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The baby boomers’ intergenerational relationships
- Authors:
- FINGERMAN Karen L., et al
- Journal article citation:
- Gerontologist, 52(2), April 2012, pp.199-209.
- Publisher:
- Oxford University Press
The Baby Boom generation are now entering late life. Increases in life expectancy over the past century have precipitated changes in family ties, and Baby Boomers may be torn between helping young adult children and ageing parents. This review article considers both these aspects of intergenerational relationships of Baby Boomers in the context of changing marital dynamics. Three major studies are described: the Within Family Differences Study (WFDS) of mothers aged 65–75 and their multiple grown children (primarily Baby Boomers) ongoing since 2001; the Family Exchanges Study (FES) of Baby Boomers aged 42–60, their spouses, parents, and multiple grown children ongoing since 2008; and the Longitudinal Study of Generations (LSoG) of 351 3-generation families started when the Baby Boomers were teenagers in 1971. These studies show that the Baby Boomers in midlife navigate complex intergenerational patterns. The WFDS finds ageing parents differentiate among Baby Boomer children in midlife, favouring some more than others. The FES shows that the Baby Boomers are typically more involved with their children than with their aging parents. The LSoG documents how divorce and remarriage dampen intergenerational obligations in some families. These studies provide insights into the nature of intergenerational ties and caregiving in the future.
What do people value when they provide unpaid care for an older person?: a meta-ethnography with interview follow-up
- Authors:
- AL-JANABI Hareth, COAST Joanna, FLYNN Terry N.
- Journal article citation:
- Social Science and Medicine, 67(1), July 2008, pp.111-121.
- Publisher:
- Elsevier
Government policies to shift care into the community and demographic changes mean that unpaid (informal) carers will increasingly be relied on to deliver care, particularly to older people. As a result, careful consideration needs to be given to informal care in economic evaluations. Current methods for economic evaluations may neglect important aspects of informal care. This paper reports the development of a simple measure of the caring experience for use in economic evaluations. A meta-ethnography was used to reduce qualitative research to six conceptual attributes of caring. Sixteen semi-structured interviews were then conducted with carers of older people to check the attributes and develop them into the measure. Six attributes of the caring experience comprise the final measure: getting on, organisational assistance, social support, activities, control, and fulfilment. The final measure (the Carer Experience Scale) focuses on the process of providing care, rather than health outcomes from caring. Arguably this provides a more direct assessment of carers' welfare. Following work to test and scale the measure, it may offer a promising way of incorporating the impact on carers in economic evaluations.
Navigating through incontinence: a qualitative systematic review and meta-aggregation of the experiences of family caregivers
- Authors:
- TALLEY Kristine M.C., et al
- Journal article citation:
- International Journal of Nursing Studies, 123, 2021, p.104062.
- Publisher:
- Elsevier
Background: Community dwelling older adults who are care dependent are highly affected by incontinence, resulting in substantial informal caregiver burden. Understanding the experiences of these caregivers is needed to develop supportive programs that reduce caregiver burden and rates of institutionalization for care recipients. Objectives: This systematic review aimed to critically appraise and synthesize the qualitative literature on the perceptions, experiences, and consequences of informal caregivers managing incontinence in community dwelling older adults. Design: A qualitative evidence synthesis using meta-aggregation. Data sources: CINAHL, Embase, Ovid Medline, PsycInfo, Scopus, and ProQuest Dissertations and Theses. Review methods: A comprehensive search was conducted to identify qualitative studies of all designs, published in English from January 1970 to November 2020, reporting on the experiences of unpaid adult family members or friends providing care at home to an adult aged 60 or older with urinary and/or fecal incontinence. Screening, data extraction, and quality appraisal were conducted independently by two reviewers, with disagreements resolved by consensus with all team members. Joanna Briggs Institute (JBI) processes were used to assess study quality, and the dependability and credibility of both study findings and synthesized findings. All articles included met predetermined criteria. Results: Database searches yielded 1165 references, of which 117 full-text documents were screened. Seven articles of moderate to high methodological quality met eligibility criteria and were included. Studies occurred in nine countries with 134 participants who were mostly female spouses of the care recipient. From these eligible studies, 49 findings were extracted with 35 equivocal or credible findings eligible for meta-aggregation. Findings were synthesized into the following four categories: 1) emotional responses, 2) physical, financial, and social consequences, 3) family roles and caregiver support, and 4) management and coping strategies. Conclusions: Informal caregivers experience many physical, psychosocial, and financial challenges in caring for an older family member with incontinence. Educational and supportive programs for managing incontinence should be multi-component and tailored to meet the individual needs of informal caregivers. Future research should incorporate strategies to cope with emotional responses and offer practical strategies for managing incontinence. (Edited publisher abstract)
What do we know about older former carers? Key issues and themes
- Authors:
- LARKIN Mary, MILNE Alisoun
- Journal article citation:
- Health and Social Care in the Community, 25(4), 2017, p.1396–1403.
