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Psychosocial factors among Chinese American women dementia caregivers and their association with salivary cortisol: results of an exploratory study
- Authors:
- HOLLAND Jason M., et al
- Journal article citation:
- Ageing International, 35(2), June 2010, pp.109-127.
- Publisher:
- Springer
- Place of publication:
- New York
Descriptive information is presented for a sample of 47 Chinese American dementia caregivers on a variety of psychosocial measures, including measures of depressive symptoms, overall perceived stress, stress specific to caregiving, coping, positive aspects of caregiving, caregiving self-efficacy, and belief in Asian values. The association between these psychosocial factors is also examined. The caregivers were found to report significant levels of distress but also showed indications of resiliency, as suggested by their high levels of self-efficacy, positive caregiving experiences, and problem solving. Stronger beliefs in Asian values were associated with less depressive symptoms, and greater self-efficacy, highlighting the importance of culture in shaping the caregiving experience of Chinese Americans.
Do trajectories of at-home dementia caregiving account for burden after nursing home placement? A growth curve analysis
- Authors:
- NIKZAD-TERHUNE Katherina A., et al
- Journal article citation:
- Social Work in Health Care, 49(8), September 2010, pp.734-752.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Moving into the nursing home setting is a difficult process for family caregivers of older people with dementia. It is known that nursing home placement can alleviate certain caregiving responsibilities, but new stressors can also emerge. This study examined how care-related factors can change leading up to nursing home placement and how these factors influence caregiver outcomes following nursing home placement. Six hundred and thirty four family dementia caregivers were surveyed at three six-month intervals prior to nursing home placement and once during the 12 month period following institutionalisation. Findings revealed dynamic changes in certain factors leading up to nursing home placement, such as caregivers' perceived health, while other factors such as burden remained stable. Several factors emerged as significant predictors of caregiver burden following nursing home placement, including pre-placement burden and adult day service usage. For geriatric social workers, these findings may be useful in assessing family caregivers, and in the development and utilisation of appropriate interventions.
Coping with dementia and older families of adults with Down syndrome
- Authors:
- JANICKI Matthew P., ZENDELL Anna, DEHAVEN Kathleen
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 9(3), August 2010, pp.391-407.
- Publisher:
- Sage
The study investigated a group of older carers of aging adults with Down syndrome (DS) to determine what effects such caregiving may have on them given the presence of dementia. The study also explored the comparative levels of care provided. Key signs were noted when decline was beginning – the subjective burden being experienced, and the key health factors when carers faced a changed level of care. Findings indicated that this group was made up of long-term, committed carers who have decided early on to look after their relative with DS over their lifetime. When faced the progression of dementia, their commitment was still apparent as evidenced by adopting physical accommodations and finding ways to continue to provide care at home, while also seeking help from outside sources. Most participants saw a family or group home environment as the place of choice for their relative with DS when they decided they could no longer offer care. The study did not suggest any burn-out or significant health related problems associated with their continued caregiving.
Men caring for wives or partners with dementia: masculinity, strain and gain
- Authors:
- BAKER Kevin L., ROBERTSON Noelle, CONNELLY David
- Journal article citation:
- Aging and Mental Health, 14(3), April 2010, pp.319-327.
- Publisher:
- Taylor and Francis
Over the last 3 decades, demographic changes in the developed world have meant more older men find themselves in caregiving roles. Little research has been undertaken with male caregivers in dementia care. Although there is general consensus that men construe care differently to women, gender has seldom been treated as an independent variable that can inform supportive interventions. This study sought to explore how facets of masculinity might relate to male caregivers' appraisals of strain and gain in dementia care. Seventy men, currently caring for a partner with dementia, completed questionnaires exploring their gender identity (Personal Attributes Questionnaire), gender role conflict (Gender Role Conflict Scale), and appraisals of carer strain and gain (Brief Zarit Burden Interview and Caregiving Satisfaction Scale). They were also asked to provide demographic information and, since caregiver strain is significantly affected by a care-receiver's cognitive and behavioural difficulties, to complete the revised Memory and Behaviour Problems Checklist. A series of regression analyses revealed contrasting findings to previous studies. Gender identity did not appear important in carer's evaluations of strain or gain, and only the 'restrictive affectionate behaviour between men' subscale of gender role conflict had explanatory power in analyses with all strain and gain variables. The discussion considers possible explanations for these findings, and how they may be influenced by response bias and defended masculinity.
