Predictors of In-Home and Out-Of-Home Service Use By Family Caregivers of Alzheimer’s Disease Patients Few studies have examined whether the use of different types of services is predicted by different characteristics of elderly care recipients and primary kin caregivers. Most research aggregates services into a single category, thereby assuming that different services have the same predictors. This investigation differs from the aggregation approach by comparing four groups of elderly care recipients: in-home service of users, out-of-home service users, users of both in- and out-of-home services, and those who do not use services. Data come from personal interviews with 171 family caregivers of mild to moderate dementia patients who reside in the community. Using the modified Andersen framework and multiple group discriminant analysis, results show that care recipients who do not use services and those using only in-home services have inadequate informal supports, more emotionally strained caregivers, and more functionally impaired care recipients compared with users of out-of-home or both in- and out-of-home services. Read more
Respite Use and Caregiver Well-Being in Families Caring for Stable and Declining AD Patients The current controversy about respite's value centers on consistent reports of no significant reduction in caregiver strain with respite service use. In this study one explanation for the inability of prior research to document respite's impact is offered. This research demonstrates that respite may well reduce depression, reported health problems and family relationship strain in families caring for stable AD patients and may stabilize caregiver strain in families of declining AD patients. Read more
Involvement of Elders in Care-Related Decision A Black/White Comparison This research uses data from 244 family caregivers to examine racial differences in the composition of care-related decision-making networks. Analyses reveal blacks are significantly less likely to identify the older care recipient as involved or as the key decision maker when compared to whites. The older individual's physical and mental impairments are also important predictors of the involvement in decision making. Discussion addresses sensitivity to racial differences and elder cognitive capacity in assessing older individual decision-making involvement. Read more
The Influence of Caregiving and Bereavement Support on Adjusting to an Older Relative’s Death This study examines the influence of both caregiving social support to an impaired older relative and bereavement social support to a surviving caregiver on that caregiver's bereavement adjustment. Although past research has considered the link between bereavement support and adjustment to a loved one's death, the influence of support to the care recipient has not been investigated. Analyses of prospective panel data from 73 spouse and adult-child caregivers show caregiving support characteristics to be more important for bereavement adjustment than support provided to the surviving caregiver after their relative's death. Read more
The Transition from Caregiving to Bereavement The Relationship of Care-Related Strain and Adjustments to Death This study examines two competing hypotheses about the relationship between care-related strain and the difficulty adjusting to the impaired relative's death. One hypothesis, and the limited available empirical evidence, suggests that family members who perceive caregiving as stressful will experience some relief when their relative dies because care responsibilities end. An alternative hypothesis, derived from several conceptualizations, posits the opposite relationship, with greater care-related strain predictive of greater strain during bereavement. Panel data from spouse and adult-child caregivers collected before and after the death support the second hypothesis. Respondents who appraise caregiving as more difficult and those who report more negative caregiving consequences for the family assess bereavement as more difficult and report greater bereavement strain for the family. Read more
The Impact of An Aged Relative’s Death on the Family This chapter focuses on the consequences of an elderly relative’s death for surviving kin. The analysis begins by describing societal norms and values that guide reactions to and perceptions of death, dying, and bereavement. These guidelines make up the social context of death. After outlining these macro-level societal influences, we turn to the consequences of the death for the well-being of family members. The final sections outline two categories of factors that may account for differences in survivors’ well-being. These factors include pre-death characteristics such as awareness of and preparation for death and post-death characteristics related to coping with loss. Read more
Health Care Professionals and Family Involvement in Care-Related Decisions Concerning Older Patients This article examines care-related decision making within the context of in-home family care. It also uses the Andersen-Newman model to identify the correlates of physician involvement and centrality in decision making and the impact that it has on family members' caregiving satisfaction. Analysis of data from 244 family caregivers shows that elders (40%) and nuclear kin (53%) are key decision makers, indicating that families prefer to control care-related decisions. However, physicians are part of the decision-making process for nearly one fourth of the families in this study. The patient's impairment and the caregiver's education correlate with physician involvement in decision making. Shared residence and caregiver's overall satisfaction with the caregiving process correlate with physician centrality on the network. Discussion centers on implications for physician interactions with caregiving families around decision making. Included are indications for improved communication in decision-making contexts. Read more
Family Caregivers A Valuable but Vulnerable Resource This paper reviews research that used a comparative or longitudinal approach to examine whether family caregivers exhibit poorer health and well-being, either over time or in relation to other populations findings from surveys of family caregivers conducted by the Margaret Blenkner Research Center of The Benjamin Rose Institute will be discussed, because these studies included both panel designs and matched comparison samples of noncaregiving family members. The findings should help to clarify whether all family caregivers are equally at risk of stressful effects or whether certain types are more vulnerable. The forms or manner in which caregiving's stress is manifested by different types of kin caregivers will also be addressed. An innovative model service program for caregiving families that was developed at The Benjamin Rose Institute will be discussed in terms of its relationship to the Research Center's findings on caregiver vulnerability (PsycInfo Database Record (c) 2022 APA, all rights reserved) Read more
Longitudinal Impact of Interhousehold Caregiving on Adult Children’s Mental Health The wear-and-tear hypothesis of caregiving (the longer care provided, the more psychological strain on caregivers) was examined using panel survey data from 112 adult children providing interhousehold care to an impaired elderly parent. Measures included subjective caregiving stress and perceived caregiving effectiveness ("wear") and depression and affect balance ("tear"). Contrary to the hypothesis, data revealed variability in children's adaptation to caregiving, improvement rather than deterioration being the norm. In a recursive path model, both subjective stress and perceived effectiveness were significant predictors of changes in depression. Depression was not significantly related to duration of caregiving. Discussion suggests that future researchers consider other types of caregivers and care settings, factors predicting variability in caregivers' adaptation over time, and changes as well as stability in care arrangements. Read more
