Care Giving Offspring to Aging Parents: How it Affects Their Marital Relations, Parenthood, and Mental Health

The study examined the effect of direct and indirect stresses on the mental health of offspring caring for an aging parent. The study is based on Pearlin, Lieberman, Menaghan, and Mullan's (1981) Stress Development Model. The research examined 345 subjects, men and women aged 40-59 who filled a questionnaire sent by post within their workplace. The research findings show that the various stresses of the caregiver role are mutually connected and have a significant positive effect on the mental health of caregiving offspring. Another finding shows that the extended family support variable acts as a buffer on the caregiving burden on the adult child.

Predictors of driving cessation, independent living, and power of attorney decisions by dementia patients and caregivers

This study examines factors associated with decisions made by dementia patients and their caregivers regarding whether the patient should cease driving, live alone or with their spouse, and assign a Durable Power of Attorney. Using data collected by the Alzheimer's Disease Research Center (ADRC) in the Memory Disorders Clinic at the University of Kentucky Medical Center, we analyzed 827 first visits to predict patients’ and caregivers’ decisions. Caregiver relationship and patient gender and perceptions of patient abilities, as measured by Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) were more important than cognitive functioning, as measured by the MMSE, in predicting decisions made. These findings have theoretical implications for modeling the impact of the course of the disease and practical implications for interventions aimed at supporting the decision-making processes of patients and caregivers.

What decisions are made by family caregivers?

Before decision support can be offered, we need to understand what decisions family caregivers face, which are considered challenging, and what causes the challenge. To address these issues, 100 caregivers were asked to:

• Indicate decisions faced;

• Describe challenging decisions; and

• Describe specific decision making questions.

Eighty surveys (80 percent) were returned and used in the analysis. The most prevalent decisions involved nursing home placement, communicating the diagnosis, and driving. The most challenging decisions involved providing care and relocation. The most prevalent question involved the timing of actions. These results will guide the design of decision aids for family caregivers.

Breakaway: A social supplement to caregivers' support groups

The objective of the Breakaway program is to thwart negative influences of social isolation in caregivers by involving them with peers who share similar burdens. A simple developmental model brings informal groups together monthly for dinners, cultural entertainment, excursions, and other convivial diversions in the empathetic company of others with similar emotional and social pressures. Breakaway is designed to supplement the clinical and emotional assistance provided by the usual support groups. Resultant improvements in interest,joie de vivre, demeanor, personal esteem, depression, and other aspects of social isolation have been observed.

The Breakaway program may be of significant benefit-to participating caregivers who seek relief from the social isolation and other psychosocial burdens associated with constantly caring for the homebound or chronically ill.

Essential information and support needs of family caregivers

The purpose of this study was to identify essential information and support needs of family caregivers for individuals with Alzheimer's disease or a related dementia, and to examine the relationship between caregiver characteristics and needs. Caregivers (n=128, response rate=49.4%) returned a survey detailing information needs, support needs, and personal information. The need for information concerning diagnosis/treatment and legal/financial issues was more important than general information about the disease. Specifically, information about health plan coverage was most important. Experienced caregivers also needed legal/financial information, as well as support. Female caregivers rated needs related to support as significantly more important than male caregivers. Practitioners should realize that caregivers may have different information and support needs and these needs may change throughout the caregiving experience.

Pflegende Familienangehörige von Demenzpatienten

Zusammenfassung: Zweiundsiebzig Angehörige (AG) von Demenzpatienten wurden über ihre Belastung und ihre Bedürfnisse befragt. Angst, Depression sowie subjektive Belastung traten häufiger in späteren Demenzstadien auf und waren ausgeprägter, je beeinträchtigter das Alltagsverhalten (Nurses' Observation Scale for Geriatric Patients «NOGER», Spiegel et al., 1991 ) des Patienten und je schlechter die eigene subjektive Gesundheit beurteilt wurde. Im multivariaten Regressionsmodell konnten 66 % der subjektiven Belastung durch die Angst der AG, die Hilfe durch die Familie/Freunde sowie durch die NOSGER-Dimensionen «Selbstpflege» und «störendes Verhalten» erklärt werden (F 4,71) = 32.2, p < .0001). Die Bedürfnisse betrafen v. a. den Wunsch nach Information über und den Umgang mit der Krankheit sowie Betreuungsmöglichkeiten. Entlastende Unterstützungsangebote würden den AG ermöglichen, ihre Patienten länger zuhause zu betreuen.

Daughters and sons as caregivers for their demented and non-demented elderly parents. A part of a population-based study carried out in Sweden

The study focuses on adult children (n = 81) having the main responsibility for parents with dementia (study group). They were compared with children (n = 102) of non-demented parents (reference group). The children were interviewed about burden experienced. The interviews also secured information about the children's co-operation with the informal and formal network and their willingness to remain as caregivers during the progression of the disease or ageing process. The results showed that the daughters reported feeling more affection in their caregiving role than the sons. About one third of the participants in the study could not get relief from someone else. Eighty-nine per cent of the children in the study group and 76% of the children in the reference group were not willing to care for their parents in the family home during the progression of the disease, even if they were employed as caregivers.

Cardiovascular and psychosomatic symptoms among relatives of patients waiting for possible coronary revascularization

OBJECTIVE

To examine the consequences for close family members of patients on a waiting list for possible coronary revascularization.

BACKGROUND

An increasing number of patients with symptomatic ischemic heart disease require evaluation for possible revascularization. Many of these patients must wait a long time before receiving treatment. The negative consequences of this long wait for patients and their relatives have not been satisfactorily evaluated previously.

DESIGN

Cross-sectional descriptive study.

SETTING

All hospital in Southwestern Sweden.

STUDY POPULATION

One hundred relatives of patients referred for possible revascularization and a sex- and age-matched reference group. The convenience sample consisted of 85% (n = 76) women and 15% (n = 13) men.

OUTCOME MEASURES

Frequency of cardiovascular and psychosomatic symptoms.

EVALUATION

One hundred relatives and 100 members of the control group were sent a questionnaire to evaluate their clinical condition; working situation; use of tobacco, alcohol and sedatives; and cardiovascular and psychosomatic symptoms.

RESULTS

Family members had a significantly higher frequency of anxiety, depression, and irritability compared with the control group. Furthermore, family members reported sleeping disorders, including difficulty waking, tiredness due to lack of sleep, and restless sleep, more frequently than did the control group.

CONCLUSION

Close family members of patients waiting for coronary revascularization have particular difficulties, and these difficulties should receive more attention.