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The prevalence of older couples with ADL limitations and factors associated with ADL help receipt
- Authors:
- SHENA Huei-Wern, et al
- Journal article citation:
- Journal of Gerontological Social Work, 58(2), 2015, pp.171-189.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Using the Andersen-Newman model, this study investigates the prevalence of activities of daily living (ADLs) limitations in older married couples, and couple characteristics associated with activities of daily living (ADL) help-receipt. In this sample of 3,235 couples age 65+ in the 2004 US Health and Retirement Study, 74.3%, 22.1%, and 3.6% were couples in which neither partner, one partner, or both partners had limitations, respectively. Logistic regression results indicate that help-receipt was associated with certain health needs in the couple, but not with their predisposing characteristics or enabling resources. The data showed that couples in which both partners have ADL limitations were more likely to receive any ADL help than were couples with one such partner. When the couples’ predisposing socio-demographic characteristics, enabling family and financial resources, and health needs were taken into account, only the couple-level measures of health needs (i.e., ADL limitations, IADL limitations, and use of equipment) emerged as key determinants of ADL help-receipt. Whether the couple included one or two partners with ADL limitations was not among the significant predictors. This finding suggests that it is not simply the number of partners in a couple with ADL limitations but other aspects of the health of the couple that influence their help-receipt. Social workers could target couples most in need of assistance by assessing both partners’ health problems. (Edited publisher abstract)
Perceived self-competency among the recently bereaved
- Authors:
- UTZ Rebecca L., et al
- Journal article citation:
- Journal of Social Work in End-of-Life and Palliative Care, 7(2-3), April 2011, pp.173-194.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia
Drawing on data from the US Living after Loss project, based in Salt Lake City and San Francisco and involving older people who had recently lost their spouse or partner, this study analysed information about widowed people's experiences in early stages of bereavement (2-6 months post-loss). The information used for the research came from questionnaires about perceptions of competence to perform daily living tasks completed by 328 recently bereaved older adults. The results suggested that those who had more personal resources (income and good health) were the most competent in daily life tasks, and that neither death forewarning nor marital quality improved competency after widowhood. Generally, perceived self competency was fairly high and men and women reported similar levels of self competency after widowhood.
“Well if he could see me now”: the facilitators and barriers to the promotion of instrumental independence following spousal bereavement
- Authors:
- BENNETT Kate M., et al
- Journal article citation:
- Journal of Gerontological Social Work, 53(3), April 2010, pp.215-234.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This two phase qualitative study defines independence as being able to do things oneself and freedom to choose what to do. Twenty-one widows (69-83 years, average widowhood 14 years) from urban, north western England were interviewed, at home, about traditional male-orientated tasks, pre- and post-bereavement (e.g. what changes occurred in instrumental independence following loss of their partner? What was the nature of this independence? What parameters promoted or hindered independence?). A typology of four (dependent/independent, dependent/dependent, independent/independent, independent/dependent) with most women previously, financially dependent on partners becoming independent, and only one moving in reverse was observed. All independent previously, remained so. Eight dependent women developed independence, with 2 women losing their independence with regard to domestic repairs – all these findings were close to significance. Seven women became independent in terms of obtaining MOTs and tax discs and showed autonomy as regards car servicing, with none moving in the opposite direction, which was highly significant. Some women preferred to get rid of cars, rather than become dependent on others to drive. Barriers to post-bereavement independence include pre-dependence, physical demand, anxiety about and financing tradesmen, availability of family help, poor health, disability, and lack of statutory service provision. Factors promoting independence are prior independent/shared experience, being dying partner’s carer, lack of close family, wealth, the availability of voluntary help and the influence of the widow’s father’s ideology.
Changes in the couple relationship in dementia care: spouse carers’ experiences
- Authors:
- O'SHAUGHNESSY Margaret, LEE Kristina, LINTERN Tracey
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 9(2), May 2010, pp.237-258.
