Trade-Offs Between Formal Home Health Care and Informal Family CareGiving

Using 1994 National Long Term Care Survey data, we estimated logistic regressions of formal and informal home health care use and hours. Home health care use and intensity were differentially impacted by chronic conditions, are higher for Medicaid enrollees and rural or small town residents, but lower for HMO enrollees. Decreases in the probability of home health care use increased informal instrumental activities of daily living (IADL) support four hours and decreased informal activities of daily living (ADL) support eight hours weekly. IADL caregiving substituted for formal care, but ADL caregiving declined with reductions in formal care. Public policy reducing formal home health care access may reduce informal ADL caregiving and increase informal IADL caregiving, producing net declines in support.     

Predicting Future Commitment to Care for Frail Parents Among Employed Caregivers

A study of 133 full time employees with parent care responsibilities investigated various factors that could reduce this group's future caregiving commitment to aging parents. Study factors included: caregiver attributes, level of caregiving involvement, job stress, tensions between the caregiver and the dependent parent, caregiver's level of physical and mental strain, and limited support from family and friends. The relationship between the caregiver and the parent was the best predictor of sustained commitment to caregiving. One aspect of the employees' work experience made a small, but important contribution to respondents' future care plans. Those employees who frequently adjusted their work schedule and routine to accommodate parent care demands were less likely to sustain their caregiving commitment. Reasons for these findings are explored and implications for social policy and clinical practice are discussed.     

Complex home care: challenges arising from the blurring of boundaries between family and professional care

Over the last 50 years, increasingly complex care (such as tracheostomy management, dialysis or enteral feeding) has shifted from hospital to home, with a concomitant rise in patient self-management and care given by family members. Recognition of the importance of the contribution of family care to the health system is also growing. This article reports the findings of a New Zealand study which explored the experiences of family carers who manage technical health procedures at home. It then draws attention to some broader issues raised by shifting complex care from professional management in hospital settings to family care at home, namely the ways in which complex home care blurs the boundaries between professional and family care (creating the ambiguous position of the expert carer) and questions of safety and responsibility in family care. We also discuss the implications for policy around family caregiving in New Zealand. Given the potential physical and mental health impacts of caring, it is time for renewed consideration of what family carers should be expected or allowed to manage and how the health system can support them in their important role.     

Adolescents' perspectives on relationships with grandparents: The contribution of adolescent, grandparent, and parent–grandparent relationship variables

There is limited research on adolescent–grandparent relationships, especially from the adolescent perspective and on large-scale samples. The study examined the associations between the adolescent–grandparent relationship (i.e., importance of, emotional closeness to, and respect for grandparents' views) and the characteristics of the adolescent, grandparent, and parent–grandparent relationship, as well as the interactions between several of these factors. It was based on a representative sample of 1478 students aged 11–16 from England and Wales who completed a structured questionnaire. Results supported the position that grandparents are a significant factor in the lives of adolescents. Findings of hierarchical regression analyses showed that more frequent contact, greater grandparent involvement, and better parent–grandparent relationships predicted adolescents' reports on higher levels of emotional closeness to, importance of, and respect for their closest grandparent's views. The interactions consistently emphasized the role of parents as gatekeepers of intergenerational exchange.     

Web-Enhanced Preservice Training for Prospective Resource Parents: A Randomized Trial of Effectiveness and User Satisfaction

ABSTRACT

Traditionally, prospective resource parents must attend all preservice training in person. Although live sessions are necessary for screening applicants, instructional portions of training could be enhanced by Web-based sessions. This pilot study compares the effectiveness of online and classroom versions of one session from a widely used preservice training program. Ninety-two individuals enrolled in the program in two states were randomly assigned to a treatment group that viewed an online version of the class on child abuse and neglect or to a comparison group that took the same class in person. Written questionnaires were completed before and after the class. Significant group differences on knowledge of child maltreatment and empathy toward birth parents plus high user satisfaction were hypothesized. Analysis of covariance results showed the online training was more effective than the live training at increasing knowledge. Multivariate analysis of covariance findings on empathy were not significant but trended toward greater empathy for the online group. Feedback indicated high satisfaction with the online course. The finding that online instruction is more effective than live instruction has positive implications for practice, because Web-based training offers advantages like standardizing instruction, cutting agency and trainee costs, and providing greater flexibility.     

Issues of Elder Care and Elder Abuse in the Indian Context

Summary

With 7% of the population of India being elderly, two-thirds of whom live in villages and nearly a half of them in poor conditions, the care of the elderly is a difficult problem to be tackled. The dwindling of the joint family, the rise of dual-career families, a possible shift in filial piety values, the increasing life expectancy with greater chances of a prolonged old age characterized by poverty, degeneration, more empty-nest years, and dependency, have all added to the seriousness of the problem and made the elderly more susceptible than ever to abusive treatment. This paper examines these issues as well as the issue of elder abuse in light of available data and suggests some strategies to meet the problem. Also discussed are the problems, stresses, and strains of caregivers of the elderly. A greater role is envisaged for Non-Governmental Organizations (NGOs) than the state in the care of the elderly, particularly in providing support services to family caregivers.     

One million and counting: the hidden army of young carers in Canada

The term ‘young carer’ refers to those youth under the age of 25 years who provide substantial unpaid support to a family member due to factors including, but not limited to, familial or parental absence, disability, mental health issue(s) or problems with alcohol and/or other drugs. In the UK, national statistics have been integral to tracking the prevalence of young carers while serving as an important tool towards the development of (and justification for) a national legislative framework supporting these youth. In Canada, research and awareness for young carers remains in its infancy and available national datasets have yet to be examined in relation to youths providing unpaid caregiving. As a result, this research provides the first trend analysis of youth-based caregiving in Canada using census data for the 1996–2006 time-period. Methodological limitations of official statistics are also discussed in terms of conceptual and operational constraints limiting the full identification of all those potential young carers.     

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.     

A Support Group for Caregivers of Children with Craniofacial Differences

ABSTRACT

Caregivers of children with craniofacial differences (CFD) experience psychosocial stressors; however, few groups are described for this population. The authors outline an eight-session group and qualitative analysis of caregivers’ experiences. The majority of participants (n = 100) were mothers (76%) of children who were female (75%) and identified as Latino (79%). Children’s mean age was 10.6 (SD = 2.8) years, and they were born with cleft lip/palate (56%) along with other CFD diagnoses. Themes included: group appreciation (21%), mutual acceptance (18%), coping (18%), parenting skills (17%), learning (9%), resiliency (7%), empathy (4%), diagnosis information (3%), and self-care (3%). Caregivers’ reported experiences largely corresponded with group goals.