Effect of Giving Care on Caregivers’ Health This longitudinal study of 121 caregivers of the elderly evaluates the change in their self-assessed mental and physical health over two years. The care recipients, who were drawn from a random sample of noninstitutionalized urban elders, showed increased need for help with personal and instrumental activities of daily living in this period. Both the physical and mental health of the caregivers declined significantly during the study. Predictors of decline in physical health of the caregivers at the end of the study were poorer physical health at the start, the amount of help they provided, a decline in their own mental health, and an increase in the number of other persons also available to provide care. In contrast, decline in caregivers’ mental health at the end was predicted only by poorer mental health at the start and by decline in physical health. Read more
The Buffering Effect of a Computer Support Network on Caregiver Strain ComputerLink was a computer support network for family caregivers of people with Alzheimer's disease. In a 12-month experiment, 102 caregivers were randomly assigned to an experimental group that had access to ComputerLink or to a control group that did not. This investigation examined whether caregivers in the experimental group had greater reductions in four types of care-related strain by the end of the 1-year study. ComputerLink reduced certain types of strain if caregivers also had larger informal support networks, were spouses, or did not live alone with their care receivers. More frequent use of the communication function was related to significantly reduced strain for caregivers who were initially more stressed and for non-spouse caregivers. Greater use of the information function was related to significantly lower strain among caregivers who lived alone with care receivers. Overall, ComputerLink appeared to be an effective tool for reducing strain for some caregivers. Read more
Family Caregivers and In-Home Respite Options The Consumer-Directed Verses Agency-Based Experience This study examined the preferences for and characteristics of consumer-directed (i.e., direct pay) and professionally-managed (i.e., agency-based) respite for family caregivers of adults with cognitive impairments. The sample of 168 caregivers was drawn from the in-home respite caseload of California’s Caregiver Resource Centers. Respondents in both groups reported the same ‘‘most important’’ reasons for preferring their respective mode of respite: wanting to be sure their loved one was safe, and having good, reliable and trustworthy help. The data revealed a clear preference for consumer direction in respite care in the home. Practice implications are addressed for improving the delivery of in-home respite care. Read more
Distress and Burden for Family Caregivers Providing care to an older adult with a dementing condition is often associated with a variety of physical and mental health conditions. Substantial empirical evidence indicates that caregivers are in poorer physical health and experience depressed immunologic functioning (Kiecolt-Glaser et al., 1987; Stone et al, 1987; Schulz et al., 1995; Tennstedt et al., 1992), use prescription drugs for depression, anxiety, and insomnia two to three times as often as the rest of the population, and report higher levels of depression, anger, and anxiety (Anthony-Bergstone et al., 1988; Gallagher et al., 1989; Haley et al., 1987). As a result of over 20 years of research, it is now widely accepted that providing care for a person with dementia is stressful and demanding. Caregiver burden, the term often used to describe the stress experienced by caregivers who provide hands-on care to impaired relatives, has received a great deal of attention from the research, practice, and policy communities. What was once a unidimensional concept reflecting a family caregiver’s general level of stress has evolved over the years into a multidimensional phenomenon that applies to both informal and formal caregivers. In describing this transformation, the present chapter will first provide a brief history of family caregiving research and burden. Next, more recent advancements in the study of burden will be presented with an emphasis on innovations in research and intervention. The chapter ends with discussion of future directions for research and intervention. Read more
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
Institutionalization A Continuation of Family Care It is often assumed that with institutionalization comes an end to family caregiving. The goal of this study is to show that family caregiving continues even after institutionalization of the care recipient. The data come from 81 families who institutionalized their elders. The findings indicate that families remain involved in the care of the elder after institutionalization, although to a lesser degree and in different ways. Involvement in personal care tasks is reduced, not terminated; involvement in the specialized needs of the elder, such as their financial and legal concerns, continues, along with the new role of advocacy. The effects of caregiving are still felt by the primary caregiver, as are the effects of institutionalizing the care recipient. Read more
Depression and Health in Family Caregivers Adapation Over Time This study examined the predictors of caregiver depression and "adaptation" over time in a sample of 202 family caregivers of cognitively impaired adults. By examining caregiver adaptation (i.e., a caregiver's ability to adjust psychologically to the demands of providing Long Term in-home care), we were able to account for initial levels of depression, regression to the mean, and floor and ceiling effects. Results indicated that the strongest predictors of caregiver depression 1 year after baseline were initial levels of depression, worsening of caregiver subjective physical health status and burden, and short-term use of in-home respite assistance. These findings suggest that caregivers who experience deterioration in levels of physical health and burden and who use in-home respite on a short-term or sporadic basis may be especially vulnerable to the chronic stress of providing Long Term in-home care. 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
