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Perceived overload as a predictor of physical strain among spousal and adult child caregivers of frail elders in the community
- Author:
- KANG Suk-Young
- Journal article citation:
- Journal of Human Behavior in the Social Environment, 26(7-8), 2016, pp.636-647.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Family caregivers of frail elders can experience physical strain associated with caregiving. Identifying correlates of caregiver strain can provide an important impetus for tackling the causes and providing effective interventions. Utilizing data from the 1999 National Long-Term Care Survey, the current study examined correlates of caregiver physical strain among 956 family caregivers, using the stress process model. As multiple regression analyses indicated, the caregiver’s perceived overload predicted greater strain for both spousal and adult child caregivers. For both groups, common correlates of physical strain were caregiving demands, the caregiver’s perceived overload, and limitations placed on the caregiver’s life. The results demonstrate that the family relationship of the caregiver (spouse or adult child) leads to variations and dynamics in caregiver strains, due to qualitatively different relationships. (Publisher abstract)
A review of the biopsychosocial aspects of caregiving for aging family members
- Authors:
- COLVIN Alex D., BULLOCK Angela N.
- Journal article citation:
- Journal of Family Social Work, 19(5), 2016, pp.420-442.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
With the ever-increasing growth in the ageing population, the need for care providers will also continue to rise. Many of these caregivers will provide informal care to family members and friends at a price to their own physical, psychological, and social well-being. This article examines the phenomenon of caregiving and provides a review of the biological, psychological, and social impacts of caregiving to care providers. George Engel’s biopsychosocial model is explored to examine the biological, psychological, and social factors that can affect a caregiver’s health and well-being. This article further explores social work practice implications and strategies for future intervention to reduce caregiver burnout and aid in their self-preservation. (Edited publisher abstract)
Assistive technologies in reducing caregiver burden among informal caregivers of older adults: a systematic review
- Author:
- MARASINGHE Keshini Madara
- Journal article citation:
- Disability and Rehabilitation: Assistive Technology, 11(5), 2016, pp.353-360.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Aim: The world population is rapidly ageing. As population age, the incidence of functional limitations increases, demanding higher levels of care from caregivers. Assistive technologies improve individuals’ functioning, independence, well-being and quality of life. By increasing independence of older adults, assistive technologies decrease workloads required from informal caregivers. This review investigates, evaluates, and synthesises existing findings to examine whether and how assistive technologies reduce caregiver burden. Methods: Databases searched included MEDLINE, EMBASE, Scopus, and Cochrane Library. Three groups of keywords were combined: those relating to assistive technology, caregiver burden, and older adults. Results: Two theories emerged from the analysis of study results. Caregivers reported that assistive technologies decrease caregiver burden. However, caregivers had concerns that assistive technologies could add to caregiver burden, highlighting the limitations of assistive technology. Conclusions: As suggested by a majority of the studies in this review, assistive technologies contribute to reducing caregiver burden among caregivers of older adults. Assistive technologies assisted caregivers by reducing time, levels of assistance and energy put towards caregiving, anxiety and fear, task difficulty, safety risk particularly for activities requiring physical assistance and increasing the independence of the users. Further research is required to better understand limitations of assistive technologies. (Publisher abstract)
Caregivers create a veteran-centric community in VHA medical foster homes
- Authors:
- HAVERHALS Leah M., et al
- Journal article citation:
- Journal of Gerontological Social Work, 59(6), 2016, pp.441-457.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The Veteran’s Health Administration’s Medical Foster Home program offers a unique long-term care option for veterans who require nursing-home- or assisted-living-level care. Veterans in a medical foster home reside with community-based caregivers who provide 24-hr-a-day care and monitoring. The veterans often remain in the medical foster home until end of life. Support and oversight is provided to the caregiver from the Veteran’s Health Administration’s community-based medical team. This qualitative descriptive study is based on secondary analysis of interviews with 20 medical foster home caregivers from 7 programs across the United States. The study’s research aims are to describe and explain (a) the type of care backgrounds and skills these caregivers possess, (b) caregivers’ primary motivations to open their homes to veterans who often have complex medical and social needs, and (c) how caregivers function in their role as primary caregiver for veterans. Findings indicated that caregivers interviewed had worked in long-term care settings and/or cared for family members. A strong desire to serve veterans was a primary motivation for caregivers, rather than financial gain. The caregivers’ long-term care skills aided them in building and sustaining the unique medical foster home family-like community. (Publisher abstract)
Monetising the provision of informal long-term care by elderly people: estimates for European out-of-home caregivers based on the well-being valuation method
- Authors:
- SCHNEIDER Ulrike, KLEINDIENST Julia
- Journal article citation:
- Health and Social Care in the Community, 24(5), 2016, pp.e81-e91.
