Caring for my wife: voices from Malay older husbands in Singapore

This study explores how Malay older husbands giving care to their wives in Singapore respond to these roles through coping strategies and social support. This study uses in-depth interviews with five Malay older husbands whose wives are homebound because of dementia and kidney problems. Key findings suggest that husbands report low caregiver burden or strain. However, all the participants report that they do not take time off from their caregiving roles because they have no other immediate sources of support. Services relieving their caregiving responsibilities would be helpful to reduce stress and prevent future burnout.     

Relationships Among Caregiving,Income, Gender,and Health: A Cross-Sectional Examination of a Representative Sample of Older Americans

Although there is substantial evidence to support the effect of burden on caregivers, few studies have compared caregivers to their noncaregiving counterparts on the basis of health and well-being outcomes. This study examines the relationship between caregiving and health and whether other factors may have stronger influence on well-being measures. Using a nationally representative sample of older adults in the United States (N = 3,005), this study examines relationships between caregiving status, gender, and income, and 9 outcomes (self-rated physical and mental health, time since seeing a doctor, time since most recent pap smear or prostate-specific antigen [PSA] test, depression, loneliness, stress, anxiety), using logistic and linear regression models. Results support that paradoxically, caregiving was associated with increased likelihood of PSA test in male caregivers, although data also indicated higher levels of anxiety and stress, as might be expected. Income was associated with 8 of 9 outcomes, and gender predicted depression, anxiety, stress, and self-rated mental health. The study highlighted the importance of psychosocial stressors, such as income and gender, on the health outcomes of older adults who may be caregiving. Considering complexity of unique experience is necessary to accurately assess vulnerability to poor mental health or health-related outcomes.     

Meditation Program Enhances Self-efficacy and Resilience of Home-based Caregivers of Older Adults with Alzheimer’s: A Five-year Follow-up Study in Two South Asian Cities

This article reports a five-year follow-up study in two South Asian cities on the impact of a long-term meditation program in enhancing self-efficacy and resilience of home-based caregivers of older adults with Alzheimer’s. Intervention group caregivers (pre-test N = 96; post-test N = 78) reported lower perceived caregiving burden, higher self-efficacy in obtaining respite, responding to disruptive patient behaviors and controlling upsetting thoughts, and greater resilience, post-test, in comparison to the control group (pre-test N = 89; post-test N = 67). Gender and relationship with the patient were two strong moderators determining program impact. Caregiver women, spouses, Hindus, middle class, with college and higher education, homemakers, who attended at least 75% of the meditation lessons and regularly practiced at home (i.e. once weekly for at least 75% of the weeks) reported lower post-test perceived caregiving burden, higher self-efficacy, and resilience. Results of the Tobit regression models confirmed the meditation-related moderators and indicated that home practice was the strongest predictor of post-test scores. Overall the meditation program is an effective intervention, however, would need to be refined for specific caregiver subgroups such as men, children and children-in-law and those working outside the home, to suit their realities.     

A stress process model of family caregiver service utilization: factors associated with respite and counseling service use

This study examines whether caregivers' differential utilization of respite and counseling support services is associated with different situational stress processes. A multinomial regression analysis was conducted to compare respite users, counseling users, and those who used neither service, using data collected on a statewide random sample of 1,643 California caregivers providing assistance to individuals aged 50 or older. Compared with caregivers who used neither service, respite service users were more likely to have demanding care situations giving rise to physical symptoms of stress, and were more likely to use community services for the care recipient to augment their care. In contrast, counseling service users were more likely to be managing the meaning of their care situation by seeking out information about services and talking with a confidant about their situation, while coping with both emotional and physical symptoms of stress. Tailoring caregiver interventions to meet the support needs and coping strategies stemming from diverse caregiving situations and caregiver characteristics may increase the likelihood that those interventions will be effective in alleviating or preventing deleterious secondary stress frequently experienced by family caregivers.     

