I’m Here,You’re There: In-Absentia Caregiver Stress & Transnational Support of Elderly Mothers by Adult Children

ABSTRACT

Providing support between generations in a transnational family context is understudied in the aging literature. Specifically, this study investigated the stress experiences and stressors experienced by adult children in the United States when providing transnational support to their elderly mothers in India. Information gathered from two focus groups was supplemented by an online survey of 131 adult children. Participants expressed sentiments of worry, sadness, guilt, and especially helplessness at their limited capacity to care for their mothers from a distance. Results indicate that transnational family aged care is an important dimension of aging that requires further research. In particular, “in absentia caregiver stress” is experienced remotely, and has implications for the immigrant adult’s health and well-being.     

Introduction to the special issue: Family Support of Persons with Disabilities Across the Life Course

ABSTRACT

Family members are a key source of services and supports for people with disabilities across the life course, helping people to remain living at home and in the community. As part of an effort to generate a strategic plan for research on family caregiver experiences and supports, this issue includes four literature reviews on the current state of research, each specific to a life course stage. This introduction presents a framework that combines life course and ecological perspectives to organize the existing literature of family caregiver support and to identify gaps in existing research, as well as opportunities for future investigations.     

The family caregiving context among adults with disabilities: A review of the research on developmental disabilities,serious mental illness,and traumatic brain injury

ABSTRACT

A majority of adults with serious disabilities are cared for in the home by family members. Guided by an ecological framework, this article presents the findings of a literature review of research on family caregiving and family support for adults with disabilities. This review included 33 research studies published between 2000 and 2015 focused on three disabilities: Developmental disabilities, serious mental illnesses, and traumatic brain injury. A synthesis of the findings underscores the critical role that family caregivers occupy in addressing the needs of their loved one with a disability; however, the needs of the caregiver are insufficiently met by existing service approaches. A better understanding of the unique needs and strengths of the family support context of caregivers and care recipients is needed, giving greater attention to ethnic, racial, and cultural considerations in future research.     

Differentiating Characteristics and Needs of Minority Grandparent Caregivers

Abstract

Data collected over a three-year period compared two groups of African American grandparent caregivers with a group of European American grandparents who were raising their grandchildren. Gender, marital status, and household income differentiated minority from nonminority participants. Statistically significant differences among certain of the demographic variables between the two groups of African American grandparents were also found. Practical implications of the results for research and practice are discussed through illustrating differences in advocacy needs and agenda-making between two grandparent caregiver support groups.     

“It's Really Not Easy to Get Help”: Services to Drought-Affected Families

Abstract

The present paper details the results of research conducted with drought-affected farm families in New South Wales (NSW), Australia. The study reveals the significant health and welfare stresses experienced by families and the lack of access to services and support. The research was conducted in three sites in rural and remote areas of NSW in 2003. Farm family members, service providers, and other community key informants were interviewed. The paper outlines ways that the social work profession can respond to significant natural disasters.     

Dementia Caregiving in the Context of Late‐Life Remarriage: Support Networks,Relationship Quality,and Well‐being

Caregiving research has not accounted for increasingly diverse and complex marital and family histories of older Americans. The authors examined social relations and care‐specific positive and negative support networks among late‐life remarried wife dementia caregivers (N = 61) to determine associations among network structure, relationship quality with and support received from network members, and global assessments of family and stepfamily disagreement on caregiver well‐being. Own family and friends predominated in the social relations and positive networks. Although over half (54%) of respondents included a stepfamily member in their positive networks, stepchildren comprised the largest group (35%) in the negative networks. Larger negative networks and actively negative interactions were related to greater caregiver burden, and more global disagreement with stepfamily was associated with greater depression and burden. The findings illustrate the complex nature of support and the value of targeted examinations of caregiving support dynamics among late‐life remarried older adults and stepfamilies facing health demands.     

Most Successful Intervention Strategies for Abused Older Adults

ABSTRACT

In this Project CARE study, intervention plans for 83 cases, with a total of 473 strategies, are analyzed in a qualitative content analysis method. The 473 strategies are designed and implemented by an abuse-trained, multidisciplinary, health and social service agency, home care team. Each strategy is rated by the team for its acceptance/refusal by clients and levels of success. The most accepted and successful strategies for abused older adults are concrete: nursing and other medical care and homemaking assistance, followed by empowerment strategies, such as support groups for abused older adults, information about rights and resources and volunteer buddy/advocates. Less successful strategies for abused persons are referrals to general community activities and programs. For caregiver abusers, the most successful and accepted interventions involve individual supportive counselling to reduce anxiety, stress and depression and education and training. Abuser-oriented strategies are most accepted and successful in the study. Thus, it would seem pertinent for intervenors to focus services and strategies on abusers and not only on abused older adults, in particular offering them supportive individual counselling to reduce anxiety, stress, and depression. For abused care receivers, home-based services can offer the necessary support to move out of their abuse situation with the help of volunteers and support group activities.     

