A Computer Network for Alzheimer’s Caregivers and Use of Support Group Services Computer networks of informal caregivers may serve as an alternative to more traditional face-to-face support services. This investigation examines whether a computer support network for family caregivers of persons with Alzheimer, s disease affects their use of support groups for family members. Two competing hypotheses are examined: one posits that the use of a computer network will be substituted for participation in support groups, while the alternative hypothesis suggests that the computer network will supplement or increase support group use. A longitudinal analysis indicated a relationship between use of the computer network and changes in support group attendance. The relationship, however, is sometimes supplementation and sometimes substitution, depending on the caregiver's previous use of support groups. We offer an interpretation of the changing relationship that is based on the predispositions, abilities, and needs of the caregiver for support services. Read more
Restraint Removal and Changes in Social Response Among Nursing Home Residents This study investigated whether removing physical restraints from previously restrained nursing home residents would change their social response. A quasi-experimental design was used to obtain data from 93 previously restrained subjects who became restraint-free (experimental group) and from 93 randomly selected never-restrained subjects (nonequivalent control group) in seven nursing homes. A repeated measures analysis of covariance (ANCOVA) controlling for group differences in cognitive status and physical activities of daily living (PADL) was used to examine changes in social response at pretest, posttest, and follow-up. Findings suggested that restraint removal had no effect on changing social response over time. Even after attempting to control for differences between groups, social response was significantly related to subjects’ cognitive abilities and PADL status. The control group was better functioning in both areas, and this affected their ability to respond socially at a much higher level throughout the study than the experimental group. Read more
An Intergenerational Program for Persons with Dementia Using Montessori Methods An intergenerational program bringing together older adults with dementia and preschool children in one-on-one interactions is described. Montessori activities, which have strong ties to physical and occupational therapy, as well as to theories of developmental and cognitive psychology, are used as the context for these interactions. Our experience indicates that older adults with dementia can still serve as effective mentors and teachers to children in an appropriately structured setting. Read more
The Moderating Influence of Service Use on Negative Caregiving Consequences This investigation adapts the social support conceptual framework to examine the moderating influence of community service use by impaired older persons on the negative consequences of caregiving for informal helpers. The model is modified by defining services as a type of social support that can counteract the stress associated with various care recipient impairments. Results from multivariate analyses of data from 401 caregivers suggest that certain services for care recipients can reduce the adverse effects of certain impairments on informal caregivers. The use of health care service by care recipients who are more disabled is related to lower levels of caregiver depression, health deterioration, and social isolation. Personal care service use consistently offsets the negative effects of care recipients' behavioral problems. Additionally, the use of household service when care recipients exhibit behavioral problems is associated with lower levels of caregiver depression. Read more
Service Use By Caregivers of Elders Receiving Case Management Although research on the effects of caregiver services has increased in recent years, the call for a research focus on the extent and predictors of their use has been largely ignored (Ory et al., 1985). The investigation described in this article addresses the gap in knowledge by examining the extent to which five types of caregiver services were used by study respondents: respite care, assistance finding or arranging for services, counseling or emotional support, education or training related to caregiving, and assistance with other responsibilities such as household tasks or child care. It also investigates the predictors of caregiver service use by applying a modified conceptual framework originally developed to examine factors influencing the use of health services (Andersen & Newman, 1973; Bass & Noelker, 1987). Read more
Influence of the Success of Psychoeducational Interventions on the Course of Family Care A reanalysis is presented of a previously reported study in order to investigate whether the short-term success of caregiver interventions is associated with positive longer-term outcomes. This new analysis focuses on whether or not families institutionalized their relative in the year following treatment, and the influence of response to treatment on the placement decision. Treatment outcomes (i.e., whether caregivers improved, failed to improve, or dropped out of treatment) were found to predict patient placement one year following initial assessment. Thus, caregiver interventions may have longer-term positive effects related to rates of patient institutionalization. Read more
Caregiving and its Social Support Social support is a feature of social relationships that can be discerned in many of the ordinary exchanges of daily social life but becomes especially prominent in the presence of adversity. However, despite its ubiquity, it is certainly no universal panacea. Not everyone has access to supportive relationships; people having such relationships do not necessarily benefit from them equally; and some adversities may be more resistant than others to the protective qualities of social support. These caveats notwithstanding, probably most people faced with difficult life exigencies have been the beneficiaries of social support, often without being aware of it. Indeed, individuals commonly confront unexpected and problematic junctures of the life course at which support goes beyond being merely useful and becomes, instead, a virtual requirement for the maintenance of well-being. Read more
The Interface Between Health and Social Services and Family Caregivers In the current debate over healthcare reform, an unresolved issue is Long Term-care coverage—whether it will be included in a reform package, and if so, to what extent, or whether deficit reduction and other economic considerations will make its cost prohibitive. Despite the uncertainty, extensive lobbying efforts continue to advocate linking acute and Long Term care in a reform package, and a number of plans to this effect have been proposed. The paradox is that while families currently are the unpaid yeomen of Long Term care and cost containment is a chief goal in healthcare reform, most plans ignore or give relatively little attention to the role of family caregivers. Read more
