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.     

Older Couples

This study examines the degree to which older, noninstitutionalized husbands and wives are involved in providing various types of assistance, the likelihood of providing assistance to one's spouse and to others, and the characteristics associated with giving more forms of help. The findings suggest that older wives are more likely than older husbands to provide most of these forms of assistance. Furthermore, husbands are more likely to help their spouses, while wives are more likely to report helping people outside the conjugal pair. Multiple regression analysis suggests that the ability of the potential recipient spouse to perform daily living tasks is a key factor in determining number of forms of help provided by the potential helping spouse.     

Philanthropy and Government

Abstract

This study examines the effect of characteristics of the caregiving network on the likelihood of using supportive services by dependent older persons. Logistic regression analysis was conducted with a probability sample of community-dwelling elders cared for by their wives or daughters (n = 209). Results indicate that the specific composition of the caregiving networks, including the identity of the primary caregiver (wives vs. daughters), the availability and identity (kin or friends) of secondary helpers determines the likelihood of service use. The findings suggest that elders cared for by their wives alone may be quite isolated and should be the priority for community outreach services.     

Caregiver Isolation

Abstract

Caregiving to a partner with Alzheimer's disease results in isolation, which impacts on the help/service seeking behaviors of care givers. In-depth interviews done with caregiving wives found that they experienced multiple dimensions of isolation. A tentative ecological model of the dimensions of caregiver isolation is proposed. Research participants did not engage early in supportive help because they were not aware of their isolation, did not know about available supports, and were not identified by medical or social services personnel as needing support and assistance. Social workers need to be aware of the isolating effects of caregiving and reach out to caregivers to avoid or lessen isolation in their caring role.     

Attitude towards career progression in Spanish dual-earner couples: A dyadic approach

This study addresses the relevance of gender roles and perceived gender discrimination against women in attitude towards career progression in heterosexual dual-earner couples. One hundred and thirty-nine wives and their husbands completed the questionnaires independently. From a dyadic data analysis, using the actor-partner interdependence model (APIM), we examined the actor and partner effect. The following findings were made: (a) an actor and partner effect of gender roles in husbands, (b) an actor effect of perceived gender discrimination in wives, and (c) an interaction effect between partner gender roles by actor professional status in wives. Overall, results showed that gender roles and perceived gender discrimination are useful factors in understanding couples’ interdependence in their attitudes towards career progression. Results are discussed in terms of the influence of traditional gender roles in perpetuating inequality between men and women and the relevance of perceived gender discrimination against women in attitude towards career progression.     

The emotional terrain of parenting and marriage: Emotion work and marital satisfaction

This study examines how the division of labor surrounding emotion work relates to the marital satisfaction of husbands and wives. The analysis is performed on data from a random sample of couples with at least one child from a northern city in a western state (N = 96 couples). Results suggest that for both husbands and wives the emotion work received from and performed for their spouse is significantly and positively related to marital satisfaction. Results also suggest that the marital satisfaction of husbands is enhanced when they are involved in performing emotion work for children, but if their levels of emotion work for children begin to approach or exceed that of their wives then their marital satisfaction tends to decline. Implications of the study are discussed.     

How Appreciated Do Wives Feel for the Housework They Do?*

Objective. Sense of appreciation for the work one does contributes to subjective well‐being and relational satisfaction, but few studies examine the factors that may affect levels of recognition for household labor. We formulate and test hypotheses based on the effort‐reward imbalance model in occupational health research to investigate the extent to which married women feel that the work they do around the house is appreciated. Methods. We use data from a sample of married women from the 1987–1988 National Survey of Families and Households to test these hypotheses. Results. We find that wives' absolute time spent in housework and the share they do are both important in shaping their perception of appreciation for housework. Women who hold relatively liberal attitudes toward gender roles and those who have more options outside marriage are less likely to feel appreciated. Finally, wives who often share time with their husbands tend to report higher levels of gratitude for their work at home than those who do so rarely. Conclusions. This study suggests that the literature on psychological and relational outcomes of household labor should go beyond amounts and divisions of housework to include beliefs about roles, couples' dependency, and their relationship.     

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.     

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.     

Do Caregivers Benefit More From Educational and Volunteer Activities Than Their Noncaregiving Peers?

Informal caregivers are a critical component of the US long-term care system, but caregivers often experience poor physical and mental health as a result of strain from the caregiving role. Engagement in community-based educational and volunteer activities contributes to older adult well-being, but previous studies have not assessed whether the effects of these types of engagement are different for older adults who are also caregivers. Using a sample of participants in educational and volunteer activities sponsored by a national nonprofit organization, we find that participants who are caregivers report more benefit from these community-based activities than their noncaregiving counterparts. Connecting caregivers to existing community-based activities may be an efficient strategy for improving caregiver well-being.     

Deciding to Institutionalize: Caregiving Crisis,Intergenerational Communication,and Uncertainty Management for Elders and Their Children in Shanghai

This phenomenological study integrated crisis theory, social identity theory, and uncertainty management theory to conceptualize the decision-making process around institutionalization among nursing home residents and their children in Shanghai. I conducted face-to-face, semistructured interviews with 12 dyads of matched elders and their children (N = 24). The findings suggest that caregiving crises triggered intergenerational communication about caregiving alternatives and new arrangements, although each generation had different stances and motivations. Children finalized the decision by helping their parents to manage the uncertainties pertaining to institutionalization. This study sheds light on caregiving decision-making dynamics for the increasing aging population across cultures.     

