Caregiver Commitment Research Articles

Family caregiving: the positive impact on adolescent relationships.

Adult children are a significant contingent of elder care providers; a number of these individuals simultaneously care for children of their own while coping with caregiving commitments. Unfortunately, there is a paucity of information regarding the caregiving impact on these children and young adults. Moreover, the possible positive consequences of caring for an impaired elder are rarely mentioned. The current study was undertaken to examine the potential positive caregiving experiences of adolescents and their perceptions of relational enhancement as a result of caregiving. Twenty adolescents aged 14-18 were interviewed and asked a series of semistructured questions concerning satisfaction related to caregiving. To be included, respondents had to be a child, grandchild, or niece/nephew of an Alzheimer's (or Alzheimer's Type Dementia) patient cared for by the adolescent's immediate family. Employing features of content analysis methodology, all interviews were audiotaped and transcribed verbatim. The results merged into four primary categories: 1) increased sibling activity/sharing; 2) greater empathy for older adults; 3) significant mother-adolescent bonding and 4) peer relationship selection and maintenance. The implications for future research and practice are discussed.

Do Birth Plans Empower Women? Evaluation of a Hospital Birth Plan

In early 1993 a birth plan for the South Western Sydney (Australia) Area Health Service was introduced in two district hospitals. Its ease of use and effectiveness were evaluated from May to July 1993, using a questionnaire that was completed postnatally by the first 100 women who had completed a prenatal birth plan. All women were asked to complete the questionnaire regardless of whether they had used the written birth plan during labor. Ninety-five percent of women said that they would encourage other women to use the plan. It increased their own understanding about the processes of labor and birth, and the hospital options open to them. Women said it was helpful, enabled them to express their needs and preferences, enhanced their confidence, and improved communication between them and staff. Birth plans show the commitment of health caregivers to recognizing and supporting diversity, allow for critical reappraisal of existing hospital policies and practices, and provide an opportunity for quality improvement in the context of client rights and preferences. They empower women by increasing their knowledge and understanding of birth practices, and helping them make informed choices.

Alzheimer's disease afflicted spouses who remain at home: Can human dialectics explain the findings?

When one spouse has Alzheimer's disease (AD), marital interactions tend to decline. Findings from this study suggest that level of spousal interactions influence longitudinal outcomes for afflicted spouses. Thirty AD spouses and their spouse caregivers were assessed at baseline (time 1) and two years later (time 2). Continued in-home care at time 2 is predicted by high levels of positive spousal interactions, high caregiver commitment, good caregiver health, and shorter time as caregiver (all assessed at time 1). The same variables but in an inverse relationship predict which AD spouses are deceased at time 2. Nursing home placement is predicted by AD spouses' higher educational level, unhappy marital relationships, and low caregiver commitment. Afflicted spouses' cognitive and functional impairment levels, their physical health and depression do not predict outcomes. A theoretical explanation is developed drawing on Riegel's dialectical theory of human development and Bowlby's attachment theory. It is suggested that interactions between spouses are crucial for afflicted spouses' survival

Predicting Future Commitment to Care for Frail Parents Among Employed Caregivers.

A study of 133 full time employees with parent care responsibilities investigated various factors that could reduce this group's future caregiving commitment to aging parents. Study factors included: caregiver attributes, level of caregiving involvement, job stress, tensions between the caregiver and the dependent parent, caregiver's level of physical and mental strain, and limited support from family and friends. The relationship between the caregiver and the parent was the best predictor of sustained commitment to caregiving. One aspect of the employees' work experience made a small, but important contribution to respondents' future care plans. Those employees who frequently adjusted their work schedule and routine to accommodate parent care demands were less likely to sustain their caregiving commitment. Reasons for these findings are explored and implications for social policy and clinical practice are discussed.

