experienced and negotiated by distant mothers. On the one hand, mobile device use enables left-behind mothers to deliver emotional and practical caregiving. On the other hand, everyday temporal conditions and technological barriers impede the provision of intergenerational care. Communicative constraints are constantly managed through various tactics, ensuring the sustenance of transnational relationships. By interrogating the contradictory outcomes of transnational caregiving, I underscore the politics of mediated mobilities in a digital society. Here, the mobilization of gendered, networked, and differential care practices is influenced by uneven structural and even socio-technological dimensions. Ultimately, this paper elucidates a critical stance on re-examining the provision of informal, gendered, and networked care practices.     

Dynamic modelling of long-term care decisions

This paper describes and analyzes research on the dynamics of long-term care and the policy relevance of identifying the sources of persistence in caregiving arrangements (including the effect of dynamics on parameter estimates, implications for family welfare, parent welfare, child welfare, and cost of government programs). We discuss sources and causes of observed persistence in caregiving arrangements including inertia/state dependence (confounded by unobserved heterogeneity) and costs of changing caregivers. We comment on causes of dynamics including learning/human capital accumulation; burnout; and game-playing. We suggest how to deal with endogenous geography; dynamics in discrete and continuous choices; and equilibrium issues (multiple equilibria, dynamic equilibria). We also present an overview of commonly used longitudinal data sets and evaluate their relative advantages/disadvantages. We also discuss other data issues related to noisy measures of wealth and family structure. Finally, we suggest some methods to handle econometric problems such as endogeneous geography.     

Dignity in dementia: Person-centered care in community

Drawing on Kitwood's [Ageing Soc. 13 (1993) 51] theory of person-centered care and the interpersonal process of caregiving, this article offers an alternative to the image of the family caregiver as victim through an exploration of the lived experience of caring for a person with dementia in community. Extending care beyond coping, the act of giving care is promoted as a worthy activity and reciprocal social opportunity. Three nonfamily caregiver “portraits” are offered in an arts-informed representational form. The relational processes of caregiving are explored from the vantage point of personal experience and theoretical knowledge. Dignity emerges as the resonant quality, essential value, and guiding principle in an ethic of dementia care. Implications about the direction of research about care and caregiving and research accessibility and usefulness are explored.     

Caregiving transitions: Developmental and gendered perspectives

Providing care for family members is a life event that both reflects and influences family dynamics. Caregiving careers, or the length of time a person provides care, are characterized by a series of transitions to which they must continuously adapt. Women are more likely than men to assume the caregiver role and this role encompasses gender inequalities associated with work and caregiving expectations. This article presents qualitative data from interviews conducted with caregivers who participated in a community-based supportive services program. The experiences of these women provide insight into how caregivers transition into their role, strategies for supporting new and experienced caregivers, and their concerns for their future. Developmental and gendered perspectives of caregiving were used as a context to analyze their experiences.     

We Know Some Things: Parent–Adolescent Relationships in Retrospect and Prospect

This article examines the most important ideas to have emerged from the last 25 years of research on adolescent development in the family context and suggests some directions for the future. Two major sets of questions organize the review. First, how can we best characterize normative family relationships during adolescence, and, more specifically, is adolescence a time of parent à child conflict? Second, how do variations in parent – child relationships affect the developing adolescent? The answer to the first question depends on what is meant by conflict and, more importantly, from whom one gathers data. There is a need for a new perspective on the family, one that emphasizes the different viewpoints and stakes that parents and adolescents bring to their relationship with each other. Special attention should be paid to studies of the mental health of parents of adolescents. With regard to the second question, it is argued that there is enough evidence to conclude that adolescents benefit from having parents who are authoritative: warm, firm, and accepting of their needs for psychological autonomy. Therefore, it would seem most beneficial to institute a systematic, large‐scale, multifaceted, and ongoing public health campaign to educate parents about adolescence, one that draws on the collective resources and expertise of health‐care professionals, scientists, governmental agencies, community organizations, schools, religious institutions, and the mass media.     

Facilitators and barriers to family engagement and retention of young children in mental health care: A qualitative study of caregivers’ perspectives

This study examines facilitators and barriers that influence family engagement and retention of children in mental healthcare from the parent and caregiver perspective. Researchers recruited and interviewed parents and caregivers (n=18) from urban community health and early childcare centers. The study team analyzed the data and identified barriers to retention in care, including stigma, lack of integrated health care services,and a shortage of providers with the expertise in early childhood mental health care. Social workers, case managers, parent peers, and community support groups helped facilitate parent and caregiver engagement and retention of children in care. Education,community support programs, and integrated healthcare systems would improve access to quality early childhood mental health care.     

Family Influences on Mexican American Adolescents’ Romantic Relationships: Moderation by Gender and Culture

This study examined prospective associations between the family context and adolescents’ romantic relationships as moderated by adolescents’ gender and culture among Mexican American families (N = 189). Adolescents at Time 1 (early adolescence) were on average 12.29 years of age (SD = 0.50) and 54% female. Mothers and fathers reported on family structure and dynamics during early adolescence, and youth reported on their romantic relationship involvement and quality during middle and late adolescence. Results from path analyses indicated that family structure and dynamics (supportive parenting, consistent discipline, and parent–adolescent and interparental conflict) were associated with adolescents’ romantic involvement and quality, and with differences by adolescents’ gender and culture. Findings highlight Mexican American family contexts that contribute uniquely to adolescents’ romantic relationships.     