Migration and Employment Among the Civilian Spouses of Military Personnel*

Objectives. This article attempts to directly observe the effect of being a tied migrant on the economic status of the civilian husbands and wives of military personnel in order to confirm whether previously observed trailing‐wife effects are consistent with being a tied migrant. Methods. A sample of the civilian husbands of women in the military and the civilian wives of men in the military are drawn from the Public Use Microdata Sample of the 1990 U.S. Census. Ordinal logit models of labor‐market status and tobit models of hours worked are estimated, which include a migrant status variable. Results. Migration is associated with a 10 percent decline in employment among all civilian wives and a four‐hour decline in hours worked per week among civilian wives who remain employed. Migration is associated with a statistically insignificant but very similar 6 percent drop in employment among all civilian men and a five‐hour decline in hours worked per week among civilian men who remain employed. Conclusions. The results provide solid evidence that being a tied migrant, irrespective of gender, is disruptive to both labor‐market status and hours worked. Thus, the assumption that wives are harmed because of their disproportionate status as tied migrants is supported.     

Observing Women Caregivers’ Everyday Experiences: New Ways of Understanding and Intervening

This article discusses the practice implications of videographic research examining the everyday lived experiences of 5 women family caregivers of older adults with chronic illness. The women’s nonverbal expressions and gestures revealed how caregiving is accomplished and lived on a daily basis, in particular through emotion and body management, abnegation, and performance. The findings from this microethnographic study suggest that observing women caregivers’ everyday experiences can open new avenues for holistic intervention with this population. Observing nonverbal cues can offer a way for practitioners to better understand women caregivers’ realities, to question their practice, and to adapt their interventions accordingly.     

The Potential of Information Technology to Navigate Caregiving Systems: Perspectives from Dementia Caregivers

Technologies designed to support caregivers of adults with Alzheimer’s disease and related dementias (AD/RD) have been developing at an increasingly rapid pace. However, little remains known about caregivers’ perspectives on how technologies can and should help them navigate larger service systems they interact with to engage in caregiving. This study involved in-depth interviews and a beta test of an AD/RD caregiver app to learn more about how they currently use technologies and how potential technological features and functions can best meet their needs. Thematic findings suggest a conceptual model for designing AD/RD caregiver technologies. The findings suggest that eHealth and individual technologies may not fully meet the needs of caregivers as they navigate the larger systems within which they provide care. Findings highlight the need to develop technologies for caregivers that are effective, easy to use, and more widely disseminated – especially for caregivers from disadvantaged backgrounds.     

Compulsory intergenerational family solidarity shaping choices between work and care: Perceptions of informal female carers and local policymakers in Estonia

Estonians are obliged by law to provide maintenance for family members who are unable to cope by themselves. As a result, 80% of fragile older people receive informal care. Whether this is because the carers themselves feel solidarity and choose informal caring or because they lack alternatives is the question. We applied the cultural approach for explaining the construction of compulsory family solidarity in care provision to older people through the perceptions of informal carers and policy actors. Our interest is in how filial norms framed by individual responsibilities of care provision required by law can influence (i) informal carers’ perceptions concerning their choices between work and care and (ii) impact policy actors’ perceptions concerning eldercare service provision. Analysing the empirical data produced during focus groups with female carers and interviews with policy actors, we demonstrate the triple‐fold pressure to informal caregiving as an expression of compulsory family solidarity. Key Practitioner Message: ? The article demonstrates how the national Family Law Act constitutes a compulsory requirement of family solidarity in society; ? The compulsory family solidarity norm influences local‐level policymaking and inhibits the development of formal care services for older people; ? Informal carers’ choices between work and care are shaped by their personal filial norms, familialistic policymaking, and pressure exerted by older people.     

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.     

Racial Differences in Family Burden

This article examines the clinical implications for social work practice of the differential impact of caregiving strain according to race. Data for this report is drawn from a study of 810 patients in a community-based geriatric assessment center. Although this research found no essential difference, based on race, in the experience of family burden as a social problem, there was a difference within the interaction of race and the care for an elderly person with Alzheimer's disease. The authors suggest a classification scheme of specific interventions for different caregiving groups and subgroups, based on both race and relationship; these selected variables can provide more insight into possible vulnerable caregiving conditions.     

Experiences of rural male caregivers of older adults with their informal support networks

More male caregivers are assuming primary caregiving roles for older adults with chronic health conditions. One of the main sources of support for many caregivers is the assistance that is provided by members of their informal support network. Little is known about the relationship between male caregivers and their informal support networks. This qualitative study examines the experience of male caregivers with their informal support networks, specifically looking at two phenomena: (1) Perceptions of the male caregivers about the willingness of their informal support networks to provide caregiving assistance and (2) Willingness of the male caregivers to ask their informal support networks for assistance. Twenty male caregivers were recruited across a rural Midwestern state. Each male caregiver engaged in two interviews that lasted between 60 and 120 minutes. Seven themes emerged from the data about the male caregivers experience with their informal support networks. Results from this study have implications for geriatric health professionals who work with male caregivers to obtain the necessary amount of caregiving assistance.     

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.