Racial and Ethnic Differences in Family Caregiving in California

Abstract

Family caregivers are the main source of long-term care for older persons in the United States. At the same time, cultural values and beliefs shape decisions surrounding who provides care and whether families use formal support interventions to assist the caregiver. The current article examines how the family caregiving experience differs among racial and ethnic groups in terms of caregiver characteristics, service utilization, caregiver strain, and coping mechanisms. Telephone interviews were conducted in English and Spanish with a random sample of 1,643 respondents in California who provide care to someone age 50 or over. Bivariate analyses showed evidence of ethnic differences in the demographic characteristics of caregivers, intensity of care provided, caregiver health, level of financial strain, religious service attendance, formal service utilization and barriers to formal services. Odds ratios showed that White and African American caregivers were about two times as likely to use formal caregiver services as were Asian/Native Hawaiian/Pacific Islander and Latina American caregivers. Implied by these findings is the need for further understanding of caregiver service needs among diverse racial and ethnic groups.     

Availability of Caregiver Support Services

Abstract

This study examines the scope and range of existing resources for family caregivers from the perspective of the Area Agencies on Aging (AAAs), which are charged with implementing Title III-E of the reauthorized Older Americans Act. California is used as a case example because of its substantial experience in providing caregiver support services. In particular, we examine the extent and adequacy of resources available in California corresponding to each of the five Title III-E service areas, utilizing data from AAA Area Plans, a follow-up survey of AAAs, and an Internet search. AAAs identified more than 276 providers of caregiver support services, and our Internet search identified another 195. Nearly two-thirds of these programs offer access to respite care, while other support services (e.g., counseling, training, support groups) are less often available. Service gaps most frequently identified included culturally and linguistically appropriate caregiver services, transportation, respite care, financial assistance, and services in rural areas. These findings suggest the need for enhanced efforts to improve the service network for supporting family caregivers, as states implement the National Family Caregiver Support Program.     

The Effects of Polyvictimization and Quality of Caregiver Attachment on Disclosure of Illegal Sexual Behavior

ABSTRACT

The current study examined the relationship among self-disclosure of illegal sexual behaviors and two conceptually relevant constructs in psychotherapy: childhood polyvictimization (i.e., cumulative types of victimization experienced during childhood) and caregiver attachment. Participants consisted of 63 adolescent males participating in mandated treatment for illegal sexual behavior. Childhood polyvictimization and caregiver attachment were expected to predict self-disclosure of illegal sexual behaviors. Quality of caregiver attachment was also expected to mediate the relationship between polyvictimization and disclosure. Consistent with our main hypothesis, results indicate that quality of caregiver attachment mediated the relationship between childhood polyvictimization and self-disclosure of illegal sexual behaviors in psychotherapy. The current findings highlight the impact of polyvictimization on important therapeutic processes as well as the importance of assessing for multiple types of victimization in adolescents who engage in illegal sexual behavior. Further clinical implications regarding the use of trauma-informed approaches during sex offender treatment are discussed.     

Family support in late life: A review of the literature on aging,disability, and family caregiving

ABSTRACT

For older adults and people with disabilities in the United States, family caregiving is an important part of remaining at home and in the community. As care recipients and caregivers age, family dynamics change, and the health, social, and financial impacts of this (largely unremunerated) work have implications for individuals, families, and social policy. In this review, the authors map the literature across multiple fields related to disability and aging to understand caregiving in late life, what it means to be an older caregiver and/or to care for older people. The authors summarize the findings of 97 articles to address the care, services, and supports family caregivers provide for older adults; negative and positive impacts for caregivers serving in this role; supports that family members use or need; and societal impact of family caregiving. Much of the literature describes the work family caregivers provide and negative impacts of caregiving. Less attention is devoted to caregiving benefits, supports used by family caregivers, and societal impacts. The authors conclude with an agenda for future research that attends to the need for research that includes: more diverse samples, new types of caregivers, longitudinal data, qualitative data and analysis, and comparative research.     