Earlier stress exposure and subsequent major depression in aging women
- Authors:
- KASEN Stephanie, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(1), January 2010, pp.91-99.
- Publisher:
- Wiley
Asserting that despite evidence that stress exposure earlier in the life course may have long-term consequences for psychopathology most models of vulnerability for later life depression are limited to current stressors or retrospective reports of stress history, the authors of this study employed longitudinal data from a community sample of 565 women from New York counties assessed over three decades to examine whether major depressive disorder at average age 60 is associated with childhood adversity and both negative life events and chronic marital stress over adulthood. The results showed that greater childhood adversity, earlier high levels of negative life events and marital stress, and an increasing trajectory of marital stress over time all elevated the odds of major depressive disorder at average age 60, independent of all stressors and other salient risk factors. The authors conclude that the findings support the enduring effects of earlier stress burden on major depressive disorder in women into old age and have important clinical implications for identification and treatment of those at risk for depression.
Older carers and adults with learning disabilities; stress and reciprocal care
- Author:
- GANT Valerie
- Journal article citation:
- Mental Health and Learning Disabilities Research and Practice, 7(2), Autumn 2010, pp.160-172.
- Publisher:
- South West Yorkshire Mental Health NHS Trust and University of Huddersfield
This paper presents some of the findings from a qualitative study which explored the perceptions of stress and experiences of the longevity of care giving of older carers of adults with learning disabilities together with the views of people with learning disabilities about their relationship with their parents. Twenty four adults over the age of 60 who were carers for adults with learning disabilities living in the community were interviewed and 14 adults with learning disabilities who lived with carers older than 60 participated in focus groups. Five major themes emerged from the interviews with carers: a high degree of stress; how much their lives revolved around their child; support given to them by the adult with learning disability; reluctance to use respite services, linked to their previous experiences; not defining themselves as carers, instead viewing their parenting role as a permanent one. Major themes that emerged from the focus groups were: a high level of concern regarding their parents; the amount of practical and emotional support they gave to their parents; restriction placed on their lives, either by their parents or self-imposed so their parents would not be left on their own; lack of planning for the future; lack of knowledge regarding their available options. The author comments that the findings show that there is often co-caring between the older carer and their relative with a learning disability, and that the amount and quality of mutual caring is frequently overlooked by service providers and professionals.
The impact of family functioning on caregiver burden among caregivers of veterans with congestive heart failure
- Author:
- MOORE Crystal Dea
- Journal article citation:
- Journal of Family Social Work, 13(5), October 2010, pp.451-462.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This cross sectional study of 76 family caregivers of US veterans aged 55 years or more with congestive heart failure used the McMaster model of family functioning to examine the impact of family functioning variables on caregiver burden dimensions. The majority of the caregivers who participated in the telephone interviews were women (n=72), White (n=73) and living with the care recipient (95%); their average age was 69.7 years. On average the health of the veterans was described as good to fair. Measures of family functioning comprised problem solving, communication, roles, affective responsiveness, and affective involvement. Caregiver burden dimensions assessed were relationship burden (extent to which caregiver perceives patient requests as unreasonable), objective burden (extent to which care-giving demands infringe on caregiver’s time for self and others), stress burden (affective component of caregiver burden), and uplifts (degree to which caregiver feels fulfilled and rewarded by care-giving tasks). Regression analyses indicated that the five dimensions of family functioning were significantly related to relationship burden and uplifts. Increased relationship burden was associated with problems in family roles and increased uplifts was related to higher levels of affective responsiveness. This suggested that healthier family functioning is related to decreased perceptions of being taken advantage of and manipulated in the context of the care-giving relationship. Improved family functioning is also associated with increased perceived rewards in the care-giving context.. The author comments that the data support the conclusions of other studies that family functioning is significantly related to the experience of caregiver burden.