- Publisher:
- Sage
Many people with dementia are cared for in their own homes by their spouses, who, on average, are 76 and 86 years old, for husbands and wives respectively. These carers’ face unique challenges as they adjust to the demands of caring, whilst experiencing significant losses in their marital relationship. The ‘professionalisation’ of carers by services has been criticised, and recent UK government guidance proposes that carers receive an assessment of psychological need. This study, using semi-structured interviews with seven spouses, explored spouse carers’ experiences. Participants who were caring for their partners with mid-stage dementia at home were recruited though local Alzheimer’s Societies. Data analysis, using Interpretative Phenomenological Analysis, identified four major themes: connectedness and separateness; tension between meeting own needs and meeting needs of spouse; knowing and not knowing the future; and seeking control in both emotional and practical strategies. Findings showed that with the progressive decline in their partners’ functioning, spouse carers experienced an ongoing process of re-evaluation and re-positioning of themselves in relation to their partner and their relationship. In conclusion, the authors highlight the importance of support groups and psychological support for carers.
The dynamics of continuity and discontinuity for women caring for a spouse with dementia
- Authors:
- WALTERS Alun H., OYEBODE Jan R., RILEY Gerard A.
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 9(2), May 2010, pp.169-189.
- Publisher:
- Sage
The responsibility for community based care for older people with dementia is often left to a spouse, and, unlike caring for a partner with physical health problems, care of dementia sufferers has been found to be associated with high rates of depression, and a sense of burden. This qualitative study explores spouse caregivers’ understanding of, and responses to, partners with dementia. Interviews were held with six wives, aged 64 to 78 years, who had been providing care to their husbands in the community for at least two years. Transcripts were analysed using Interpretative Phenomenological Analysis and four interconnected themes were proposed and described: same person or different; relational change; emotional responses to behaviours; and impact on day-to-day life. Participants’ sense of continuity with the past was suggested to influence each theme. The construct of continuity was proposed to be elastic, with both intra-psychic and inter-psychic factors impacting upon its elasticity. In conclusion, the authors suggest that a sense of continuity seemed to be associated with better adjustment to care giving.
Caregiving and its impact on families of the terminally ill
- Authors:
- BRAZIL K., et al
- Journal article citation:
- Aging and Mental Health, 7(5), September 2003, pp.376-382.
- Publisher:
- Taylor and Francis
Changes in the health care system have meant that increasing numbers of the terminally ill receive the majority of their care at home. The purpose of this paper was to document patterns of informal and formal care provided to the terminally ill and assess the impact caregiving has on family members. One hundred and fifty-one family caregivers were recruited for interviews from two community-nursing agencies in an urban region of the province of Ontario, Canada. The majority of respondents 119 (79%) were the female spouses of the patient. The numbers of caregivers providing assistance in specific functional activities were: bathing, 133 (88%); mobility, 123 (81%); dressing and undressing, 114 (76%); toileting, 101 (67%), and assistance at night 97 (64%). Sixty-two (41%) respondents reported that they had been providing some form of caregiving for over one year. They also reported that physical demands in caregiving increased substantially during the last three months of the care recipient's life. As family caregivers provided more assistance in activities of daily living they were at greater risk of reporting high caregiver burden. The results of this paper identify the types of care provided by family caregivers of the terminally ill and the impact these demands have on the family caregiver.
Effects of an automated telephone support system on caregiver burden and anxiety: findings from the REACH for TLC intervention study
- Authors:
- MAHONEY Diane Feeney, TARLOW Barbara J., JONES Richard N.
- Journal article citation:
- Gerontologist, 43(4), August 2003, pp.556-567.
- Publisher:
- Oxford University Press
The authors sought to determine the main outcome effects of a 12-month computer-mediated automated interactive voice response (IVR) intervention designed to assist family caregivers managing persons with disruptive behaviors related to Alzheimer's disease. Researchers conducted a randomized controlled study of 100 caregivers, 51 in the usual care control group and 49 in the technology intervention group, who received yearlong access to an IVR-mediated system. The system provided caregiver stress monitoring and counseling information, personal voice-mail linkage to AD experts, a voice-mail telephone support group, and a distraction call for care recipients. The authors conducted analyses by using a repeated measures approach for longitudinal data and an intention-to-treat analytic approach. Outcomes included the caregiver's appraisal of the bothersome nature of caregiving, anxiety, depression, and mastery at baseline, 6, 12, and 18 months. There was a significant intervention effect as hypothesized for participants with lower mastery at baseline on all three outcomes: bother (p =.04), anxiety (p =.01), and depression (p =.007). Additionally, wives exhibited a significant intervention effect in the reduction of the bothersome nature of caregiving (p =.02). Wives who exhibited low mastery and high anxiety benefited the most from the automated telecare intervention. Findings suggest that, to optimize outcome effects, similar interventions should be tailored to match the users' characteristics and preferences.