Sense of Need for Financial Support and Respite Services among Informal Caregivers of Older Americans

ABSTRACT

Financial support and respite services are two of the most frequently reported types of help that caregivers of older adults need. Using an expanded health behavioral model, this study examined the effects of predisposing, enabling, and needs factors on caregivers' sense of need for these two types help. Data were drawn from the 1999 National Long-Term Care Survey and included 1,058 caregiving dyads in the community. The results indicated that caregiver-related factors more than care recipient–related factors affected caregivers' sense of need to seek both types of help. The findings direct to two important implications for long-term care policy for and practice with older adults: improvement of service for caregivers and service delivery systems.     

Effects of Caregiving on Employment and Economic Costs of Chinese Family Caregivers in Canada

A telephone survey with 339 randomly selected Chinese Canadian caregivers examined the employment and economic costs of family caregiving for the elderly. Although the Chinese culture places a strong emphasis on filial obligation, caregiving is not without economic consequences. Caregiver’s age, financial adequacy, and employment, caring for an additional care receiver, and levels of assistance in Activities of Daily Living (ADL), were the predictors for economic costs perceived by family caregivers. Caregiver’s age, caring for an additional care receiver, and care receiver’s financial adequacy were significant predictors for male caregivers. Caregiver’s financial adequacy and higher levels of assistance in ADL were the predictors for female caregivers. Policies to support family caregivers should not just focus on the social aspect, but also the financial needs.     

The Impact of Family Functioning on Caregiver Burden among Caregivers of Veterans with Congestive Heart Failure

A cross-sectional study of 76 family caregivers of older veterans with congestive heart failure utilized the McMaster model of family functioning to examine the impact of family functioning variables (problem solving, communication, roles, affective responsiveness, and affective involvement) on caregiver burden dimensions (relationship burden, objective burden, stress burden, and uplifts). Regression analyses indicated that the five dimensions of family functioning were significantly related (p < 0.01) to relationship burden (R ² = .27) and uplifts (R ² = .29). More specifically, increased relationship burden was associated with problems in family roles, and increased uplifts was related to higher levels of affective responsiveness.     

Use of the Internet by Informal Caregivers Assisting People with Multiple Sclerosis

The Internet is used to help informal caregivers provide assistance to people with chronic illness and disability. We identified factors associated with Internet use by informal caregivers assisting people with multiple sclerosis (MS) using a logistic regression model. Duration of MS in the person receiving care and caregiver age predicted lower Internet use. More hours per week providing care and higher caregiver educational level increased odds of Internet use. The Internet can be a low-cost service delivery option to provide education and support to caregivers assisting people with MS.     

Informal Caregiving for Elders in Sweden: An Analysis of Current Policy Developments

The purpose of this study was to conduct a systematic review of the literature related to state policies concerning older drivers and to draw policy conclusions about which policies appear to work to reduce older driver crashes and to identify areas needed for further research. Specific policies examined in this paper concern medical reporting and medical review, license renewal processes, and driver testing. A study was included in the systematic review if it met the following criteria: published in English between 1991and January 2013; included data on human subjects aged 65 and older residing in the United States; included information on at least one policy related to older drivers; and had a transportation-related outcome variable (e.g., crash, fatality, renewal). A total of 29 studies met inclusion criteria. Twenty-two studies investigated license renewal and seven articles examined medical reporting. In-person license renewal requirements were associated with reduced risk for fatal crashes. Restricted licenses were associated with reduced number of miles driven per week. More intensive renewal requirements and being the subject of a medical report to the licensing authority was associated with delicensure. Given the importance of driving to mobility, quality of life, and public safety, more research is needed.     

Informal Caregiving and the Politics of Policy Drift in the United States

Informal caregivers play an increasingly important role in caring for aging Americans. Yet existing social policies that could support informal caregiving have experienced “policy drift,” a failure to adapt to social risks that develop after policies are initially enacted. This article examines policy makers’ success at updating seven major policies to address caregiver needs. It draws on an original data set of legislation in this area introduced between 1991 and 2006 (n = 96). Findings indicate that drift is more likely when policy updates are costly, lack support from members of majority parties in the House and Senate, and fail to generate bipartisan support.     