- Publisher:
- Wiley
Despite a significant growth in the number older former family carers, they remain largely invisible in carer-related research and literature. To begin to address this deficit, a four-stage literature review was conducted to identify existing knowledge about older former carers. Narrative synthesis of the findings yielded five themes – the concept of ‘older former carer’, the legacies of caring, influences on the legacies of caring, conceptualising post-caring and support services for older former carers. Critical analysis of these findings suggests that existing evidence has a number of strengths. It highlights the terminological and conceptual confusion in the field, identifies the profound financial and health-related legacies older former carers’ experience, the factors which shape these legacies and some of the complexities of bereavement older former carers face. The support needs of older former carers are also illuminated. However, the field is characterised by key weaknesses. The evidence base is fragmented and uneven. In part this reflects lack of definitional consensus and in part the fact that there is much more evidence about some sub-groups, such as carers of relatives admitted to a care home, than others. Methodology-related weaknesses include small sample sizes and a focus on a single, often condition-specific, group of older former carers. An overarching criticism relates to the narrow conceptual/theoretical purview. As post-caring tends to be viewed as one of the final temporal ‘stages’ of the carer's ‘care-giving career’, a bifurcatory model of carer/former carer is created, i.e. that a carer actively provides care and a former carer is no longer caring. This constructs being a former carer – namely formerality – as a single fixed state failing to capture its dynamic and shifting nature and constrains the potential of research to generate new knowledge and extend understanding. (Publisher abstract)
Literature review: use of respite by carers of people with dementia
- Authors:
- NEVILLE Christine, et al
- Journal article citation:
- Health and Social Care in the Community, 23(1), 2015, pp.51-63.
- Publisher:
- Wiley
Respite care is a cornerstone service for the home management of people with dementia. It is used by carers to mitigate the stress related to the demands of caring by allowing time for them to rest and do things for themselves, thus maintaining the caring relationship at home and perhaps forestalling long-term placement in a residential aged care facility. Despite numerous anecdotal reports in support of respite care, its uptake by carers of people with dementia remains relatively low. The aim of this paper was to examine the factors that constitute the use of respite by carers of people with dementia by reviewing quantitative and qualitative research predominantly from the years 1990 to 2012. Seventy-six international studies of different types of respite care were included for this review and their methods were critically appraised. The key topics identified were in relation to information access, the barriers to carers realising need for and seeking respite, satisfaction with respite services including the outcomes for carers and people with dementia, the characteristics of an effective respite service and the role of health workers in providing appropriate respite care. Finally, limitations with considering the literature as a whole were highlighted and recommendations made for future research (Publisher abstract)
The redefinition of the familialist home care model in France: the complex formalization of care through cash payment
- Author:
- BIHAN Blanche Le
- Journal article citation:
- Health and Social Care in the Community, 20(3), May 2012, pp.238-246.
- Publisher:
- Wiley
This article examines French policy measures on the organisation of home-based care for older people, by investigating the balance between formal and informal care. It specifically focuses on the cash for care scheme which is at the core of the French home-based care policy. A detailed analysis was made of different policy documents and public reports, together with a systematic review of existing studies. Findings highlighted the complexity of the process related to the introduction of care allowance and demonstrate. It outlined the diversity of the resources available: heterogeneous professional care, semi-formal forms of care work with the possibility to employ a relative and informal family care. Finally, the analysis revealed the importance of the regulation of cash payments on the reshaping of formal and informal care.
Informal carers: who takes care of them?
- Authors:
- HOFFMANN Frederique, RODRIGUES Ricardo
- Publisher:
- European Centre for Social Welfare Policy and Research
- Publication year:
- 2010
- Pagination:
- 16p., bibliog.
- Place of publication:
- Vienna
The aim of this policy brief is to look at what is known about who provides informal care and who benefits from it, what differences, if any, are found between different countries, and what policies are in place to support informal carers, focusing mainly on countries of the European Union and using data from national and international sources and qualitative information from the European Centre's publication Facts and Figures on Long-Term Care - Europe and North America. It provides an overview of informal care giving across Europe, highlighting common characteristics and differences across countries, and discusses whether informal care in its present form is sustainable and why it may come under pressure in future, and recent policy developments in long-term care including providing cash to carers and the importance of providing services to carers. The authors conclude that informal caregiving remains the backbone of care provision in Europe and is the preferred care option for many dependent older people, that complete replacement of informal care by formal care services is neither financially feasible nor socially desirable, and that policy-makers should therefore ensure that carers' needs, as well as those of the care recipients, are taken into consideration and met, commenting that some countries already provide carers with a statutory right to receive an assessment of their needs for services in addition to services for older people, as is the case of the United Kingdom.