Going public as an AIDS family caregiver

Images of AIDS invoke fears of contagion, disability and formidable death, and moral overtones directed toward drug use, sexuality and sexual identity and freedom. Responses to these images are both private and public, and have profound consequences for individuals whose lives have been touched by the disease, both the person with AIDS and the family caregiver. The purpose of this paper is to analyze in detail ‘going public,’ one category of a substantive theory of AIDS family caregiving. This category was developed from a grounded theory study of 53 AIDS family members who were asked to describe their experiences as an AIDS family caregiver during an indepth interview. Data were content analyzed using constant comparative analysis. Going public referred to how AIDS family caregivers let others know that they were caring for a PWA. Specifically, going public entailed selecting appropriate persons and audiences to tell, formulating approaches to communicating information, and considering the risks and benefits of the possible choices. The description of going public as an AIDS family caregiver details the assertiveness involved in political action and social change, contrasted with the isolation and secrecy involved in maintaining relationships with others under the condition of a stigmatizing illness. Data revealed a particular emphasis on the phenomenon of ‘guilt by association’. Because of their close relationship to a person with AIDS, caregivers were obligated to share the stigma of AIDS and were likewise discredited. Findings from our study emphasize the tremendous personal suffering experienced by caregivers which was associated with AIDS stigma in the form of rejection, loss of friends and harassment. Data also revealed the strong commitment of many caregivers to social activism which ranged from participating in educational efforts to marching in demonstrations. The rationale for the apparent increased activism among AIDS family caregivers compared to other groups of caregivers is explored. Going public highlights both the personal suffering and social manifestations of AIDS, significant issues to consider in planning health services for the second decade of the AIDS epidemic.

The Consequences of Elderly Wives Caring for Disabled Husbands: Implications for Practice

This study examines the mental well-being and special problems of 188 elderly wives identified as the primary caregivers who care for their disabled husbands. The findings indicate that the women have low morale scores associated with the arduous tasks of caregiving. Despite low morale scores, the health status of an elderly wife appeared to contribute significantly to her ability to cope with the caregiving responsibilities of a disabled spouse. Constant care and supervision, emotional and physical strain, and reduced social contact and finances were the major problems encountered in the caregiving commitment.

Relationship of caregiver education to child-oriented attitudes, job satisfaction, and behaviors toward children

This study examined relationships between behaviors toward children and a variety of caregiver characteristics—formal education, child-oriented attitudes, satisfaction with child care employment, and commitment to the child care field as a career. Detailed narrative descriptions of the behavior of 37 center-based caregivers responsible for groups of three- to five-year-olds were collected and then coded according to the Prescott, Jones, and Kritchevsky (1967) observational system. Caregivers also answered attitude and job satisfaction questionnaires and provided information about their educational background and child-related preparation. Overall findings indicated that, for the most part, caregiver actions stressed “caretaking” as opposed to “educational” functions. However, variations in behavior were related to caregiver characteristics. In contrast to previous research, higher education, as well as child-related preparation, was associated with several qualities of caregiver behavior—decreases in restriction and increases in encouragement, development of children's verbal skills, and the use of indirect forms of guidance. Education was positively associated with caregiver commitment to child care as a career. Also, career commitment, child-oriented attitudes, job satisfaction, and stimulating but nondirective behaviors toward children were positively correlated with one another. Results are discussed in relation to social policies concerning the preparation and training of child care professionals.

Reciprocity and Affection

Why do families provide care to their older relatives? Familial obligation emerges as a major motivator but does not sufficiently explain the variation in caregiving commitment which has been documented in previous research. This paper explores the influence of affection and reciprocity on the caregiving behavior and experiences of 203 individuals identified as the primary caregiver to an older frail relative. Findings indicate that while close affective relations were the norm, caregiving could and did take place in their absence. Past relationships were also characterized by a flow of services from the older relative to the current caregiver. Reciprocity was found to be significantly related to the amount of help given by the caregiver but not to the impact of caregiving, while affection is positively correlated to the level of commitment and negatively correlated to the level of perceived stress. Implications for professionals who work with family caregivers are discussed.

Why Measure Behaviour?

The upsurge in the use of behavioural change techniques with children in education and residential settings has not always involved an equally strong commitment to behavioural measurement (by which is meant quantitative data collection relating to latency, duration or, most often, frequency of the target behaviour in question). This paper outlines several advantages, other than effectiveness evaluation, which accrue from behavioural measurement; in relation to (a) deciding whether to change behaviour, (b) deciding the type of intervention required, (c) assessment of caregiver skills and commitment, (d) therapeutic effects, (e) reinforcement, (f) analysis of critical variables and (g) analysis of caregiver attitudes and behaviour. Case examples are included throughout.