Depression and Missed Work among Informal Caregivers of Older Individuals with Dementia

Although providing informal care can negatively affect caregiver emotional health and lead to depression, the association between caregiver depression and missed work is unknown. We use data from the National Longitudinal Caregiver Survey to examine the relationship between caregiver depression and missed work among informal caregivers for older veterans with Alzheimer’s disease or vascular dementia. Two-part models are used to estimate the expected hours of work missed among working caregivers. Caregiver depression is statistically significantly associated with the likelihood and amount of time missed at work, resulting in an average of an extra half-day of work missed per month. While the effect of caregiver depression on work missed is modest, it represents another possible benefit from interventions to support caregivers.     

The Role of Appraisal and Expressive Support in Mediating Strain and Gain in Hispanic Alzheimer's Disease Caregivers

Abstract

The purpose of this study was to examine how appraisal of burden and satisfaction, and perception of expressive support mediate the effects of caregiving on depression, somatic complaints, life satisfaction and personal gain with a sample of Hispanic Alzheimer's disease (AD) primary caregivers. A purposive-snowball sampling technique was used to identify 103 Hispanic caregivers, who completed a self-report questionnaire. A translation-back-translation process was used to translate the instruments into Spanish. Translated instruments were then pilot tested prior to being administered to the participants. Appraisal of burden was found to mediate the effects of caregiving on depression and somatic complaints and had significant direct effects on life satisfaction. Appraisal of satisfaction did not have a mediating effect on any of the measures, but did have a direct effect on depression and personal gain. Expressive support did have a mediating effect on depression, as well as direct effects on somatic complaints and life satisfaction. These findings suggest a need for improving outreach to older minorities and developing culturally sensitive interventions that can improve caregivers' understanding of problematic behavior, thereby altering appraisal of the situation, as well as developing extended systems of support.     

Intergenerational Caregivers of the Oldest Old

No abstract available for this article.     

Connections and Constraints: The Effects of Children on Caregiving

This article assesses the effects of children on parents' involvement in caregiving. On the basis of interviews with 273 respondents, we address the effects of having children on care given to kin and nonkin; assess the effects of children's characteristics, especially age and gender, on the help mothers and fathers provide; and examine how these vary with mothers' employment. Overall, we find that the presence of children connects parents into networks of care more than it constrains them. The effects vary depending on the characteristics of the child (including age and gender) as well as characteristics of the parent (like gender and employment).     

Caregiving mothers of children with impairments: coping and support in Russia

Parents providing long‐term care for their children with impairments face myriad physical and emotional challenges. Researchers have examined coping strategies among parent caregivers in various contexts internationally. However, little research has focused on caregiving mothers of children with impairments in developing countries, and even less on mothers in Russia. The purpose of this qualitative study is to investigate the ways in which caregiving mothers cope and their perceptions of services and supports they need and utilize in a small Russian city. Semi‐structured interviews were conducted with caregiving mothers (n = 20) concerning postnatal and current treatment, information and services, finances, social support, and future plans. Analysis revealed that planning for the future and navigating limited resources, overcoming structural barriers and cultural obstacles, and maintaining social support were the three most important facets of mothers’ abilities to cope with the demands of caregiving.     

Laughing Your Way to Peace of Mind: How a Little Humor Helps Caregivers Survive

As the numbers of caregivers continue to increase, more attention is being focused on the unique stresses these individuals experience. Caring for a loved one tests the limits of even the most resilient, regardless of professional status or experience. Laughter is a universal elixir which allows people to cope more sanely with stress and caregiving responsibilities. Research on the emotional and physical benefits of laughter supports the use of humor by professionals and family members who occupy caregiving roles. This article addresses this research and examines common caregiver emotions while providing concrete guidelines for developing humor. Case examples demonstrate how laughter and wit are utilized by those caring for a loved one.     