What are the consequences of caring for older people and what interventions are effective for supporting unpaid carers? A rapid review of systematic reviews
- Authors:
- SPIERS Gemma F, et al
- Journal article citation:
- BMJ Open, 11(9), 2021, Online only
- Publisher:
- BMJ Publishing Group
Objectives: To identify and map evidence about the consequences of unpaid caring for all carers of older people, and effective interventions to support this carer population. Design: A rapid review of systematic reviews, focused on the consequences for carers of unpaid caring for older people, and interventions to support this heterogeneous group of carers. Reviews of carers of all ages were eligible, with any outcome measures relating to carers’ health, and social and financial well-being. Searches were conducted in MEDLINE, PsycInfo and Epistemonikos (January 2000 to January 2020). Records were screened, and included systematic reviews were quality appraised. Summary data were extracted and a narrative synthesis produced. Results: Twelve systematic reviews reporting evidence about the consequences of caring for carers (n=6) and assessing the effectiveness of carer interventions (n=6) were included. The review evidence typically focused on mental health outcomes, with little information identified about carers’ physical, social and financial well-being. Clear estimates of the prevalence and severity of carer outcomes, and how these differ between carers and non-carers, were absent. A range of interventions were identified, but there was no strong evidence of effectiveness. In some studies, the choice of outcome measure may underestimate the full impact of an intervention. Conclusions: Current evidence fails to fully quantify the impacts that caring for older people has on carers’ health and well-being. Information on social patterning of the consequences of caring is absent. Systematic measurement of a broad range of outcomes, with comparison to the general population, is needed to better understand the true consequences of caring. Classification of unpaid caring as a social determinant of health could be an effective lever to bring greater focus and support to this population. Further work is needed to develop and identify suitable interventions in order to support evidence-based policymaking and practice. (Edited publisher abstract)
Older persons’ experiences of adapting to daily life at home after hospital discharge: a qualitative metasummary
- Authors:
- HESTEVIK Christine Hillestad, et al
- Journal article citation:
- BMC Health Services Research, 19(224), 2019, Online only
- Publisher:
- BioMed Central Ltd
Background: Researchers have shown that hospitalisation can decrease older persons’ ability to manage life at home after hospital discharge. Inadequate practices of discharge can be associated with adverse outcomes and an increased risk of readmission. This review systematically summarises qualitative findings portraying older persons’ experiences adapting to daily life at home after hospital discharge. Methods: A metasummary of qualitative findings using Sandelowski and Barroso’s method. Data from 13 studies are included, following specific selection criteria, and categorised into four main themes. Results: Four main themes emerged from the material: (1) Experiencing an insecure and unsafe transition, (2) settling into a new situation at home, (3) what would I do without my informal caregiver? and (4) experience of a paternalistic medical model. Conclusions: The results emphasise the importance of assessment and planning, information and education, preparation of the home environment, the involvement of the older person and caregivers and supporting self-management in the discharge and follow-up care processes at home. Better communication between older persons, hospital providers and home care providers is needed to improve the coordination of care and facilitate recovery at home. The organisational structure may need to be redefined and reorganised to secure continuity of care and the wellbeing of older persons in transitional care situations. (Edited publisher abstract)
‘Add info and stir’: an institutional ethnographic scoping review of family care-givers’ information work
- Author:
- DALMER Nicole K.
- Journal article citation:
- Ageing and Society, early cite 8 October 2018,
- Publisher:
- Cambridge University Press
Family care-givers are increasingly expected to find, understand and use information to meet the complex needs of older adults in their care. A significant number of studies, however, continue to report that care-givers’ information needs are unmet. Following Arksey and O'Malley's scoping review framework, this study examined 72 articles for the range and extent of available research on the information work done by family care-givers of community-dwelling older adults living with dementia. To untangle the complex relationship between information and care, this scoping review maps out (a) the ways scholarly literature conceptualises the informational components of family care-givers’ work and (b) the degree to which scholarly research acknowledges these components as work. An institutional ethnography inflection enhanced the scoping review framework, enabling the privileging of lived experiences, questioning of assumptions of language used, attending to authors’ positioning and highlighting care-givers’ information work made invisible throughout the processes of academic research. (Edited publisher abstract)