Institutionalization A Continuation of Family Care It is often assumed that with institutionalization comes an end to family caregiving. The goal of this study is to show that family caregiving continues even after institutionalization of the care recipient. The data come from 81 families who institutionalized their elders. The findings indicate that families remain involved in the care of the elder after institutionalization, although to a lesser degree and in different ways. Involvement in personal care tasks is reduced, not terminated; involvement in the specialized needs of the elder, such as their financial and legal concerns, continues, along with the new role of advocacy. The effects of caregiving are still felt by the primary caregiver, as are the effects of institutionalizing the care recipient. Read more
Depression and Health in Family Caregivers Adapation Over Time This study examined the predictors of caregiver depression and "adaptation" over time in a sample of 202 family caregivers of cognitively impaired adults. By examining caregiver adaptation (i.e., a caregiver's ability to adjust psychologically to the demands of providing Long Term in-home care), we were able to account for initial levels of depression, regression to the mean, and floor and ceiling effects. Results indicated that the strongest predictors of caregiver depression 1 year after baseline were initial levels of depression, worsening of caregiver subjective physical health status and burden, and short-term use of in-home respite assistance. These findings suggest that caregivers who experience deterioration in levels of physical health and burden and who use in-home respite on a short-term or sporadic basis may be especially vulnerable to the chronic stress of providing Long Term in-home care. Read more
The Moderating Influence of Service Use on Negative Caregiving Consequences This investigation adapts the social support conceptual framework to examine the moderating influence of community service use by impaired older persons on the negative consequences of caregiving for informal helpers. The model is modified by defining services as a type of social support that can counteract the stress associated with various care recipient impairments. Results from multivariate analyses of data from 401 caregivers suggest that certain services for care recipients can reduce the adverse effects of certain impairments on informal caregivers. The use of health care service by care recipients who are more disabled is related to lower levels of caregiver depression, health deterioration, and social isolation. Personal care service use consistently offsets the negative effects of care recipients' behavioral problems. Additionally, the use of household service when care recipients exhibit behavioral problems is associated with lower levels of caregiver depression. Read more
Service Use By Caregivers of Elders Receiving Case Management Although research on the effects of caregiver services has increased in recent years, the call for a research focus on the extent and predictors of their use has been largely ignored (Ory et al., 1985). The investigation described in this article addresses the gap in knowledge by examining the extent to which five types of caregiver services were used by study respondents: respite care, assistance finding or arranging for services, counseling or emotional support, education or training related to caregiving, and assistance with other responsibilities such as household tasks or child care. It also investigates the predictors of caregiver service use by applying a modified conceptual framework originally developed to examine factors influencing the use of health services (Andersen & Newman, 1973; Bass & Noelker, 1987). Read more
Profiles in Caregiving The Unexpected Career More and more people are being pressed into service as caregivers for their siblings, parents, or spouses with Alzheimer's disease or other dementia. With this caregiving role comes added stress and a difficult adjustment period for what begins as a part-time role and can become an unexpected career. "Profiles in Caregiving: The Unexpected Career" is a practical source of information for anyone who teaches caregiving, acts as a caregiver, or studies caregiving. It . . . provides a research investigation into the factors associated with effective caregiving to dementia patients. Read more
Influence of the Success of Psychoeducational Interventions on the Course of Family Care A reanalysis is presented of a previously reported study in order to investigate whether the short-term success of caregiver interventions is associated with positive longer-term outcomes. This new analysis focuses on whether or not families institutionalized their relative in the year following treatment, and the influence of response to treatment on the placement decision. Treatment outcomes (i.e., whether caregivers improved, failed to improve, or dropped out of treatment) were found to predict patient placement one year following initial assessment. Thus, caregiver interventions may have longer-term positive effects related to rates of patient institutionalization. Read more
Caregiving and its Social Support Social support is a feature of social relationships that can be discerned in many of the ordinary exchanges of daily social life but becomes especially prominent in the presence of adversity. However, despite its ubiquity, it is certainly no universal panacea. Not everyone has access to supportive relationships; people having such relationships do not necessarily benefit from them equally; and some adversities may be more resistant than others to the protective qualities of social support. These caveats notwithstanding, probably most people faced with difficult life exigencies have been the beneficiaries of social support, often without being aware of it. Indeed, individuals commonly confront unexpected and problematic junctures of the life course at which support goes beyond being merely useful and becomes, instead, a virtual requirement for the maintenance of well-being. Read more
