Joy and sorrow: Explaining Chinese caregivers' reward and stress

This study explores positive and negative aspects of Chinese caregivers' experience, specifically, caregiving social reward as well as depression. Based on data collected in 1997–1999 with 110 caregivers who were then taking care of physically dependent parents or parents-in-law, this study finds that caregivers caring for elder parents with pensions reported higher levels of social rewards. Caregivers who were unemployed and had poor self-rated health reported higher levels of depression. Cultural values were found to have two dimensions of effect on caregiving experiences: while caregivers' report of strong filial responsibility was positively related to caregivers' depression scores, caregivers' report of social pressure was negatively related to their report of social reward. The author argues that the dual effect of family economic conditions and caregivers' cultural values calls for greater attention to elders' financial stability and caregivers' psychological well-being.     

Unpacking Racial Socialization: Considering Female African American Primary Caregivers' Racial Identity

The relationship between female African American primary caregivers' racial identity and their racial socialization emphases was examined. Three components of racial identity were evaluated: (1) the importance of race to the self‐concept (centrality), (2) affective feelings toward group membership (private regard), and (3) perceptions of how group members are perceived by nonmembers (public regard). Latent class cluster analysis was used to identify racial identity profiles, or dominant combinations of racial centrality, private regard, and public regard among a sample of 208 female African American primary caregivers. Mean differences in the content of caregivers' socialization emphases by profile group were then assessed. Findings indicated that caregivers with different identity profiles emphasized different messages. These findings and their implications are discussed.     

Quantity and Quality of Gestural Input: Caregivers’ Sensitivity Predicts Caregiver–Infant Bidirectional Communication Through Gestures

Children's use of pointing and symbolic gestures—early communication skills which predict later language—is influenced by frequency of adults’ gestures. However, we wonder whether, like language, the sensitivity of adult–child interactions is also important for encouraging child gesturing, rather than simply quantity of adult gestural input. Furthermore, children's use of gestures influences qualities of adult–child interaction, eliciting greater responsiveness and richer communication. Thus, we investigated the moderating role of nonparental caregiver sensitivity on the relationship between caregivers’ and infants’ use of pointing and symbolic gestures. We observed 10 infants (ages 6–19 months) over 8 months with a total of 24 student caregivers completing short‐term internships, recording adult and child use of pointing and symbolic gestures. We used longitudinal growth models to examine change in gesturing and moderating roles of caregiver sensitivity in the relations between caregiver and child gesturing behavior. Caregivers’ sensitivity moderated effects of caregivers’ symbolic gestures on infants’ pointing and symbolic gestures, and the effects of infants’ pointing and symbolic gesture frequency on caregivers’ gesture use. Thus, caregivers’ gestures are most effective in supporting child gestures when in the context of sensitive interactions. Sensitivity is central to supporting children's early communicative behaviors, including pointing and symbolic gestures.     

Caregivers' Endorsement of Barriers to Mental Health Services for Children and Youth in Child Welfare

The purpose of this study was to examine the three most common types of caregivers in the child welfare system (birth parents, relative caregivers, and foster parents), an active child welfare case, caregivers' endorsement of barriers to mental health services and mental health service use by caregivers for the children under their care. The sample consisted of 430 dyads (caregivers and their children). Results indicate that an active child welfare case, provider characteristics, and accessibility of services predicted mental health service use for children. Implications for the child welfare and mental health systems are discussed.     

Cognitions and Distress in Caregivers after Their Child's Sexual Abuse Disclosure

The impact of child sexual abuse on children is well documented, but few studies have examined the impact of a child's sexual abuse disclosure on maternal caregivers. The studies that have been conducted suggest that parental response postdisclosure is variable. The present study examined the association between maternal attributions and abuse-specific cognitions with depression and trauma symptoms postdisclosure. Participants included 68 nonoffending maternal caregivers of children between the ages of 3 and 17 years who experienced child sexual abuse. Findings indicated that caregivers' abuse-specific cognitions were the best predictor of self-reported symptoms of depression after controlling for general negative attributions. These findings suggest that in order to reduce caregivers' distress and to enhance their support of their children, it is important to assess and treat caregivers' abuse-specific cognitions.

     

Bearing the Costs of Our Eldercare Policies

For many caregivers, rendering aid to frail parents, grandparents, siblings, and spouses comes at a high price: compromised physical and mental health, disturbed relationships with spouse and children, truncated opportunities for social life, and, for caregivers who are employed, declining job performance. Using the 1982 National Long Term Care Survey's "Survey of Informal Caregivers," this study investigates how the sociodemographic characteristics of caregivers, care requirements, the availability of backup caregivers, and conditions of employment affect the likelihood that caregivers will suffer work constraints. Estimations of both the probability of work constraints and hours of work reveal that proxies for work conditions figure prominently, as do care requirements. In the model of constrained work, ill health, financial burdens, and primary responsibility for care are significant determinants; the estimation of hours of work revealed that low income and competing care demands wielded major influence. Women and white caregivers are employed fewer hours, while spouses are more likely than other informal caregivers to face constrained work. Occupation. as an indicator of work conditions, is shown to be an important addition to the factors considered in investigations of circumstances that affect caregivers' experiencing work constraints.     