Assessing coping responses within specific faith traditions: suffering in silence, stress, and depressive symptoms among older Catholics
- Author:
- KRAUSE Neal
- Journal article citation:
- Mental Health Religion and Culture, 13(5), July 2010, pp.513-529.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This quantitative research study aimed to empirically evaluate coping behaviour evident among older (aged 66 years or more), Catholic Christians in the USA, namely that of ‘suffering in silence’ when faced with ongoing economic difficulties. How to identify the benefits of ‘suffering in silence’ and what those benefits are, specifically those that are health-related, are described using a review of published literature on predominantly American and Hispanic people. The author puts forward two hypotheses. The first suggests that older Catholics are more likely to exhibit ‘suffering in silence’ responses to poverty when compared with older Christians who are Protestant. The second claim is that some older people, who prefer to suffer-in-silence will have “the potentially deleterious effects of financial problems on depressive symptoms” offset due to their ‘suffering’ type of coping response. Six core measures of ‘suffering in silence’, ‘financial strain’, ‘depressed affect’, ‘somatic symptoms’, ‘frequency of church attendance’ and ‘frequency of private prayer’ were assessed along with demographic control measures such as age, sex, race and education. Complete baseline data from 2001, waves 2, 3, and 4 from 2004, 2007 and 2008, respectively, were analysed for between 595 and 596 older Caucasian men and women who identified themselves as Christians and were already taking part in an ongoing nationwide survey of older people and supported both hypotheses.
The role of mastery and social support in the association between life stressors and psychological distress in older Canadians
- Author:
- GADALLA Tahany M.
- Journal article citation:
- Journal of Gerontological Social Work, 53(6), August 2010, pp.512-530.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This study examined the underlying causal structure of the relationships between psychological distress and common life stressors, namely socioeconomic conditions, physical health and self-rated stress level, and assessed the roles of mastery and perceived social support as mediators of these relationships. Using structural equation modelling of data collected in the Canadian National Population Health Survey in 2004-2005 and 2002-2003, the roles played by socioeconomic conditions, physical health, chronic stress, sense of mastery, and perceived social support in the stress-psychological distress relationship were estimated and compared. Data was available for 542 men and 835 women aged 65 years or older. Findings revealed that chronic stress was the strongest determinant of the level of psychological distress for both genders; however its effect was higher for men compared to women. Poor physical health played a more important role in determining women’s psychological distress compared to men. Higher levels of mastery and perceived social support were associated with lower levels of psychological distress for both men and women. These associations were somewhat stronger for men compared with women. Socioeconomic conditions played a minor role in the stress-mental health relationship for both genders. Implications of the findings for social workers and other health professionals are briefly discussed.
Effects of guided care on family caregivers
- Authors:
- WOLFF Jennifer L., et al
- Journal article citation:
- Gerontologist, 50(4), August 2010, pp.459-470.
- Publisher:
- Oxford University Press
Guided Care (GC) for multi-morbid older people is provided by a registered nurse who works with the patients’ primary care physician (PCP). This study determined whether GC improves patients’ primary caregivers’ depressive symptoms, strain, productivity, and perceptions of the quality of care recipients’ chronic illness care. A randomised controlled trial of GC was conducted within 14 PCP teams. Participants included 196 primary caregivers who completed baseline and 18-month surveys and whose care recipients remained alive and enrolled in the GC study for 18 months. Caregiver outcomes included the following: depressive symptoms; strain; the quality of care recipients’ chronic illness care; and personal productivity. Findings revealed that between-group differences in depression, strain, work productivity, and regular activity productivity were not statistically significant after 18 months, but GC caregivers reported the overall quality of their recipients’ chronic illness care to be significantly higher. Quality was significantly higher in 4 of 5 Patient Assessment of Chronic Illness Care subscales, reflecting goal setting, coordination of care, decision support, and patient activation. The authors concluded that GC improved the quality of chronic illness care received by multi-morbid care recipients but did not improve caregivers’ depressive symptoms, affect, or productivity.