Caregiving fathers and the negotiation of crossroads: Journeys of continuity and change

This article addresses the sustainability of extensive paternal involvement in caregiving by applying a temporal approach to understandings of the journeys of primary- and equal-carer fathers and their families. Drawing on a second phase of interviews with UK fathers first spoken to 5 years earlier, we explore continuities and changes in their roles, identities and outlooks as their caregiving journeys progressed and their children became older. Specifically, we explore how fathers and their families negotiated significant moments of change that had the potential to prompt reflection or reorientation, moments that we term caregiving crossroads. Through doing so, we highlight how, in spite of shifts in their arrangements and understandings, the embeddedness of fathers' caregiving routines, bonds and identities had apparently enabled their commitment to counter-normative roles to endure through such crossroads. We also outline, however, how gendered limitations to some aspects of the scope of their caregiving seemed also to persist as their journeys as fathers progressed.     

Characteristics of LGBT caregivers of older adults: Results from the national Caregiving in the U.S. 2015 survey

Using data from the Caregiving in the U.S. 2015 national survey, we compared characteristics of lesbian, gay, bisexual, and transgender (LGBT) and non-LGBT caregivers of older adults and explored predictors of caregiver strain. LGBT caregivers were younger, more racially/ethnically diverse, and less frequently a spouse/partner compared with their heterosexual counterparts. LGBT caregivers more frequently reported helping with medical nursing tasks and reported higher levels of financial strain. While LGBT identity was not an independent predictor of greater strain, characteristics more frequently reported by LGBT caregivers were, for instance, helping with medical nursing tasks. In addition, LGBT individuals who were children of the older adult were more likely to report higher levels of emotional strain than other relationship types.     

Informal Caregiving at Working Age: Effects of Job Characteristics and Family Configuration

This article addresses the relationship between employment and providing informal care for sick, disabled, or elderly people in Great Britain. Hazard rate models for taking up caring and leaving work when caring are estimated using retrospective family, employment, and caring data from the British Family and Working Lives Survey 1994 – 1995 for 9,139 British men and women. Family roles but not employment characteristics were relevant for men and women taking up caring. Being in a lower social class was, however, an important predictor of female carers leaving the labor market. Starting caring and quitting the labor market were not affected by women working part time, nor by most aspects of job flexibility that were considered.     

Analysis of HIV Caregivers in South Africa: A South African Depression and Anxiety Group

ABSTRACT

The severity of the HIV/AIDS epidemic in South Africa is well documented. However, little is known regarding the well-being of caregivers of persons with HIV/AIDS in South Africa. This study sought to evaluate characteristics, similarities and differences between groups of HIV caregivers in rural, semi-rural, and urban areas of South Africa. Interesting trends were noticed in the areas of suicidality, alcohol abuse, and intimate trauma. Findings indicate a substantial need for further study in the area of suicidality, denial of or lack of desire to know HIV status and the accompanying diagnostic stigma, and the need for a support network within lay caregivers.     

The National Family Caregiver Support Program: A Multivariate Examination of State-Level Implementation

Research on caregiver support policy implementation has offered valuable insights but has not incorporated theoretical frameworks or multivariate analysis. This article describes how the communications model for intergovernmental policy implementation was used as a framework to examine predictors of successful statewide implementation of the National Family Caregiver Support Program (NFCSP). Using data from the National Center on Caregiving State of the States survey, U.S. Census, Administration on Aging, and historical records, implementation (extent of service delivery) was examined in 50 states and the District of Columbia. State-level characteristics (demographic, historical, political, and organizational) were tested for their ability to explain more or less successful implementation. Bivariate and multivariate findings suggest that historical characteristics predict the likelihood of delivering more counseling, support group, and training. States that recognize caregivers as both service recipients (through counseling and support groups) and service providers (through training) may demonstrate more effective implementation.     

Parental Responsibilities: Dilemmas of Measurement and Gender Equality

Over the past half‐century, enormous changes have occurred in gendered divisions of housework and child care across many countries, with a growing consensus that there is a slow but steady pace of change in gendered divisions of time and tasks but one that is combined with a puzzling persistence of gender differences in parental caregiving responsibilities. Rooted in a 14‐year qualitative and ethnographic research program that focuses mainly on breadwinning mothers and fathers who self‐identify as stay‐at‐home or primary caregivers and guided by genealogical and relational sociological approaches, the author argues that the concept of parental responsibility requires greater attention and that its theorization and conceptualization have critical implications for if and how it can be measured, the methodological approaches that might be used to assess it, and the conceptual fit between parental responsibilities and gender equality.