Willingness to Use Formal Long-Term Care Services by Korean Elders and Their Primary Caregivers

This study examined predictors of older adults' and primary caregivers' willingness to use formal long-term care (LTC) services to understand possible use patterns of mandatory public LTC insurance programs in Korea. It focused on views regarding who (adult children or the government) should bear the responsibility for older adults' care. Logistic regression models were estimated using data from 1,168 older Korean adults aged 65 or older and their primary caregivers from a national survey. The results showed that older adults' and their caregivers' views on care responsibility were a dominant predictor of their willingness to use both formal home care services and nursing home care services. Both older adults and their family caregivers' willingness to use LTC services should be considered when predicting demand for LTC services. Efforts should promote the perspective that formal LTC services are an acceptable social norm.     

Older Parents Providing Child Care for Adult Children: Does It Pay Off?

This study examined whether past grandparental child care is related to present support from adult children. On the basis of social exchange theory, the authors expected that grandparental child care creates a debt that is repaid in the form of receiving support later in life. Using data from the Longitudinal Aging Study Amsterdam (N = 349 parents, N = 812 adult children), the authors found that grandparents who frequently provided child care for sons in the past more often received instrumental and emotional support from these sons approximately 13 years later than grandparents who less frequently provided child care. Investments in daughters did not pay off. Instrumental support other than child‐care provision did not predict receiving support from either sons or daughters, but emotional support did. These results support the notion of long‐term reciprocity in parent–child relationships, but its importance depends on the child's gender and the type of earlier investment.     

Inclusion of Caregiver Supports and Services in Home- and Community-Based Service Programs: Recent Reports from State Units on Aging

Caregivers have an important role in assisting frail and/or disabled individuals to maintain their independence in the community. Support to assist caregivers in this often stressful and demanding role is critical to sustaining the caregivers' health and ability to provide care. This paper reviews federal policy changes since 2000 that have expanded and enhanced services for informal caregivers. Next, data collected from State Units on Aging and other state agencies are presented to describe the extent to which caregiver services are included in home- and community-based programs under three funding streams (Medicaid waivers, Centers for Medicare and Medicaid Services–funded programs, and state-funded programs). Program characteristics, such as eligibility and consumer-directed options, are included. Finally, the accomplishments and initiatives reported by state respondents related to supporting informal caregivers are also explained. Results indicate that services for informal caregivers are receiving greater attention and are frequently offered under home- and community-based service programs by the states that participated in this study.     

Orphanage caregivers' perceptions of children's emotional needs

Problems in orphan care are endemic in sub-Saharan Africa where 80% of all children orphaned by AIDS live. Institutions are often the only level of care available for infant orphans, but such care may increase children's risk for psychological, emotional and developmental problems. This study explores Ghanaian institutional caregivers' views of children's emotional and relational needs with the aim of understanding these caregivers' capacities to provide effective care for orphans. Qualitative data was gathered from 92 staff at eight Ghanaian orphanages. Results indicate that while caregivers describe a basic understanding of children's emotional and interpersonal needs, they detail a lack of training and support necessary to fully attend to these needs. Specifically, training for caregivers regarding children's basic attachment needs and the particular emotional needs of orphaned children is critical. The present study suggests the need for training and interventions to strengthen orphanage caregivers' capacity to provide effective orphan care.     

Continuity and Change in Mothers' Favoritism Toward Offspring in Adulthood

The importance of parental favoritism in childhood and adulthood has been well documented; little is known, however, about changes over time in such within‐family differentiation. Drawing on theories of life course processes and developmental psychology, the authors used 7‐year panel data collected from 406 older mothers about their relationships with 1,514 adult children to explore patterns of favoritism regarding caregiving and emotional closeness. The findings demonstrated continuity in patterns of mothers' favoritism. Mothers tended to prefer the same children across time, particularly regarding preferred caregivers. It was anticipated that children's social‐structural characteristics, similarity to their mothers, structural position in the family, and support provision to mothers would predict favored child status across time; however, only similarity and support processes were strong and consistent predictors of change and continuity in patterns of mothers' favoritism.     

Effect of Pediatric Influenza on Caregivers’ Burden—A Literature Review

Influenza, or the flu, is a common and potentially serious infection that disproportionally affects children with more than 20,000 yearly hospitalizations in children under the age of 5. A literature review of the caregiver burden associated with pediatric influenza was conducted. Two main types of burdens were identified: economic and noneconomic. Flu treatment costs $3,990 for pediatric inpatients services and $730 for emergency department (ED) pediatric patients. Caregivers may also face out-of-pocket costs ($178 for inpatients, $125 for ED patients, and $52 for outpatients) or those not covered by health insurance. Caregivers can also face indirect costs while caring for their children with the flu. Indirect costs were common, and 75% of pediatric caregivers reported these costs when caring for a sick child. Missed work is the most common indirect cost and is estimated as high as 73 work hours ($1,456) missed while caring for a sick child. Other costs associated with pediatric influenza included noneconomic burden: sudden changes in daily life, loss of leisure time, social disruption, and psychological impact or stress. Noneconomic burdens were also found to be significant and lowered the quality of life of caregivers even after the child’s illness. Socioeconomic status is an important predictor of influenza rates. Residents in high-poverty areas are three times more likely to have hospitalizations due to pediatric influenza than those in low-poverty areas. From the literature it is evident that pediatric influenza has demonstrated a considerable impact on caregivers’ lives both financially and in other aspects.     