Quality of Relationships Between Care Recipients and Their Primary Caregivers and Its Effect on Caregivers' Burden and Satisfaction in Israel

Research on the impact of quality of relationships between primary caregivers and their care recipients on burden and satisfaction with caregiving is still rare. The sample included 335 dyads of primary caregivers and care recipients who were cognitively intact. Face-to-face interviews were conducted at the respondents' homes using structured questionnaires. No significant correlation between caregiving burden and caregiving satisfaction was found. Quality of relationship was the most significant variable in explaining both caregiving burden and caregiving satisfaction, yet different sets of additional variables were found to explain each of the outcomes. Interventions should address quality of relationships in order to reduce burden and increase caregiving satisfaction.     

Coping and Post-traumatic Stress after Hurricanes Katrina and Rita: Racial Disparities in Social Work Student-Practitioners

ABSTRACT

Recent hurricanes have focused on lives and properties lost, however, additional mental health concerns may emerge in these post-disaster settings. Post-traumatic stress symptoms (PTSS) are particularly problematic for minorities due to pre-disaster disparities. Scholars must thus examine the antecedents of PTSS to support these and other vulnerable individuals and communities. This study examined racial disparities regarding active and avoidant coping, prayer, and subsequent relative contribution of each to PTSS following Hurricanes Katrina and Rita among social work student-practitioners. Using secondary data, results revealed that minority students (n = 233) used coping via prayer more often than their non-minority peers (n = 124; t = 7.18, p < .000; d = 0.76). Moderate, positive relationships emerged between avoidant coping and PTSS for both groups (r = .58–.63, p<.01), though prayer did not emerge as inversely related to PTSS as anticipated. Avoidant coping accounted for the largest variation in PTSS for both groups (β = .35–.51, p<.001). Sampling, survey methods, and PTSS measures limit generalizability and temper findings. Directions for future research include use of PTSS measures that account for severity and cultural context and examination of coping measure psychometrics. Practice implications include enhanced publicity regarding social services available to student-practitioners on college campuses and within the community.     

Holy ABCs! The Impact of Religion on Attitudes about Education Policies

Objective . To examine the impact of religion on attitudes about three controversial education policies: creationism, school prayer, and vouchers. Methods . Using a unique, national survey of school board candidates that I undertook in 1998, I use regression analysis to examine which factors, especially religion, explain support for these three policies. Results . This study finds that conservative Christians are more likely to support such policies than mainline Protestants. Additionally, church attendance appears to have an amplifying effect on evangelicals with respect to support for these issues. By contract, those candidates with non-Judeo-Christian religious identifications have much lower levels of support for creationism and school prayer. However, conservative political ideology remains the strongest predictor of support for creationism, prayer in school, and vouchers. Conclusion . Religious beliefs, sometimes enhanced by church attendance, can have a powerful, direct effect on attitudes about creationism, school prayer, and vouchers among school board candidates. Demonstrating such a link becomes important when considering that school board members play a large role in shaping local education policy.     

Exploring spirituality among youth in foster care: findings from the Casey Field Office Mental Health Study

This study examined spiritual coping mechanisms, beliefs about spirituality and participation in spiritual activities and in other positive activities among adolescents in foster care. A multidimensional measure of spirituality was developed for face-to-face interviews with 188 youth (ages 14–17) from diverse racial/ethnic backgrounds in the United States. Findings revealed 95% of youth believe in God, over 70% believe God is 'creator' and God is 'love', and 79% considered prayer a spiritual practice. Most youth said love and forgiveness help them heal. Two-thirds (67%) reported responding to 'bad or tragic things happening' by spending time alone, and over half responded by praying (59%) or sharing the problem with someone else (56%). Youth's top three spiritual goals were to follow God's plan for them, become a better person, and know their purpose in life. Based on the value youth ascribed to spiritual coping mechanisms, recommendations for policy and practice focus on the integration of spirituality into practice and caregiving for youth in foster care.     

