Multidimensional Predictors of Caregiver Strain among Older Persons Caring for Frail Spouses

Abstract

Older persons caring for frail and disabled spouses in the community have special needs and concerns. When one spouse is incapacitated, the other spouse--if available and capable--will generally assume the role of primary caregiver (Mui, 1993; Stone, Cafferata, & Sangl, 1987). Even in , the face of their spouse's severe impairments, elderly spouse caregivers continue to provide the t bulk of care required by their disabled partners (Miller, 1990a; Pruchno & Resch, 1989). Spouses account for 36% of all caregivers of frail elderly persons (Stone et al., 1987). Most studies on the impact of caregiving on spouse caregivers have used small local samples with limited generalizability (e.g., Barusch & Spaid, 1989; Borden, 1991; Fitting, Rabins, Lucas, & Eastam, 1986; Pruchno & Resch, 1989; Zarit, Todd, Zarit, 1986). In the present study, the emotional, physical, and financial strain associated with caregiving among spouse caregivers was examined using data-from the 1982-84 National Long-Term Care Channeling Demonstration. The following research questions were studied: (a) Does emotional, physical, and financial strain associated with caregiving differ between wife and husband caregivers, and (b) what are the predictors of each domain of caregiver strain for the two spouse caregiver groups? CONCEPTUAL FRAMEWORK Older husband and wife caregivers seem to respond to the demands of their caregiving role differently because of differences in meaning attributed to caregiving and differences in ways of coping (Borden, 1991; Miller, 1990a). For example, Pruchno and Resch (1989) found that the caregiving burden of wife caregivers was associated with poorer health, less emotional involvement, higher spouse impairment, and more task help. Husband caregivers' sense of burden, however, was not easily explained by these variables, which suggested that husbands and wives may experience the distress of caregiving differently. In addition, compared with husband caregivers, wives have reported higher levels of emotional distress associated with caregiving (Barusch & Spaid, 1989; Fitting et al., 1986; Mui, 1993; Zarit et al., 1986). Gender differences in spouse caregiver strain may be due to differences in the following: meaning associated with the caregiver role, role preparedness, role satisfaction, and role expectations. For example, the caregiving experience of husband caregivers may be qualitatively different from that of wives because men define the context of caregiving differently than women do (Dwyer & Seccombe, 1991; Stoller, 1992). Husbands appear to be very involved in caregiving and, because of other role losses, may perceive caregiving as a meaningful retirement activity (Kaye Applegate, 1990; Stoller, 1990). Miller (1990a) has also suggested that husbands may derive positive feelings from caregiving because being in charge is an extension of men's traditional role of authority. Miller.(1990b) has suggested that researchers use role theory to study gender differences in spouse caregiving. The role theory perspective assumes that adults engage in continuous construction of social realities and that gender differences in caregiving occur because of current role demands. In this study, I have adopted the scarcity hypothesis of role theory (Marks, 1977) as a framework to conceptualize the experience of a caregiver who, along with many other competing role demands, cares for a frail elderly spouse. According to the scarcity hypothesis, caregivers do not have enough resources to adequately fulfill both the caregiving role and other social roles in their lives. This produces a strong tendency toward role strain as a consequence of role demand overload and role conflict (Goode, 1960; Mui, 1992). As prescribed by societal norms, a spouse caregiver typically will take on the caregiving role when the spouse becomes disabled. At the same time, the caregiver may have a variety of other social roles, such as parent, employee, and/or caregiver of another disabled relative, in addition to the caregiving role. …