Caregiver Stress and the Elderly: A Familial Perspective

This paper examines the activities and perceptions of 41 spouses and adult daughters seeking psychological and social intervention with a frail spouse/parent. Findings indicate that spouses were involved in more "hands-on" care and identified the marital relationship or their own physical abilities as sources of caregiver stress. Daughters were less involved in direct care, although overall levels of care remained comparable, and identified responsibilities outside the caregiving relationship as their primary source of stress. The significance of the caregiver's familial status in developing treatment strategies that address caregiver stress are examined.     

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.     

The Effects of Nursing Home Placement on the Perceived Levels of Caregiver Burden

Providing care for an aging parent can be one of the most fulfilling life experiences for an adult child. It can also be one of the most exhausting physically, emotionally, and financially. A caregiver experiences psychological and emotional changes when their dependent parent or spouse is placed into formal care. This research project uses the Montgomery Borgatta Caregiver Burden Scale, amended with a questionnaire, in a self-administered, anonymous survey to explore perceptions of caregiving burden before and after the nursing home placement periods. This research showed that numerous factors influence caregivers' perceptions of burden and the quality of relationships among family members.     

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.     

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.     

Relationship between quality of work life and organizational commitment among lecturers in a Malaysian public research university

Committed employees are known as a fundamental and vital resource for the success performance of organizations. In this regard, quality of work life is being as one of the interest subject as a fundamental issues on fostering employees’ commitment. By the same token, this study aimed to investigate the level and relationship between quality of work life and organizational commitment amongst academic staff in a public research university in Klang Valley, Malaysia. This study was designed based on quantitative methods. The population of current research was consisted about 2,902 lecturers of the examined university according to the university's official website. For the purpose of data collection, 330 sets of questionnaire were distributed among the academic staffs of all faculties and a total of 315 questionnaires were used for statistical analysis. The obtained results via correlation and linear regression showed that there is a high significant relationship between quality of work life and organizational commitment. This study contributes to the existing literature and suggests some human resource development strategies on how the related ministry and universities could improve their employees’ commitment.     

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 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.     

Mosaic of Difference

Summary

The professional literature has not adequately addressed the behavioral and social factors that contribute to different coping outcomes for African American elder caregivers as compared to non African Americans. Awareness and understanding of these unique experiences would better prepare professionals to work with such clients. This study examines the predictors of emotional distress among 46 African American women who provide care to dependent elderly parents. Multivariate statistical analyses show that elder caregivers' rating of quality of life, their years of caregiving, as well are their poor heath constitute significant predictors of risk for depression. The results of the study provide support for the inclusion of more culturally appropriate measures of caregiver distress, and provide insights to inform social work practice, policy and research concerning African American female elder caregivers in the 21st century.     

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.     

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.     

Caregiving Youth Knowledge and Perceptions of Parental End-of-Life Wishes in Huntington’s Disease

Knowledge of patient end-of-life (EOL) wishes and discussions are vital for family caregivers, including children and youth who may be in caregiving roles (“young carers” or “caregiving youth”). However, little is known about caregiving youth awareness and perceptions of EOL issues. This study sought to explore caregiving youth knowledge of EOL wishes and their willingness for EOL discussions. Face-to-face interviews with 40 caregiving youth ages 10–20, who have a parent with Huntington’s disease (HD), provided information about their knowledge of the presence of their ill parent’s living will (LW) and durable power of attorney for health care (DPAHC), and willingness to talk with the parent about EOL choices and possibility of death. Less than one-half of the participants were aware of the parent’s LW or DPAHC. Content analysis revealed themes in reasons to want or not want EOL discussion with the parent: respect for the parent’s wishes, caregiving youths’ opinion not valued, and avoidance of EOL issues. Themes also included reasons to not want discussion with the parent about possibility of death: protecting the parent, parent in denial, parent not ready, and realization of the terminal outcome. Findings suggest HD patients and their caregiving youth need support for open EOL discussions, and could benefit from educational programs and support groups around EOL issues.     

Towards a Dynamic Model of the Psychological Contract

This paper presents a dynamic perspective in which the psychological contract is treated as a structured set of beliefs that are held by individual employees about the mutual obligations of the organization as employer and themselves as employees. This set of beliefs is assumed to produce a state of commitment to the organization in which the employee is willing to accept work roles and tasks offered by the organization, and to carry them out in accordance with certain standards. The dynamic model that is presented can help to explain why the commitment of employees remains relatively stable over time, and why it may suddenly decrease or increase under circumstances that are perceived as critical by the employee. The model assumes that the employee's evaluation of the organization's behavior changes over time, but that the structure of the psychological contract and the associated commitment change only when certain limits are overstepped. This perspective on changes in the psychological contract transforms the concept into a powerful construct that may lead to fruitful research on the dynamics of organization‐employee relationships. Implications for future research are discussed.     