Quality of relationships between care recipients and their primary caregivers and its effect on caregivers' burden and satisfaction in Israel

Research on the impact of quality of relationships between primary caregivers and their care recipients on burden and satisfaction with caregiving is still rare. The sample included 335 dyads of primary caregivers and care recipients who were cognitively intact. Face-to-face interviews were conducted at the respondents' homes using structured questionnaires. No significant correlation between caregiving burden and caregiving satisfaction was found. Quality of relationship was the most significant variable in explaining both caregiving burden and caregiving satisfaction, yet different sets of additional variables were found to explain each of the outcomes. Interventions should address quality of relationships in order to reduce burden and increase caregiving satisfaction.     

Perspectives on family caregiving of people aging with intellectual disability affected by dementia: Commentary from the International Summit on Intellectual Disability and Dementia

ABSTRACT

This article, an output of the 2016 International Summit on Intellectual Disability and Dementia, examines familial caregiving situations within the context of a support-staging model for adults with intellectual disability (ID) affected by dementia. Seven narratives offer context to this support-staging model to interpret situations experienced by caregivers. The multidimensional model has two fundamental aspects: identifying the role and nature of caregiving as either primary (direct) or secondary (supportive); and defining how caregiving is influenced by stage of dementia. We propose staging can affect caregiving via different expressions: (1) the “diagnostic phase,” (2) the “explorative phase,” (3) the “adaptive phase,” and (4) the “closure phase.” The international narratives illustrate direct and indirect caregiving with commonality being extent of caregiver involvement and attention to the needs of an adult with ID. We conclude that the model is the first to empirically formalize the variability of caregiving within families of people with ID that is distinct from other caregiving groups, and that many of these caregivers have idiosyncratic needs. A support-staging model that recognizes the changing roles and demands of carers of people with ID and dementia can be useful in constructing research, defining family-based support services, and setting public policy.     

Spirituality Among Alzheimer's Caregivers: Psychometric Reevaluation of the Intrinsic Spirituality Scale

ABSTRACT

The purpose of this study was to reevaluate psychometric properties of the Intrinsic Spirituality Scale (ISS) and to compare its results to the original psychometric report. Attendees of Alzheimer's caregiver support groups constituted the sample, relevant to this measure given their traditional, frequent use of spirituality as a coping resource. Data were randomly split for factor and reliability analyses (N ₁= 152) and validity analysis (N ₂= 152). Factor analysis on the ISS loaded all items on a single dimension of spirituality. Reliability was strong. Convergent validity was suggested via significant correlations with prayer measures. Enhanced with the original findings, these results lend credibility to the ISS as a viable spiritual assessment tool. The ISS offers social service professionals a valuable tool for assessing spirituality that is inclusive of individuals whose spirituality is nontheistic or for whom spirituality exists independently from, or outside of, organized religious structures. Future analyses with additional populations may broaden the ISS applicability among persons with diverse demographic and spiritual backgrounds.     

Attitudes Toward Spousal Caregiving in Late Adulthood

Abstract

The study dealt with differences in attitudes toward spousal caregiving among pre-retired (n = 269) versus retired (n = 250) Israelis. Attitudes toward spousal caregiving at times of illness were examined from three perspectives: Commitment to caregiving, perceived harmful effects of caregiving, and delegation of responsibility for caregiving. Compared with the pre-retired group, the retirees revealed higher levels of commitment and showed less of a tendency to delegate responsibility for caregiving. At the same time, they perceived caregiving as having more harmful effects. In addition, different variables were found to explain these attitudes among both groups of participants. Among the pre-retired participants, equality in household tasks contributed most toward explaining commitment to spousal caregiving. Among the retired participants, in contrast, past assistance from the spouse was one of the most significant variables. For both groups of participants, past assistance from the spouse and equality in division of household tasks were the best predictors of perceived harmful effects. With regard to delegating responsibility for caregiving, the most salient variables among both groups of participants were marital tension and equality in division of household tasks. No gender-based differences were found in attitudes toward caregiving.     

Coping Strategies and Caregiving Outcomes Among Rural Dementia Caregivers

We studied the coping styles by which family caregivers living in rural areas of Alabama deal with the demands of caring for an older relative with dementia. Data were obtained from a sample of 141 caregivers through the random-digit dialing telephone survey. Two coping styles were identified: deliberate coping and avoidance coping. Deliberate coping was related to higher life satisfaction scores and, avoidance coping was related to lower life satisfaction scores and higher caregiver burden scores. Avoidance coping appeared to moderate the effects of caregiver health on caregiver burden. Social workers should pay greater attention to caregivers with dysfunctional coping styles.     

