Male family carers' experiences of formal support - a meta-ethnography

The decision-making process of palliative care among male caregivers of chronically ill patients-A grounded theory study

BACKGROUND

Family caregivers have a vital role to play in palliative care for chronically ill patients. In Taiwan, caregiver demographics are evolving, with the number of male caregivers increasing. Gender differences influence psychosocial behaviours, thought processes and communication styles. In healthcare, acknowledgement of gender differences facilitates effective delivery of high-quality care.

AIM

The aim of this study is to explore male caregivers' decision-making process for palliative care for chronically ill family members.

METHODS

This study employed grounded theory to generate a substantive theory of male caregivers' decision-making process for palliative care for chronically ill family members. We recruited 22 male participants from three inner-city teaching hospitals in Taiwan.

FINDINGS

Regarding the decision-making process of palliative care of chronic ill family, where male caregivers do not want their loved ones suffering anymore, the male caregivers' decision-making process was impacted, first, by caregivers' views on the last stage of life; second, by their wish for good care during the end of life; and third, by their conviction that the patients' wishes should be respected. Furthermore, caregivers' philosophy of life and death is also a supportive ground for decision-making. This philosophy was influenced by their education in palliative care, financial status and religious beliefs and practices. The core category emerging from this study is encapsulated by a participant's assertion, 'How difficult is it? There are no male and female differences'.

CONCLUSION

We found that palliative care experiences of male caregivers are important for the decision-making process for palliative care for their chronically ill family members. Caregivers want their loved ones to receive good care as the last step in life, to respect their wishes and no more suffering for the patient. Therefore, health professionals should be familiar with the palliative care process that caregivers go through to offer updated information when needed.

Navigating the Impacts of Dementia: The Experience of Male Spousal Carers

This article investigates the experience of male spousal carers for women living with dementia. While cultural discourses on care are highly gendered, social scientific research often addresses care relationships in gender-neutral terms. Setting out to address this matter, this qualitative research study incorporated semi-structured joint interviews with 10 couples in which a male spouse cared for a woman with dementia. The aim was to explore how couples negotiate relationships and care following a diagnosis of dementia. The focus of this paper is on the perspectives expressed in these joint interviews by the male carers. A thematic analysis was undertaken to establish the key content of the men's accounts. Three principal themes were identified: making sense of the condition; treating dementia as a problem to be solved; and engaging with professionals and support. The gendered basis of experience for male carers is explored within these themes, demonstrating how societal norms of masculinity intersect with caring roles. The paper concludes that a nuanced research approach to dementia care must continue to be developed, accounting for how gender shapes personal responses to the navigation of care relationships. Practitioners and policymakers must also consider how gendered experience shapes the identities and strategies of male carers.

Influence of spousal caregiving and living arrangement on depression among husband caregivers in rural China

OBJECTIVES

With sociodemographic changes, men are increasingly taking responsibility for spousal caregiving. Previous studies have described gender differences in the psychological outcomes of caregiving; however, few have focused exclusively on husband caregivers. This study investigates the influence of starting spousal caregiving on the psychological well-being of older husbands in rural areas and examines whether living arrangements can moderate this relationship.

METHODS

A total of 1,167 baseline non-caregiver husbands aged 60 and above in rural areas were taken from the 2011-2015 China Health and Retirement Longitudinal Study (CHARLS). The generalized estimating equation (GEE) was employed to examine the effects of spousal caregiving transitions and living arrangement changes on depressive symptoms over four years.

RESULTS

Compared with rural husbands who remained non-caregivers, those transitioning into activities of daily living (ADL) caregiving reported higher depressive symptoms at follow-up (B = 1.67, p < 0.05). Moreover, the increase in depressive symptoms when transitioning into ADL caregiving was significantly lower among participants who changed from living with spouse alone to living with spouse and other family members together (B = - 5.37, p < 0.05).

CONCLUSION

There was an association between transitioning into ADL caregiving and an elevated level of depression over four years among older husbands, which could be alleviated by living with family members. Co-residence with family members could serve as a natural support resource, buffering adverse mental health outcomes when older husbands start a demanding caregiving role.