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
The Interface Between Health and Social Services and Family Caregivers In the current debate over healthcare reform, an unresolved issue is Long Term-care coverage—whether it will be included in a reform package, and if so, to what extent, or whether deficit reduction and other economic considerations will make its cost prohibitive. Despite the uncertainty, extensive lobbying efforts continue to advocate linking acute and Long Term care in a reform package, and a number of plans to this effect have been proposed. The paradox is that while families currently are the unpaid yeomen of Long Term care and cost containment is a chief goal in healthcare reform, most plans ignore or give relatively little attention to the role of family caregivers. Read more
The Influence of a Diagnosed Mental Impairment on Family Caregiver Strain This study examines whether a diagnosis of mental impairment of a care recipient influences the strain of family caregiving. Two competing hypotheses, derived from labeling theory, provide alternative views. One posits that a diagnosis reduces strain by linking problematic characteristics of care recipients' impairment to an illness. The competing hypothesis suggests that a diagnosis increases strain by reifying the existence of a progressive chronic condition. LISREL analysis with data from a sample of 576 primary caregivers shows that the diagnosis has an important effect, but this influence varies for different types of strain. Relationship strain and restrictions in social activities are increased for caregivers of diagnosed care recipients. Functional impairment also causes a greater restriction of social activities when a diagnosis has been made. A different pattern emerges for depression, with caregivers in the diagnosed group being less depressed and less negatively affected by care recipients' impaired ability for social interaction, but more depressed by disruptive behavior and functional impairment. Read more
Relationships Between the Frail Elderly’s Informal and Formal Helpers Gerontologists have had a long-standing interest in the elderly’s social relationships and social support, particularly their integration in the family system and intergenerational exchanges. With the increasing number of chronically disabled aged, a substantial amount of recent gerontological research has focused on vulnerable or frail elderly and their use of assistance. Much of this research is confined to care by immediate family members (spouses and adult children), leading some to argue that caregiving research is characterized by an “ideology of intimacy” (Krause, 1990; Lee, 1985). This restricted focus detracts from the importance of other informal helpers, such as siblings, friends, and neighbors, and of formal service providers as the frail elderly’s caregivers (Krause, 1990; Penning, 1990). Read more
Differences in Service Attitudes and Experiences Among Families Using Three Types of Support Services One goal of support services for family members of Alzheimer's patients is to facilitate the use of other formal services. Few existing studies empirically test the relationship between support service use and the use of other community or residential services. This research describes the relationship between support and other service use by comparing families who used three types of support services: • Information and referral • Educational programs; and • Support groups. Data from in-person interviews with 127 family caregivers showed that families who used one of the three support services differed in the use of other services, service attitudes, past service experiences, and reasons for support service use. Results profile the characteristics of families who turn to different types of support services and illustrate the importance of past service characteristics for explaining current and future utilization. Information and referral (I & R), educational programs, and support groups are commonly provided support services for family members of Alzheimer's disease victims. These three support services share the common goal of facilitating and encouraging the use of other formal services for Alzheimer patients and their family members. Despite this goal, research on support services has seldom considered whether their use is related to the use of other services. Read more