Telephone Support Groups for Caregivers of Persons with AIDS

Caregivers of persons with AIDS experience numerous stressors in their caregiver role and could benefit from support groups. However, caregiving responsibilities make it difficult for many to attend face-to-face groups. This article describes experience with a telephone support group pilot project for this population. The time-limited, semi-structured groups used conference call technology; the eight session group protocol war designed to meet caregiver needs for information about resources and coping skills. Pilot data from interviews with group members from the first two completed groups on this project indicated that participants valued the group experience highly.     

Religiosity as a mediator of caregiver well-being: does ethnicity make a difference?

This study used an adaptation of the stress and appraisal model to examine the mediating effects of religiosity on caregiving strain and gain with an ethnically diverse sample of 384 Alzheimer's disease caregivers. While the regression analysis indicated that religiosity did not mediate the stress of providing care for the entire sample, there were significant differences in the use of religiosity depending on the ethnicity (African American, Hispanic, and White non-Hispanic) of the caregiver, as well as significant differences between the three cohorts in the levels of caregiving strain (depression) and gain (self-acceptance). Implications for the use of religiosity as a protective factor for AD caregivers are discussed.     

Foster carer perceptions of support and training in the context of high burden of care

The challenges of providing sensitive and structured care for children in foster care go well beyond normative experiences of parenting. The present paper describes a mixed‐methods study of foster carers' perceived need for support and training, referenced to estimates of their burden of care. Semi‐structured interviews were conducted with 17 foster carers in the Canterbury region of New Zealand. Carers' perceived need for support and training were identified through qualitative analysis of interviews using domain analysis method. Carers' burden of care was estimated from the Parenting Stress Index and from a measure of carers' encounters with children's emotional, behavioural and relationship difficulties that was designed for the present study (the Caregiver Behavioural Encounters Index). Foster carers reported substantive, unmet needs for support and training. Foster carers also reported high parenting stress and encounters with a wide range of children's mental health difficulties, including both uncommon and severe difficulties, which together represent an exceptional burden of care. Carers' highest priority need was for training and support on managing and responding to children's mental health difficulties, while their greatest existing support came from Caregiver Liaison Social Workers and other carers. The findings suggest a number of critical implications for practice.     

Service Barriers of Chinese Family Caregivers in Canada

ABSTRACT

Family caregiving is a stressful process, especially when the complexity of being an immigrant or ethnic minority is added. This paper examined service barriers experienced by Chinese immigrant family caregivers in Canada and the predictors of different types of barriers. Principle component analysis was performed with the barriers reported loading onto cultural barriers, administrative problems, circumstantial challenges, perceived negative quality of services, and personal attitudes. Multiple regression analysis was used to identify the role of the culture-related factors in predicting service barriers, controlling for socio-demographic status of the caregivers'. The results show that financial factors significantly predicted the number and types of barriers reported by the caregivers. Culture-related factors were significant in predicting the total number of access barriers and the different types of barriers experienced by the family caregivers. The findings indicate the importance of culturally sensitive support for family caregivers in order to reduce the access barriers.     

Resilience,Ambiguous Loss,and Older Same-Sex Couples: The Resilience Constellation Model

ABSTRACT

Secondary data analysis examined factors contributing to successful long-term same-sex relationships in older adults. An online survey of couple satisfaction and life factors provided data from 156 participants. Constructivist grounded theory methods were applied to analyze responses to open-ended questions regarding perceived supports and threats and ‘people or things’ contributing to relationship longevity. The resulting Resilience Constellation model identified concepts of: maturity, couple integration, compatibility, complementarity, and ambiguity of external support. This model can be used as a practitioner tool to assess couple resiliency and ambiguity related to societal, social, and intrarelationship stressors. Suggestions for application of the model and further research are explored.