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.     

Caregiving Load and Respite Service Use: A Comparison between Older Caregivers and Younger Caregivers

Study aims were to explore differences in predictors of respite care use between older (aged 65+) and younger caregivers (aged 18–64 years), and associations between caregiving load and respite care use using multivariate logistic regression analysis and unpaid caregiver (n= 10,500) data from the 2009 California Health Interview Survey. Caregiving load comprised number of care recipients, weekly hours in caregiving, and caregiving duration. Variables with a significant association with respite care for older caregivers were female gender, income, and health insurance. For younger caregivers, respite care use associations were with ethnicity, caregiving relationship, education, and availability of substitute help.     

Gerontological Social Work Student-Delivered Respite: A Community-University Partnership Pilot Program

ABSTRACT

This study describes a community-university partnership to support a gerontological social work student-delivered respite program, the Houseguest Program (Houseguest). Houseguest was designed using a community-engaged scholarship model of integrating research, teaching, and service. Houseguest was piloted with a small group of community-dwelling, coresiding dementia caregivers and care recipients. We examined caregivers’ experiences with student-delivered respite using qualitative data analysis. Thematic analysis produced 8 themes: (a) respite from full time caregiving role, (b) information on caregiving strategies, (c) no-cost supportive services, (d) opportunity for care recipients to socialize, (e) tailored activities for care recipients, (f) rapport-building between students and family dyad, (g) reciprocity between students and family dyad, and (h) program continuation. We conclude with a proposed community-engaged scholarship model for dementia caregiving. Through a community-university partnership, Houseguest reduced the impact of caregiver burden and created an opportunity for students to serve families affected by dementia through respite and tailored activities.     

Caregiver Burden: A Comparison Between Elderly Women as Primary and Secondary Caregivers for Their Spouses

The overall purpose of this research was to examine the burdens of caregiving on elderly women who serve as primary and secondary caregivers for their impaired spouses. Fifty women 60 years and older identified as spousal caregivers participated in an in-person structured interview. Data were analyzed to compare primary caregivers (caregivers living with their spouses) and secondary caregivers (caregivers of institutionalized spouses) on the following factors: loneliness, depression, time constraints, perceived health status, financial status and perceived life satisfaction. Findings suggest that both groups of women are equally susceptible to the burdens inherent in caregiving. Time constraints were identified as the one major difference between caregiving groups. In addition, the results indicate that spousal caregivers, both primary and secondary, are an at-risk population and are especially vulnerable to loneliness, mild depression, financial worries and low life satisfaction.     

Satisfaction,Communication and Affection in Caregiving

Multigenerational caregiving is becoming a prevalent means of caring for moderately to severely impaired elders. Handling the stress created in these arrangements may depend on the relationship between the elder and the caregiver. This study examines components of such relationships and highlights caregiving as experienced by the elder receiving care. Findings 'indicate that improved quality of relationship between elder and caregiver is related to a high degree of elder's satisfaction with the arrangement, whereas level of functioning of the elder is not related to degree of satisfaction. However, findings also suggest that elders fear being a burden, hide their troubles and feelings and generally feel no sense of contribution to the household.     

Children's Attachment Relationships with Day Care Caregivers: Associations with Positive Caregiving and the Child's Temperament

In this study, children's attachment relationships with their professional caregivers in center day care were observed for 48 children. We explored whether more positive caregiving was associated with a more secure attachment relationship and whether this association was stronger for more temperamentally irritable children compared to less irritable children. Trained observers coded the attachment relationship in the day care setting using the attachment Q-sort. The observational record of the caregiving environment was used to assess children's individual experience of positive caregiver–child interaction in the classroom. When caregivers showed more frequent positive caregiving behavior, children showed more secure attachment behavior toward their primary professional caregiver. Temperament was not related to attachment security, nor did it serve as a moderator. Consequently, no support for Belsky's susceptibility hypothesis was found.     

Exploring how workplace and social policies relate to caregivers’ financial strain

Informal caregiving is a critical component of the US long-term care system, but can have significant negative impacts on caregiver employment, finances, and well-being. An online survey of Colorado caregivers was piloted in 2016–17 to explore whether workplace and social policies such as access to paid family leave and public health insurance can buffer the negative financial impacts of caregiving and help caregivers to remain in the workforce. Using standardized measures, the survey assessed caregivers’ employment and financial status, well-being (physical and mental health, caregiver strain, benefits of caregiving), access to workplace supports, and covariates (e.g., caregiver demographics, health, social support, and service utilization). Ninety-five caregivers, recruited through community agency partners, completed the survey. Respondents were predominately female (89%), middle-aged (M = 57), non-Hispanic White (64%) or Latino/a (22%), and caring for a parent (40%) or spouse (30%) for over one year. Half (51%) reported working full- or part-time jobs, while 16.4% had stopped working because of caregiving. In multivariate regression modeling, predictors of financial strain included the care recipients’ financial strain and the caregiver’s reduction or ceasing of work. Medicare may be protective to minimize caregivers’ need to reduce or cease work. Implications for caregivers’ ability to stay engaged in the workforce and prepare for their own retirement are explored.     