Response Agreement Rates Between Child Welfare–Involved Youth and Their Caregivers

ABSTRACT

Data were collected from 40 youth and 37 caregivers, which represented 57 distinct youth and 20 youth–caregiver dyads to measure the level of agreement between youth self-report and their caregivers on a variety of topics. Topics included: the youth's past placements, service use and needs, experiences in the child welfare system, and the youth's emotional problems and social behaviors. Results indicated high agreement between youth and caregiver proxy related to placement history, service use, the restrictiveness of the current environment, and community safety; results indicated low levels of agreement for youth emotional difficulties and prosocial behaviors. Qualitative data were used to further identify some of the differences noted. Overall, the findings support prior research that shows higher agreement within youth–caregiver dyads for objective measures as opposed to subjective and private ones. Implications for future research are discussed, and methodological challenges related to this study are identified.     

Family and work-related risk factors in children's social–emotional well-being and parent–educator cooperation in flexibly scheduled early childhood education and care

Non-standard work schedules (NSWS) have become typical, but their associations with childcare arrangements and children's well-being are unknown. This study explores how risk factors are associated with the social–emotional well-being of girls and boys using flexibly scheduled early childhood education and care. Furthermore, the study investigates whether well-functioning cooperation between parents and educators buffers the negative effects of the risk factors. This study, which is a part of a larger survey carried out in three European countries, reports Finnish parents' (N = 146) perspectives. The results showed that high parental stress was associated with low child well-being. Strong parent–educator cooperation positively impacted both boys' and girls' social–emotional well-being. The risk factors of reconciling work and family life had negative associations with children's well-being and the fulfilment of their basic needs. The results illustrate the complex interrelations between children's well-being, risk factors relating to NSWS and the buffering effect of protective factors.     

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.     

Disabled children, parent–child interaction and attachment

Although caregiver factors are generally considered the more potent in determining children's attachment organization, a number of child factors have also been considered. Among these have been temperament and disabilities. The present paper examines the effect of various types of children's disability on parent–child interactions, including how disabilities affect parental sensitivity and communications. A brief outline of attachment theory and patterns of organization is followed by a review of the research evidence that has looked at children with disabilities and insecure attachments. A complex picture emerges in which it is not a child's disability per se that is associated with insecure attachments but rather an interaction between children with disabilities and the caregiver's state of mind with respect to attachment. Transactions between both child and caregiver vulnerability factors affect sensitivity, communications and security of attachment. Practice implications for prevention, advice and support are considered.     

Examination of a Psychoeducational Intervention and a Respite Grant in Relieving Psychosocial Stressors Associated with Being an Alzheimer's Caregiver

Alzheimer's disease can be particularly devastating to those who are caring for their loved one with the condition. There have been recent calls for the tailoring of caregiving interventions to examine outcome differences between groups of caregivers and the reporting of effectiveness via longitudinal and specific outcomes. The purpose of this study was to examine 3 interventions (psychoeducational training, a respite voucher-type grant, or their combination) while looking for possible group differences. A total of 367 caregivers participated in the study. Participants completed surveys and questionnaires before the intervention and at a 6-month follow-up. Positive outcomes were found, including lower depression scores, increased support service use, and increased support group usage. Possible effectiveness of the 3 types of interventions and variation among caregiver characteristics are discussed along with implications for future research.     

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.     

Parents in high‐conflict custodial cases: negotiating shared care across households

Understanding the dynamics of custodial conflicts is important for reducing the level of such conflicts and improving the upbringing conditions for the children involved. The parents in these cases care for children living in two households, and our approach therefore draws on the knowledge of how ‘ordinary’ parents proceed in sharing care within and between locations. The paper is based on qualitative interviews with 15 Norwegian parents who were in contact with the child protection service during their custodial disagreements, indicating a high level of conflict and concerns about inadequate care. When describing and reflecting upon their practices of care, the parents speak from two main positions: as a concerned parent or an accused parent. These positions imply different approaches on how to share care, which offer insight into the mechanisms of getting stuck. Although the concerned parent worries about the child's well‐being while staying with the other parent and thereby aims to take a continuous responsibility across households, the accused parent perceives the co‐parent's involvement as undue and negotiates increased distance in parenting. Focusing on practices of care may contribute to turning the attention away from conflicts between former partners and towards the child's situation.