- Publisher:
- Wiley
Providing informal care can be both a burden and a source of satisfaction. To understand the welfare effect on caregivers, we need an estimate of the ‘shadow value’ of informal care, an imputed value for the non-market activity. The study used data from the 2006–2007 Survey of Health Ageing and Retirement in Europe which offers the needed details on 29,471 individuals in Austria, Belgium, the Czech Republic, Denmark, France, Germany, Italy, the Netherlands, Poland, Spain, Sweden and Switzerland. Of these, 9768 are unpaid non-co-resident caregivers. To estimate net costs, researchers followed the subjective well-being valuation method, modelling respondents' life satisfaction as a product of informal care provision, income and personal characteristics, then expressing the relation between satisfaction and care as a monetary amount. The study estimates a positive net effect of providing mode rate amounts of informal care, equivalent to €93 for an hour of care/week provided by a caregiver at the median income. The net effect appears to turn negative for greater high care burdens (over 30 hours/week). Interestingly, the effects of differences in care situation are at least an order of magnitude larger. The study also finds that carers providing personal care are significantly more satisfied than those primarily giving help with housework, a difference equivalent to €811 a year at the median income. The article makes two unique contributions to knowledge. The first is its quantifying a net benefit to moderately time-intensive out-of-home caregivers. The second is its clear demonstration of the importance of heterogeneity of care burden on different subgroups. Care-giving context and specific activities matter greatly, pointing to the need for further work on targeting interventions at those caregivers most in need of them. (Edited publisher abstract)
From provider to enabler of care? reconfiguring local authority support for older people and carers in Leeds, 2008 to 2013
- Author:
- YEANDLE Sue
- Journal article citation:
- Journal of Social Service Research, 42(2), 2016, pp.218-232.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article explores developments in the support available to older people and carers (i.e., caregivers) in the city of Leeds, United Kingdom, and examines provision changes during a period characterised by unprecedented resource constraint and new developments in national-local governance. Using documentary evidence, official statistics, and findings from recent studies led by the author, the effects of these changes on service planning and delivery and the approach taken by local actors to mitigate their impact are highlighted. The statistical data show a marked decline in some types of services for older people during a 5-year period during which the city council took steps to mobilise citizens and develop new services and system improvements. The analysis focuses on theories of social quality as a framework for analysis of the complex picture of change related to service provision. It concludes that although citizen involvement and consultations exerted a positive influence in delivering support to some older people and carers, research over a longer timescale is needed to show if these changes are adequate to protect older people and carers from the effects of ongoing budgetary constraints. (Publisher abstract)
Caring for a dying spouse at the end of life: ‘It's one of the things you volunteer for when you get married’: a qualitative study of the oldest carers' experiences
- Authors:
- TURNER Mary, et al
- Journal article citation:
- Age and Ageing, 45(3), 2016, pp.421-426.
- Publisher:
- Oxford University Press
Background: Older people aged 80 and over are increasingly providing end-of-life care to spouses at home and often do so for long periods of time, while also trying to manage their own illnesses and disabilities. Little of the research on older spousal carers has focussed on the oldest carers; hence, the needs of this particular population are not fully known. Objective: To explore the experiences of the ‘oldest carers’ in caring for a dying spouse at home. Methods: Secondary analysis was undertaken on a subset of data from a larger qualitative interview study; this dataset comprised 17 interviews from participants aged 80 or over. Framework analysis methods were used, with items derived from the thematic analysis of the main study. Results: the oldest carers in this subset demonstrated high levels of resilience and the ability to adapt to their caring role. Caring until death was accepted as an integral part of the commitment made to their partner as part of the ‘wedding contract’. Carers felt they benefitted from the support provided by family, friends and care services; however, their own care needs were not always recognised by health and social care services. Conclusions: These findings underscore the complexity of the oldest carers' experiences and challenges in times of illness and end of life. Healthcare professionals should be alerted to the myriad ways caregiving is enacted in serious illness and seek opportunities for developing supportive interventions specifically for older carers. (Publisher abstract)
Exploring the prevalence of and factors associated with pain: a cross-sectional study of community-dwelling people with dementia
- Authors:
- BARRY Heather E., et al
- Journal article citation:
- Health and Social Care in the Community, 24(3), 2016, pp.270-282.