Family caregivers of the elderly: quality of life and coping in Estonia

The purpose of the study was to analyse the assessments of elderly people aged 65 and more about family caregiving as a factor influencing their quality of life and coping. The study is based on the project SUFACARE—‘Supporting family carers and care receivers in Estonia and in Finland’—in the framework of which the Institute of Social Work of Tallinn University carried out postal surveys in 2010. The Estonian survey was conducted in Tallinn and Lääne-Viru County. The total number of respondents was 581 (70% female and 30% male), of whom 98 (n=74 female and n=24 male) were family caregivers. Caregiving has not influenced the physical and mental health of caregivers, the reason being that many people who receive care are not of very ill health or suffer from dementia. People mostly take care of their spouses. Based on the Estonian Family Law Act (RT I 2009, 60, 395), adult descendants are required to provide maintenance if their relatives are not able to care for themselves. Caregivers whose health is below average consider caring to be physically demanding. We cannot speak of the social isolation of respondents who have care duties—they communicate actively and do not feel lonely. Women report caregiving to be physically strenuous more often than men. The mental health of male caregivers is better—fewer male respondents claimed to feel unhappy or depressed compared to female respondents.     

When caregiving ends: the course of depressive symptoms after bereavement

This study describes depressive symptoms among caregivers following bereavement and connects these trajectories to earlier features of caregiving using life course and stress process theory. Data are from a six-wave longitudinal survey (five years) of spouses and adult children caring for someone with Alzheimer's Disease. The analytic subsample (N = 291) is defined by death of the care-recipient after the baseline interview. A latent class mixture model is used to identify distinctive clusters of depressive symptoms over time. Of the four trajectories identified, three represent stable symptom levels over time, with two-thirds being repeatedly symptomatic (medium symptom levels), compared to two smaller groups of repeatedly asymptomatic (effectively absent of symptoms) and repeatedly distressed (severe symptoms). In contrast, about one in five caregivers experiences improved emotional well-being over time, the temporarily distressed, who progress from severe to moderate symptom levels. Caregivers with few symptoms before bereavement tend to maintain these states afterwards, but emotionally distressed caregivers tend to become more distressed. Role overload before bereavement substantially increases the odds of following an unfavorable trajectory afterwards, whereas self-esteem and socioemotional support play protective roles. These results demonstrate that caregivers are not uniform in their emotional responses to bereavement, but follow several distinct trajectories. These trajectories are linked to their previous experiences as caregivers, in particular exposure to stressors and access to resources. These findings suggest that intervention during caregiving may facilitate adaptation following death of a loved one.     

Economic transition and new patterns of parent‐adult child coresidence in Urban China

This study uses national data from the 1996 Life History and Social Change in Contemporary China survey (N= 3,087) to gauge the effect of the economic transition on parent‐adult child coresidence in urban China. Previous studies find that, thanks to state actions, traditional patterns in coresidence persisted in post‐Mao urban China. This study still finds high levels of coresidence. China's aging population, coupled with an underdeveloped social security system, means that the traditional role of family will remain strong. It also uncovers three new patterns, however, best explained as caused by changes in the economic realm. First, the coresidence pattern changes over parents’ life course, shifting from child‐centered to parent‐centered as parents age. Second, class differentials begin to emerge, most notably seen in the unique patterns of the entrepreneurial class. Last, gender differentials remain significant, but the tilt toward sons has strengthened.     

Parenting Success and Challenges for Families of Children with Disabilities: An Ecological Systems Analysis

This article examines factors that are associated with parenting success for caregivers of children with disabilities using Bronfenbrenner's ecological systems framework. Although numerous studies have investigated risk factors for negative parenting among caregivers of children with disabilities, there are relatively few research findings on parenting success. More specifically, we examine factors for parenting success within the context of micro- (parenting practices, parent-child relations), meso- (caregivers' marital relations, religious social support), and macro-systems (cultural variations, racial and ethnic disparities, health care delivery system), which is then followed by implications for social work practice.     

Feasibility of Implementation of a Parenting Intervention with Karen Refugees Resettled from Burma

Parents and children exposed to war and relocation have high rates of negative relational and mental health outcomes. This study tested the feasibility of implementing an adapted evidence‐based parenting intervention for contexts of trauma and relocation stress. Eleven Karen refugee caregivers from Burma participated in the intervention. Participants and a focal child completed ethnographic interviews as well as structured assessments at baseline and follow‐up. Caregivers reported changes in their teaching, directions, emotional regulation, discipline, and child compliance. Children reported changes in these areas and in positive parent involvement. Caregivers reported higher mental health distress immediately after the intervention, potentially due to increased awareness. Researchers made personalized referrals for counseling services as needed. Children reported a decrease in mental health symptoms.