Caregiving for persons with Alzheimer's disease (AD) has been shown to pose a challenge to the health of the spousal caregiver. Because most of the caregiving literature focuses on the female caregiver, there is some question about the generalizability of such literature to the male caregiver. This report focuses on male caregivers of spouses with AD and represents a subsample from a larger descriptive study that examined the relationship between risk factors and the health status of spousal caregivers. Twenty-nine male caregivers affiliated with Alzheimer's organizations in Pennsylvania and Ontario, Canada, returned mail surveys. On average, physical health symptoms increased by one-third when comparing pre- and post-caregiving data. Caregivers also were experiencing moderate to severe depression and burden. Male caregivers generally rated their physical health as fair to excellent and exhibited fewer than expected physical health symptoms. Caregiver health was related to perceptions of stress surrounding the provision of activities of daily living (ADL) assistance, the frequency of behavioral problems, perceptions of stress associated with the AD spouse's dysfunctional behaviors, and satisfaction with leisure opportunities. The identification of the role that caregiver perceptions of stressfulness associated with caregiving and the need for leisure satisfaction offer important implications for community-based education and respite services to maintain health status for spousal caregivers.

No abstract

No abstract

No abstract

WHEN DRUG ADDICTS HAVE CHILDREN. Edited by Douglas J. Besharov. Child Welfare League of America, 1994, 271 pages.When Drug Addicts Have Children is an engaging compilation of wellwritten contributions by experienced government officials, program administrators, practitioners and scholars in the child welfare field. This collection attempts to examine the interface between illicit drug abuse and child welfare policy and treatment.The book is divided into four sections. Section one examines the recent epidemiology of drug abuse, the neighborhood environment where the increased need for foster care has been caused in part "... by the growing number of female drug abusers" (p.44), a critical examination of the bio-behavioral effects of drug abuse on children, and a think-piece which reconsiders the role of humane institutionalized placements as an alternative for saving victimized children. Section two provides an overview of treatment approaches under the umbrella of the public health model, examines barriers to treatment, and calls for improved research in the field of drug abuse. Section three opens with a review of the multiple problems children and their families experience (in addition to substance abuse), the often overwhelming burdens placed on the existing child welfare system (highlighting New York's child welfare response to the crack epidemic), the impact on African-American children in particular, and the inadequacy of current child protective legislation. Lastly, section four examines a range of current obstacles and potential alternatives to current child welfare strategies. These include advocating for better integration between child welfare programs and substance abuse treatment, endorsing more long-term placements and outcome monitoring, re-examining the criteria for terminating parental rights, shifting outcome measures from basic protections to enhancing child development, emphasizing the unique role of kinship care, and enhancing supports for legal guardians.The variety of the contributors' backgrounds and training results in a compilation that many readers will find generally satisfying. Exam- 1859