- Publisher:
- Wiley
The aim of this study was to determine the prevalence of pain among this community-dwelling people with dementia (PWD) and to explore medication use. It also sought to investigate patient and caregiver variables associated with the presence of pain. Community-dwelling PWD and their caregivers were recruited between May 2009 and July 2012 from outpatient memory clinics in Northern Ireland to take part in a face-to-face structured interview with a researcher. Patients' cognitive status and presence of depression were established. A full medication history was taken. Both patients and caregivers were asked to rate patients' pain, at the time of the interview and on an average day, using a 7-point verbal descriptor scale. From the 206 patients who were eligible to take part, 75 patient–caregiver dyads participated in the study (participation rate = 36.4%). The majority of patients (92.0%) had dementia classed as mild or moderate. Pain was commonly reported among the sample, with 57.3% of patients and 70.7% of caregivers reporting patient pain on an average day. Significant differences were found between patients' and caregivers' reports of pain. Two-fifths of patients (40.0%) were prescribed analgesia. Antipsychotic, hypnotic and anxiolytic drug use was low, whereas antidepressant drugs were prescribed more commonly. Presence of pain was unaffected by dementia severity; however, the use of prescribed analgesic medication was a significant predictor of the presence of pain in these patients, whether reported by the patient or their caregiver ‘right now’ or ‘on an average day’. Patient and caregiver recruitment was challenging, and remains a barrier to research in this area in the future. (Edited publisher abstract)
Behind the headlines: are older people and their families really to blame when their hospital discharges are delayed?
- Authors:
- ISDEN Ruthe, et al
- Publisher:
- Age UK
- Publication year:
- 2016
- Pagination:
- 8
- Place of publication:
- London
Short report which explores the complexities around hospital discharge and the difficult situations often facing older people and their families when no follow-up support is available. It draws on real-life case studies to explain how difficult it can be for older people to make a smooth transition out of hospital and highlights the pressure many hospitals and councils now are under. Problems identified include: older people being discharged from hospital without being offered help to organise support at home; friends and neighbours offering to provide temporary support and being put under pressure when no follow up support is available; older people being sent home without the right support in place and facing the risk of hospital readmission; older people having to fund their own intermediate or reablement services; and families being under pressure to accept packages of support they do not feel are in their best interests. (Edited publisher abstract)
Longer lives, stronger families? The changing nature of intergenerational support
- Author:
- KEOHANE Nigel
- Publisher:
- Social Market Foundation
- Publication year:
- 2016
- Pagination:
- 65
- Place of publication:
- London
This study charts how the shape of the extended family has evolved over time and explores how the support given across the intergenerational family has changed historically and how it may alter in the future. Families have tended to get longer and thinner over time due to a combination of longer lives, fluctuation in the average age of first-time mothers and reduced fertility and at the same time, there has been a trend towards greater heterogeneity of family types and the traditional ‘nuclear family’ has changed dramatically. The report show the continuing and growing importance of intergenerational family assistance, with more than three quarters of the population agreeing that ‘with people living longer, it is even more important that families stay connected across the generations’. The paper identifies a number of potential challenges ahead associated with these societal and demographic shifts, including: living patterns of intergenerational families may diverge, with some intergenerational families co-residing, others geographically separated and a growing proportion growing old without children or grandchildren; pensioners may struggle to balance the twin demands of younger family members needing support for major life events and living costs versus their own needs in retirement; people in their middle years may see their hopes and expectations of receiving an inheritance or major gift thwarted; and ‘in-betweeners’ in their 60s may find themselves facing triple pressures of continuing in work as the state pension age rises, caring for an elderly parent and providing grandparental childcare. (Edited publisher abstract)