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.     

Caring for Individuals with Chronic Illness and Minor Depression: Latino Perceptions of Caregiver Burden

ABSTRACT

Informal caregiving can be fundamental to disease management. Yet, the psychosocial, physical, and financial burden experienced by caregivers can be significant. In the US, Latinos experience increasing rates of chronic conditions, the highest uninsured rates in the country, and a growing dependence on informal caregivers. This article explores the impact of caregiving on caregivers of individuals with comorbid chronic disease and depression. Findings highlight the impact of caregiving on financial insecurity, balancing competing demands, increased emotional distress, and community supports. Findings support the inclusion of caregivers in disease management programs to enhance psychosocial outcomes for both caregivers and their patients.     

The nature of relationships between orphans and their kinship carers in Botswana

Generations of parents lost to AIDS and other causes have created a vacuum of care for the orphaned children they leave behind. This crisis has resulted in rapid changes in caregiving and family life, with extended family members, having to care for orphaned children. As a result of high numbers of vulnerable orphaned children residing with kinship carers, and the fundamental importance of the relationship between carers and orphaned children, we need to understand more about these relationships. This paper explores the nature of orphaned children–kinship carer relationships in Botswana. Interview guides were used to collect data from 15 caregivers and 15 orphaned children. The results indicate that the nature of relationships between orphaned children and caregivers is influenced by the way the parties communicate, how adolescents behave and the competing responsibilities of caregivers. Lastly, the paper recommends how positive relationships can be developed and nurtured between orphaned children and their caregivers in an African setting.     

Social-economic context of parent care: explaining Chinese caregivers' psychological and emotional well-being

This paper explores Chinese familial caregivers' depression and subjective burdens among the current caregivers. Data were collected in 1997-1999 with 110 caregivers who were then taking care of physically dependent parents or parents-in-law. Regression analyses were conducted to assess the factors that influence caregivers depression and subjective burden. Findings suggest that family and individual economic conditions are related to caregivers' depression. Caregivers' involvement in caregiving tasks is associated with caregivers' subjective burden. Poorer self-perceived health is related to higher report of caregivers' depression. The author argues that poorer health and unemployment at the time of drastic social and economic changes in China may have created psychological and emotional anxieties and depression for caregivers. The lack of financial and social stability may have deleterious effect for current caregivers in the future when they grow older and have to be cared for by their one-child generation children.     

Institutionalizing Dementia Victims:

The purpose of this study was to identify factors associated with caregivers' perceived likelihood of institutionalizing dementia victims. Forty-five primary caregivers of noninstitutionalized victims completed questionnaires dealing with sociodemographic characteristics of the victim and caregiver, the level of impairment and several variables related to the caregiving situation. Most of the caregivers were spouses (64%), females (62%) and their mean age was 64.5 years. The statistical analyses revealed that anticipated institutionalization was greater if the victims were older, their impairment had progressed rapidly and rendered them more dysfunctional. Likelihood of institutionalization also was greater if the caregivers were not the victims' spouses, the caregivers experienced more burden, and if the victims' relationship with the caregivers was less close. The qualitative data identified two paradoxical aspects of the caretakers' subjective experiences a love-hate conflict and premature versus delayed institutionalization. Recommendations for future research include longitudinal studies and a broader range of variables related to the effects of caregiving.     

Social issues in contemporary native America: reflections from Turtle Island

The purpose of this study was to explore how the death and dying-related beliefs of caregivers influence their actual caregiving behavior, and to explore factors that may prevent them from translating these beliefs into functional behavior. Using a biopsychosocial-spiritual- environmental framework, semi-structured in-depth interviews were conducted with three primary caregivers of patients diagnosed with terminal illness. Caregiving behavior was found to be associated with the biopsychosocial-spiritual-environmental beliefs of the caregivers. These beliefs could have been influenced by the caregivers' past experiences with death and dying. Financial difficulty might also be a main obstacle hindering caregivers from providing the kind of care they believed was best for the patients.     

ELDERLY HUSBANDS CARING AT HOME FOR WIVES DIAGNOSED WITH ALZHEIMER'S DISEASE: ARE MALE CAREGIVERS REALLY DIFFERENT?