Transitions to Caregiving,Gender, and Psychological Well‐Being: A Prospective U.S. National Study

Guided by a life course perspective, this study examined the effects of transitioning into caregiving activity for a child, spouse, parent, other relative, or nonkin associate on nine dimensions of psychological well‐being. Data came from adults ages 19–95, who were noncaregiver primary respondents in the National Survey of Families and Households in 1987–88 and who were followed up longitudinally in 1992–93 (N= 8,286). Results from multivariate regression models confirmed that the transition to caregiving for primary kin (i.e., a child, spouse, or biological parent) was associated with an increase in depressive symptoms. However in selected instances, caregiving was associated with beneficial effects (e.g., women who began to provide nonresidential care to a biological parent reported more purpose in life than noncaregiving women). Evidence regarding gender differences was inconsistent, varying across caregiving role relationship types.     

Zoning,Accessory Dwelling Units,and Family Caregiving

Abstract

This article explores the relationship between zoning regulations and co-residential family caregiving in the United States. It first provides an overview of U.S. housing policies, especially zoning. We then describe major changes in family structure and composition in the United States with their implications for caregiving and discuss how multigenerational housing options, particularly accessory dwelling units (ADUs) in single-family homes, can help support family caregiving. After an overview of zoning policies and actions that inhibit ADU production, we document current trends, incorporating information from a small non-random study of ADU activity we conducted in 2004. Finally, we present recommendations for promoting more multigenerational housing as a supplement to other family support programs (e.g., dependent care assistance, family caregiver payments) and as a source of affordable, supportive housing for those families choosing co-residence as their eldercare solution.     

The relationship between extracurricular activities and delinquency of adolescents in foster care

This study examined the relationships between involvement in extracurricular activities and delinquency for adolescents in foster care. Using data from the National Survey of Child and Adolescent Well-Being, a subsample of adolescents (n = 117) in long-term foster care was the focus of this study. Contrary to the hypotheses, results indicated that greater involvement in extracurricular activities was associated with higher levels of delinquency. Further analyses revealed that the type of placement and closeness with caregiver predicted delinquency above and beyond the frequency of participation in extracurricular activities. Implications are discussed.     

Dementia Caregiving in the Context of Late‐Life Remarriage: Support Networks,Relationship Quality,and Well‐being

Caregiving research has not accounted for increasingly diverse and complex marital and family histories of older Americans. The authors examined social relations and care‐specific positive and negative support networks among late‐life remarried wife dementia caregivers (N = 61) to determine associations among network structure, relationship quality with and support received from network members, and global assessments of family and stepfamily disagreement on caregiver well‐being. Own family and friends predominated in the social relations and positive networks. Although over half (54%) of respondents included a stepfamily member in their positive networks, stepchildren comprised the largest group (35%) in the negative networks. Larger negative networks and actively negative interactions were related to greater caregiver burden, and more global disagreement with stepfamily was associated with greater depression and burden. The findings illustrate the complex nature of support and the value of targeted examinations of caregiving support dynamics among late‐life remarried older adults and stepfamilies facing health demands.     

A review of the biopsychosocial aspects of caregiving for aging family members

With the ever-increasing growth in the aging population, the need for care providers will also continue to rise. Many of these caregivers will provide informal care to family members and friends at a price to their own physical, psychological, and social well-being. This article examines the phenomenon of caregiving and provides a review of the biological, psychological, and social impacts of caregiving to care providers. George Engel’s biopsychosocial model is explored to examine the biological, psychological, and social factors that can affect a caregiver’s health and well-being. This article further explores social work practice implications and strategies for future intervention to reduce caregiver burnout and aid in their self-preservation.     

Zoning, accessory dwelling units, and family caregiving: issues, trends, and recommendations

This article explores the relationship between zoning regulations and co-residential family caregiving in the United States. It first provides an overview of U.S. housing policies, especially zoning. We then describe major changes in family structure and composition in the United States with their implications for caregiving and discuss how multigenerational housing options, particularly accessory dwelling units (ADUs) in single-family homes, can help support family caregiving. After an overview of zoning policies and actions that inhibit ADU production, we document current trends, incorporating information from a small non-random study of ADU activity we conducted in 2004. Finally, we present recommendations for promoting more multigenerational housing as a supplement to other family support programs (e.g., dependent care assistance, family caregiver payments) and as a source of affordable, supportive housing for those families choosing co-residence as their eldercare solution.     

Lesbian,gay, bisexual,and transgender families and health

Research consistently demonstrates that family relationships are key determinants of health, but most research on health and families focuses on a heterosexual and cisgender context. Sexual and gender identities often are overlooked or erased in family and health research. We present an overview of the current state of research on LGBT families and health, using a life course approach and pointing to the ways that LGBT people's experiences of families occur within a broader social structural context, with implications for their health and the health of their family members. We focus on parenthood, parent–child ties, intimate relationships, and caregiving. We also identify two theoretical obstacles for studies of LGBT families and health as well as important research areas for moving forward, such as the inclusion of non‐binary and queer identities in our studies of family and health. Incorporation of LGBT and other queer families and family forms into our health research interrogates assumptions within family and health research and offers insight into how to move the field forward.     

Sources of stress reported by daughters of nursing home residents

The accounts of 31 daughters (M = 48.2 years) who had a parent living in a nursing home were examined. Data from 7 focus group discussions that explored the stressful experiences daughters encountered in providing care to their parents were content-analyzed. Eight major stressor themes were identified: sense of responsibility, losses, role change, conflicting perceptions of parent's ability, realization of own vulnerabilities, facing the unknown, lack of family support, and lack of appropriate facility care. The results shed light on the kinds of stressors these daughters faced and point to the influence that prior family and caregiving histories may have on the daughters' present experience.