The implications for research include a variety of methodological problems related to recruiting and retaining participants, instrumentation, and data collection. Research designs are needed that move beyond descriptive and epidemiological approaches to interventional and outcome studies. Ethical considerations take on special significance with vulnerable populations.
The purpose of this qualitative case study is to describe the contrasting perspectives between a family caregiver and the caregiver's professional provider in regards to the placement decision-making experience of the caregiver. A qualitative, descriptive, revelatory case study, using a grounded theory approach for data analysis, was conducted to identify and compare major themes drawn from interviews with the caregiver-professional dyad. The case is described on the basis of three interviews, two caregiver interviews (pre- and post-placement) and one health professional interview. The 77-year-old caregiver in this case was a wife caring for her 88-year-old husband who was diagnosed with Alzheimer's disease. The health professional was a social worker who led the support group the caregiver attended. Separate and private interviews were conducted by the principal investigator with the caregiver and health professional. Analysis revealed 11 major emerging categories that were compared from the caregiver's and professional's perspective. The perspectives of the family caregiver and the health professional had some elements that were congruent and some that were incongruent. Professionals may be unaware that they are not providing the kind of help that the situation requires. In particular, anticipatory guidance is needed before crisis events make placement immediately necessary. Further research is needed to identify what kind of conditions contribute to smoother decision-making processes and long-term care transitions for caregivers of relatives with dementia.
Family members caring for aging parents experience both negative and positive outcomes from providing care. Theoretical explanations for negative outcomes have been developed. There is need for models that explain and predict positive outcomes. This article describes the evolution of the Caregiver Empowerment Model (CEM) to explain and predict positive outcomes of family caregiving. Although empirical findings support positive outcomes of family caregiving, less attention has been given to theoretical rationale for positive effects. The CEM predicts that, in the presence of filial values and certain background variables, caregiving demands are appraised as challenges instead of stressors. Appraising caregiving demands as a challenge, finding meaning, and using certain types of coping strategies are posited to be associated with growth and well-being. The CEM extends our understanding of the complexity of the caregiving experience, and can serve as a framework to guide in developing and testing theory-based interventions to promote positive outcomes.
The aim of this study was to examine whether formal support and coping would mediate the effects of primary stressors and caregiver characteristics on three stress outcomes: yielding of role, anxiety, and physical health. Secondary analysis of longitudinal data from a convenience sample of 452 spouse and adult child caregivers of Alzheimer's patients was used for model testing. Path analysis suggested that decreased physical health of the caregiver was best explained by caregiver overload. Caregiver anxiety was explained by lower levels of care receiver dependency, higher levels of caregiver overload, and higher levels of caregiver anxiety measured 1 year earlier. Yielding of the caregiver role was explained by the direct effect of higher levels of care receiver problem behaviors as well as more use of formal supports. Spouse relationship had a negative effect and care receiver dependency had a positive effect on yielding of the role through the mediating influence of formal support. Neither coping nor formal support mediated primary stressors and caregiver characteristics in the directions hypothesized.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.