In Australia, there is a dearth of literature available on men as principal carers despite reports which show that in the 60 + age group, looking after a sick spouse becomes the major form of caregiving and men as carers predominate (ABS, 1993). The paper reports findings from a study of 26 aged husbands who cared at home for their cognitively impaired wives. In‐depth interviews collected quantitative and qualitative data about men's caregiving experiences. Findings challenge the literature about the role gender plays in evoking care and service responses. Results show how men demonstrated a strong injunction to care, performed intimate personal care tasks competently, received limited government support and derived some satisfaction from the caregiving role. Despite similarities between male and female caregivers being noted, some gender differences in the way in which men approached the care role are described. The need for community care policies to be more sensitive to the gendered context of elderly care provision is discussed.     

Continuing to Pay: the Consequences for Family Caregivers of an Older Person's Admission to a Care Home

This paper aims to discuss the reasons why caregiving in the community had ended for a sample of dependent older people, two-thirds of whom had dementia. Comparisons are made between the situation of a spouse caring for a partner and a daughter or son caring for a parent in a separate household. Spouses in the study had often sustained a greater burden before caregiving collapsedthan had daughters or sons. They were less likely, however, to have had support from the home care service. When caregiving in the community ended and the dependent older person entered a care home, family caregivers themselves often had a financial price to pay. Currently spouses have a legalliability to contribute to a partner's care costs. The implementation of this liability depended on individual local authority policies and the views of the individual social worker doing the financial assessment. Because of the UK's means-testing rules, daughters and sons were often penalizedbecause a parent's assets that they might have inherited had to be used to meet the care home costs. Resentment at being disinherited was related to the daughter's or son's family situation. Those with children or grandchildren themselves were far more likely to be angry than those without children.     

Impact of a multicomponent support services program on informal caregivers of adults aging with disabilities

A multicomponent support services program was implemented for veterans aging with disabilities and their informal caregivers (n = 42 dyads). Caregiver outcomes (satisfaction, physical and mental health status, burden, and benefits) were evaluated before and after program use. Caregivers reported significant improvements in mental health post-program. Caregivers who provided care to individuals with impaired physical health experienced meaningful improvements in burden after the support services were rendered. Supporting caregiver health status through such programs is vital to preserve noninstitutional long-term care for persons aging with disabilities, particularly when care is provided over many years to an individual with physical impairments.     

Dementia Caregiving Outcomes: The Impact of Caregiving Onset,Cognitive Impairment and Behavioral Problems

With a projected increase in the prevalence of Alzheimer’s disease (AD) and related dementias, family caregiving is steadily increasing. Caring for an individual with AD is characterized as a “career,” and within this career are a number of key transitions, including the onset of caregiving. Research reveals a number of negative emotional health outcomes for AD caregivers, including depression and role overload, but less research has examined the influence of key transitions on the emotional adaptation of caregivers. The purpose of this study is to examine how different patterns of caregiving onset (gradual and abrupt) impact emotional health outcomes for AD caregivers. This study also explores how care-recipient cognitive impairment and behavioral problems moderate these relationships. Cross-sectional, quantitative data from 100 caregivers completing self-administered surveys were used. A series of one-way ANOVAs and multiple regression analyses were conducted to address study aims. Results indicate that care-recipient cognition and behavioral problems moderated the relationship between caregiving onset and emotional health outcomes for caregivers who experienced a more abrupt entry into the caregiving role. Results suggest the importance of considering different onset transitions and moderating factors within the caregiving career to target clinical interventions. Implications for social work practice are discussed.     

Quality of Life among Compound Caregivers and Noncompound Caregivers of Adults with Autism

ABSTRACT

Children diagnosed with autism spectrum disorder (ASD) are reaching adulthood and require some form of lifelong care. Many parents continue caring for their adult children with ASD for as long as physically possible. As parents age, many also may provide care for another loved one, such a spouse or parent. This study compares compound (those providing care for multiple loved ones) and noncompound parental caregivers (those providing care solely for an adult child with ASD) on six dimensions of quality of life (enjoys life, life is meaningful, ability to concentrate, accepts bodily appearance, satisfied with self, and frequency of negative feelings). Specifically, this study determined the extent to which compound and noncompound caregivers’ quality of life differed. The present study included 320 parents (age 50 or older) of adult children (18 or older) diagnosed with ASD who completed a web-based survey. T-tests for independent samples compared the six dimensions and overall quality of life between compound and noncompound caregivers. Results indicated that compound caregivers were less able to concentrate and had fewer negative feelings than noncompound caregivers. Further research is needed to determine the effects of caregiving on the multidimensional aspects of quality of life.