Health Care Professionals and Family Involvement in Care-Related Decisions Concerning Older Patients This article examines care-related decision making within the context of in-home family care. It also uses the Andersen-Newman model to identify the correlates of physician involvement and centrality in decision making and the impact that it has on family members' caregiving satisfaction. Analysis of data from 244 family caregivers shows that elders (40%) and nuclear kin (53%) are key decision makers, indicating that families prefer to control care-related decisions. However, physicians are part of the decision-making process for nearly one fourth of the families in this study. The patient's impairment and the caregiver's education correlate with physician involvement in decision making. Shared residence and caregiver's overall satisfaction with the caregiving process correlate with physician centrality on the network. Discussion centers on implications for physician interactions with caregiving families around decision making. Included are indications for improved communication in decision-making contexts. Read more
Family Caregivers A Valuable but Vulnerable Resource This paper reviews research that used a comparative or longitudinal approach to examine whether family caregivers exhibit poorer health and well-being, either over time or in relation to other populations findings from surveys of family caregivers conducted by the Margaret Blenkner Research Center of The Benjamin Rose Institute will be discussed, because these studies included both panel designs and matched comparison samples of noncaregiving family members. The findings should help to clarify whether all family caregivers are equally at risk of stressful effects or whether certain types are more vulnerable. The forms or manner in which caregiving's stress is manifested by different types of kin caregivers will also be addressed. An innovative model service program for caregiving families that was developed at The Benjamin Rose Institute will be discussed in terms of its relationship to the Research Center's findings on caregiver vulnerability (PsycInfo Database Record (c) 2022 APA, all rights reserved) Read more
Longitudinal Impact of Interhousehold Caregiving on Adult Children’s Mental Health The wear-and-tear hypothesis of caregiving (the longer care provided, the more psychological strain on caregivers) was examined using panel survey data from 112 adult children providing interhousehold care to an impaired elderly parent. Measures included subjective caregiving stress and perceived caregiving effectiveness ("wear") and depression and affect balance ("tear"). Contrary to the hypothesis, data revealed variability in children's adaptation to caregiving, improvement rather than deterioration being the norm. In a recursive path model, both subjective stress and perceived effectiveness were significant predictors of changes in depression. Depression was not significantly related to duration of caregiving. Discussion suggests that future researchers consider other types of caregivers and care settings, factors predicting variability in caregivers' adaptation over time, and changes as well as stability in care arrangements. Read more
Home Care for Elderly Persons Linkages Between Formal and Informal Caregivers Prior research has generally focused on characteristics of elderly persons that predict contact with community services or the volume of services used. In contrast, this study investigates how personal care and home health services are used in relation to assistance from primary kin caregivers. A typology was developed based on task sharing or segregation between kin caregivers and service providers, and four types of informal-formal linkages around these tasks were identified: kin independence, formal service specialization, dual specialization, and supplementation. Findings regarding predictors of the types showed that caregiver and care recipient variables were most significant in differentiating among them, although caregiver gender also had some discriminatory power. Read more
Care-Related Stress A Comparison of Spouse and Adult-Child Caregivers in Shared and Separate Households This research examines the role that relationship and household arrangement have in explaining the levels of care-related stress effects experienced by spouse and adult-child caregivers in shared and separate residences. Data from 180 spouse and adult-child caregivers were analyzed to identify differences in caregiver health decline, relationship strain, and activity restriction across these settings when the effects of elder impairment, caregiver age, and use of social supports are controlled. Results show that spouse and adult children in shared households experience similar levels of care-related strain. However, comparison of adult children in shared and separate households show having significantly greater activity restriction but less relationship strain. These findings have implications for the delivery of social services, specifically for targeting health monitoring, respite, and family counseling services. Read more
Symptoms of Mental Impairment Among Elderly Adults and Their Effects on Family Caregivers Research that has examined the relationship between caregiving stress and elders’ symptoms of mental impairment has focused primarily on cognitive incapacity. This research expands the symptoms of mental impairment to include caregivers’ reports of problems in elders’ social functioning and the presence of disruptive behavior, in addition to the traditional measure of cognitive incapacity. Results from a study of 614 families living with and caring for an impaired elder show cognitive incapacity to have a less important direct effect on caregiving stress than disruptive behavior and impaired social functioning. Cognitive incapacity does have an important indirect effect through its influence on disruptive behavior and social functioning. Read more
Caregiving for the Elderly Recognizing Your Strengths and Resources This booklet is designed to assist family caregivers in identifying the strengths and resources that may enable them to avoid the stress often associated with caring for an ill or disabled relative. Because it focuses on the emotional and social aspects of caregiving, rather than on how to perform specific tasks or activities, this booklet is distinct from many other publications. It is also different because the primary source of information comes from research findings. The issues discussed reflect the feelings of over 150 family members who care for an ill parent or spouse. We hope their experiences will help you better understand your own situation so that you can effectively care for your relative and, at the same time, take care of yourself. Read more
Characteristics of Hospice Patients and Their Caregivers This study describes selected characteristics of a group of terminal patients who were enrolled in a home-based hospice program. Similar characteristics of the patients' primary caregivers also are described. Relationships between the characteristics of patients and caregivers are examined, as are relationships between these characteristics and the rate at which various services were utilized. Implications for hospice service delivery and for future hospice research are explored. Read more
The needs of hospice patients and primary caregivers While much has been written about the needs of terminally ill patients and of those who provide care for them, little empirical research has addressed this issue. Such research is required to enable hospice programs to evaluate the extent to which they are meeting their goals and to develop adequate programs of care. For this study, a list of ten need categories for patients and five need categories for primary caregivers were developed out of a review of relevant literature. Primary caregivers and nurses were asked to rank the importance of these needs for patients and for caregivers. There was a high degree of congruence between the rankings of caregivers and nurses at the beginning of hospice care; A second measure taken after the patient’s death showed that the level of congruence increased over the course of hospice treatment. Read more
