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.     

Veterans’ Informal Caregivers in the “Sandwich Generation”: A Systematic Review Toward a Resilience Model

Social work theory advanced the formulation of the construct of the sandwich generation to apply to the emerging generational cohort of caregivers, most often middle-aged women, who were caring for maturing children and aging parents simultaneously. This systematic review extends that focus by synthesizing the literature on sandwich generation caregivers for the general aging population with dementia and for veterans with dementia and polytrauma. It develops potential protective mechanisms based on empirical literature to support an intervention resilience model for social work practitioners. This theoretical model addresses adaptive coping of sandwich- generation families facing ongoing challenges related to caregiving demands.     

Can Cultural Values Help Explain the Positive Aspects of Caregiving Among Chinese American Caregivers?

This study used an adaptation of the caregivers' stress model to examine the positive aspects of caregiving with 113 Chinese American family caregivers who provided care to their elderly relatives. The hierarchical multiple regression analysis indicated that combination of caregiver background characteristics, stressors, and cultural values had direct effects on positive aspects of caregiving. Unlike previous studies in which cultural values were not measured, this study found that cultural values helped explain positive aspects of caregiving. Specifically, cultural values, caregiver's health, and caregiver's age predicted positive aspects of caregiving. Service implications are discussed based upon the findings.     

Effects of Nurturing and Non‐nurturing Caregiving on Child Social Initiatives: An Experimental Investigation of Emotion as a Mediator of Social Behavior1

This study examined the effects of one unfamiliar adult's warm, responsive interactions or cold, aloof, unresponsive interactions on child emotion and subsequent social initiatives to a second adult. Participants were 32 4¹/₂‐ to 5¹/₂‐year‐old preschool children. Nurturing, responsive caregiving and non‐nurturing, unresponsive caregiving were experimentally manipulated by experimenter facial and vocal affective expressions, positive versus negative statements to the child, and contingency of responding to the child's behavior. The effect of nurturance was examined on child emotions and social initiatives to another adult. Non‐nurturing caregiving produced less expressed happiness and fewer subsequent social initiatives. Furthermore, child emotion was found to mediate partially the relation between nurturing caregiving and social initiatives, with children who experienced interactions with a non‐nurturing caregiver expressing less happiness, which led to decreased social initiatives to a second adult.     

Chinese American Family Caregivers’ Perception of Program Use and Caregiver Stress

Caregiver programs provide specialized services and resources to reduce caregiver stress and improve family quality of life and health. Although there are resources and community services available, Chinese American family caregivers’ perceptions on caregiver programs and how specific services help to viably reduce their stress has yet to be examined. An in-depth interview was conducted with four Chinese American family caregivers in exploring their caregiving experiences and program service use; two of the caregivers were spouses and two were adult children. Content analysis revealed that their value of familial piety, and their need to ameliorate caregiver stress fueled their interest in new interventions to improve their quality of life and health. Spousal caregivers and adult children caregivers disclosed different needs due to caregiving, and adult children caregivers were less resistant to new interventions. The results of this study fill the knowledge gap on Chinese American family caregivers’ perception of caregiving in a cultural context as well as their needs. Suggestions for future research are to better understand the effectiveness of the specific services within caregiver programs that are effective in reducing caregiver stress among Chinese American family caregivers.     

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.     

老人的居住模式与子女的赡养行为

本文使用2006年全国社会综合调查的抽样数据,分析了老年人的居住模式、与子女的居住距离和儿女数量对子女赡养行为的影响。研究发现,老人的居住模式和居住距离并不明显影响子女给予的经济支持,但会影响子女在日常照料和情感慰藉方面给予的支持。有同住子女的父母可以得到子女更频繁的关心和照顾,而空巢家庭的父母从子女处获得的日常照料和经济支持则较少;子女居住得离父母越近,则越经常给予父母日常照料和情感慰藉。研究也发现,子女给予父母各方面照料的频繁程度不受兄弟姐妹数量的影响,独生子女并不比非独生子女更频繁地照顾父母。     

Danger and Dementia: Caregiver Experiences and Shifting Social Roles During a Highly Active Hurricane Season

This study examined disaster preparedness and decision-making by caregivers of community-dwelling persons diagnosed with Alzheimer’s or a related dementia (ADRD). Interviews were conducted with 20 caregivers in South Florida. Twelve of these interviews include caregiving experiences during the highly active 2004–2005 hurricane seasons. Results indicate that persons in earlier stages of ADRD can, and often do, remain engaged in the disaster preparation and planning process. However, during the early stages, persons may also resist evacuation, even if the caregiver felt it was necessary. During later stages of the disease, caregivers reported less resistance to disaster-related decisions, however, with the tradeoff of less ability to assist with preparation.     

Well‐being among employed and non‐employed caregiving women in Taiwan

Chou Y‐C, Kröger T, Chiao C, Pu C‐Y. Well‐being among employed and non‐employed caregiving women in Taiwan This study addressed various groups of non‐employed/employed and non‐caring/caring women in Taiwan. Data from the 2006 National Taiwanese Women Survey (at age 16–64, n= 6,017) were analysed to determine whether there are differences in terms of well‐being, as measured by self‐rated health and family life satisfaction, between women who work and/or care and between different carer groups. Other factors associated with well‐being of carers of young children (n= 1,697) were also analysed. The results showed that non‐employed carers of disabled adults stood out as the most disadvantaged group. However, the importance of work has been replaced by support among carers of young children. This study suggests that unpaid carers, particularly carers of disabled adults who are non‐employed, ought to be supported by policies. To improve carers' well‐being, care–work reconciliation among working‐age women needs to be included in the future care scheme in Taiwan.     