Self-identifying as a caregiver: Exploring the positioning process

There is a huge body of research focused on family caregivers. Underpinning this body of knowledge is the assumption that there exists some distinct entity known as a ‘caregiver’. Drawing on data generated through in-depth qualitative interviews with forty seven family caregivers, this paper will examine the usefulness of this self-identification to family members. Questions asked of the data included: how does one come to self-identify as a caregiver, what does it mean to be a caregiver, and how does affiliation with this self-identity influence the experience of caring for an older or frail family member. The analysis suggests that a recognition of oneself as a caregiver is produced primarily through interactions with others; without external influence, family members will often see the work they are doing as simply an extension of their relational role. Affiliating oneself as a family caregiver appears to have positive benefits which include promoting effective use of community support services and creating a sense of belonging and connection to a broader community. This can be empowering. However, an unintended consequence of assuming the position of caregiver may be the inadvertent discounting and marginalization of the person requiring care. Positioning theory is introduced as a useful conceptual frame for understanding the process and implications associated with self-identifying as a caregiver.     

Black women’s experience of colorist microaggressions

ABSTRACT

This paper reports the findings of a study that investigated Black women’s experiences of colorism. The authors introduce a new framework, “colorist microaggressions”, which highlight the microaggressions experienced by Black women. The results indicate that colorist microaggressions impacted the social, relational, emotional, and relational aspects of Black women’s lives and their well-being. The results also showed that like racial microaggressions, the “colorist microaggressions” that Black women encountered in their community, family, and in society, were pervasive. We conclude with a discussion of the implications for social work research, education, and practice.     

A Study of Australian Intercountry Adoption: Choosing Applicants to Parent

Abstract

Australian families are changing and parenthood is increasingly being seen as an individual choice. One important arena for exercising such choice is adoption, which today takes place across national boundaries in the form of intercountry adoption. This is now the predominant type of adoption in Australia. In order to reach their goal of parenthood, individuals choosing intercountry adoption must undergo an education and assessment process. This paper presents the findings from research undertaken as part of a larger doctoral study, with prospective intercountry adoptive parents, intercountry adoptive parents, adoption professionals, and support group representatives living in Australia. Three groups were found to exist in relation to the intercountry adoption assessment process: embracers, acceptors, and pragmatists. Factors influencing each group are discussed and suggestions for strengthening the role and efficacy of education and assessment in the selection of Australian intercountry adoptive parents are recommended.     

Experiences of vulnerability due to loss of support by aged parents of emigrated children: a hermeneutic literature review

ABSTRACT

In disrupted families due to migration individual members support each other through transnational care. The care is often reciprocal as the members who are left behind support the members who emigrated and in return receive care from the emigrated family members. Aged parents who get left behind, however, often become vulnerable. The hermeneutic literature review shows that social, psychological or emotional and economic vulnerability are experienced. They have to deal with cultural challenges as their children form part of a new culture in their receiving country. Strong feelings of loss, helplessness and loneliness are experienced. The emigration of their children may also contribute to the financial vulnerability of the elderly.     

Perceived overload as a predictor of physical strain among spousal and adult child caregivers of frail elders in the community

ABSTRACT

Family caregivers of frail elders can experience physical strain associated with caregiving. Identifying correlates of caregiver strain can provide an important impetus for tackling the causes and providing effective interventions. Utilizing data from the 1999 National Long-Term Care Survey, the current study examined correlates of caregiver physical strain among 956 family caregivers, using the stress process model. As multiple regression analyses indicated, the caregiver’s perceived overload predicted greater strain for both spousal and adult child caregivers. For both groups, common correlates of physical strain were caregiving demands, the caregiver’s perceived overload, and limitations placed on the caregiver’s life. The results demonstrate that the family relationship of the caregiver (spouse or adult child) leads to variations and dynamics in caregiver strains, due to qualitatively different relationships.     

Internet-Based Clinical Services: Virtual Support Groups for Family Caregivers

ABSTRACT

Objectives: An internet-based psychotherapeutic support group intervention for family caregivers of persons with neurodegenerative diseases was developed in a series of pilot studies and subsequently evaluated in a feasibility study with 34 participants. The aim was to duplicate online group interactions typical of face-to-face support groups. Methods: A user-friendly web site was developed according to usability criteria for older adult users. Unique features of the web site included video conferencing in two formats, one-on-one and a group format with up to 6 participants and a facilitator. Following ten professionally facilitated sessions, each group evolved into a web-based self-help support group facilitated online by a group member. Results: Qualitative analyses of early, middle and late group video conferencing sessions yielded themes congruent with face-to-face group process. Follow up interviews six months following the initiation of the online groups showed overall positive participant responses in each of the following areas: learning to use computers, negotiating the web site links, obtaining disease-specific information from the website, using technology to communicate, bonding with group members, providing mutual guidance and support, and benefiting in terms of coping with the stresses of caregiving.