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.     

Assessment and decision-making in a case of child neglect and abuse using an attachment perspective

Assessment and decision-making in complex cases of child abuse and neglect is a difficult and taxing process. Although social workers have become increasingly good at collecting information, often under the direction of agency checklists and manuals, there is less confidence in knowing how to make sense of that information for purposes of assessment and decision-making. Theories help organize knowledge and attachment theory is proving to be a powerful player in helping practitioners make sense of what they know. The paper outlines the basic tenets of attachment theory. When adapted to the context of social work, a key principle of an attachment-based practice is the recognition that young children develop a range of adaptive strategies that are designed to help them cope with, survive, and function in whatever caregiving environment they happen to find themselves, including ones in which there is abuse and neglect. Although these strategies are functional within the context of adverse caregiving environments, they carry the risk of children suffering a variety of developmental impairments and failure to develop social competence. A case is described in which there are elements of abuse and neglect both within and across the generations. An attachment perspective is used to analyse and assess the quality and character of parenting and the different adaptive strategies developed by each child in the caregiving context in which they have found themselves. The assessment is then used to inform the decision whether or not to leave the children in the care of their mother or to place them with a long-term substitute family, with or without contact.     

A perfect storm: Challenges encountered by family caregivers of persons with Alzheimer’s disease during natural disasters

ABSTRACT

Since Hurricane Katrina there has been a movement across the U.S. to examine best practice for disaster response within the aging population. However, little is known about the experience of natural disasters from the perspective of family caregivers of persons with Alzheimer’s disease and related dementia (ADRD). In this exploratory, qualitative study, family caregivers (n=27) were interviewed about their experience with the historic 2015 South Carolina flood. By using thematic analysis, themes were identified to better understand what unique challenges caregivers of person with ADRD experienced. While many caregivers stated they had experienced a natural disaster previously, none had ever done so in their current caregiving role. The caregiving role affected their ability to prepare for the storm and influenced their decision-making regarding evacuation and utilization of recovery resources. Thus, caregivers were confronted by a “perfect storm” of circumstances and uncertainty. Family caregivers need to have actionable emergency plans for disasters that are specific to their role as caregivers of persons with ADRD. Study implications also suggest the role social work professionals can have in educating, advocating, evaluating, and coordinating support to assist caregivers of persons with ADRD as a potentially vulnerable and at-risk population during all phases of disaster.     

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.     

Depressive Symptoms among Former Spousal Caregivers: Comparing Stressors,Resources, and Circumstances of Caregiving Cessation among Older Husbands and Wives

Little research focuses on the mental health of caregivers (CGs) who stop providing care to their community-dwelling spouse. We examine depressive symptoms of former primary CG spouses who stopped caregiving over a two-year follow-up period when the care recipient (CR): (1) no longer has functional problems; (2) continues having functional problems; or (3) dies. Using data from the Health and Retirement Study (2000–2014), we located 2,370 couples who were both 50+ at baseline and where one partner provided help with ADL and/or IADL limitations but did not do so two years later. OLS regressions stratified by gender indicated that both male and female former spousal CGs whose CR died had significantly more depressive symptoms than those who ceased caregiving when their spouse did or did not still have functional problems. Former wife CGs who were older and whose husbands had more baseline ADLs had fewer follow-up depressive symptoms; wife CGs whose husbands had a nursing home stay had more depressive symptoms. Former husband CGs who had provided longer monthly hours of care had fewer follow-up symptoms. Findings underscore the importance of targeting mental and physical health services to both former caregiving husbands and wives, especially after spousal death.     

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.     

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 United States should recognize and support caregiving youth

In the United States, more than 5.4 million children and adolescents under age 18 provide care for family members who are aging or have chronic illness, disability, or other health conditions that require assistance. In this policy report, we describe youth’s care for the family, and highlight the increasing prevalence, global challenges, and uneven successes of measurement and categorization. We briefly summarize research on how caregiving affects youth’s academic, social, and emotional well-being. Next, we present novel, emerging evidence from the public school-based 2019 Youth Risk Behavior Survey for the State of Florida, which suggests that as many as 24% of middle school students and 16% of high school students provide at least some care to the family on a regular basis. Drawing on this evidence, we discuss targeted social programs which have been shown to promote the well-being of caregiving youth outside of the United States, as well as a 13-year-old school-based intervention in The School District of Palm Beach County, Florida. We conclude with specific recommendations for a path toward recognizing and supporting caregiving youth via policy and practice in the United States. Our aim is to increase the awareness and feasibility of identifying and supporting caregiving youth and their families via government-organized data collection and targeted social policies.     

Identities in Transition: Women Caregivers in Bereavement

Population aging and longevity due to medical advances over the past few decades have meant that the approximately 44 million caregivers in the United States and eight million caregivers in Canada must provide more intensive levels of care and for longer periods of time. Consequently, caregivers are often profoundly affected by their caregiving role in emotional, psychological, physical, and financial ways. Thirty years of research on this population have helped to create a caregiver profile and identify the significant challenges for caregivers. One area explored to a much lesser extent is the postcaregiving period, when the caregiver transitions into a period of bereavement. This period can be particularly challenging for caregivers given the commitment inherent in the caregiving process. Research has shown that the emotional reactions of caregivers as well as practical challenges do not end with the death of the care recipient. In fact, complex realities, tensions, and responses continue well after the death into the postcaregiving period. This study of bereaved women caregivers explored their lived experiences in the postcaregiving phase. One central theme emerged and suggested that the experience of caregiving had an effect on the caregivers’ identities, which then influenced their bereavement processes and experiences.     

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.