Family Caregiving Responsibilities Research Articles

Caring for Individuals with Alzheimer's Disease: A Spotlight on Hispanic Caregivers.

A caregiver is a constantly evolving role that an individual most likely undertakes at some point in their lifetime. With discoveries and research in increasing life expectancy, the prevalence of neurological-related diseases, such as Alzheimer's disease (AD) and dementia, is certainly likely to require more caregivers. The demand for AD caregivers is escalating as the prevalence of the disease continues to rise. The projected rise in AD within the Hispanic population in the United States over the next few decades is expected to be the most significant among all ethnic groups. The Hispanic population faces unique dementia risks due to cultural factors like language barriers, lower education, and limited healthcare access. Higher rates of conditions such as diabetes and cardiovascular disease further elevate dementia risk. Family dynamics and caregiving responsibilities also differ, affecting dementia management within Hispanic households. Addressing these distinct challenges requires culturally sensitive approaches to diagnosis, treatment, and support for Hispanic individuals and their family's facing dementia. With AD and other dementia becoming more prevalent, this article will attempt to expand upon the status of caregivers concerning their economic, health, and cultural statuses. We will attempt to focus on the Hispanic caregivers that live in Texas and more specifically, West Texas due to the lack of current literature that applies to this area of Texas. Lastly, we discuss the ramifications of a multitude of factors that affect caregivers in Texas and attempt to provide tools that can be readily available for Hispanics and others alike.

Why employees engage in proactive career behavior: examining the role of family motivation

PurposeThis study established and examined a moderated mediation model connecting family motivation with proactive career behavior (PCB). Drawing on social cognitive career theory model of career self-management and person-environment fit theory, the authors posit that the influence of family motivation on PCB is mediated by career goal setting (CGS) and moderated by career support climate (CSC).Design/methodology/approachUsing multilevel modeling techniques, data were collected from 98 leaders and 416 employees at two-time points.FindingsResults show that family motivation has a positive direct and indirect effect on PCB through CGS. Additionally, CSC strengthens the positive effect of family motivation on PCB through CGS.Practical implicationsFor employees, proactive career management and the establishment of clear career goals are vital for fulfilling family responsibilities. Simultaneously, for managers and organizations, creating a supportive work environment is crucial to encourage employees in career management.Originality/valueWhile existing research highlights the detrimental effect of fulfilling family caregiving responsibilities on employees' career development, the comprehension of this relationship remains limited. Taking a family motivation perspective, this study explores the mechanisms through which family motivation stimulates employees to engage in PCB, with a specific focus on the moderating influence of CSC. The findings offer fresh insights into the role of family motivation in career development, contributing significantly to the broader literature on the intersection of family and careers.

The Impact of COVID-19-Induced Responsibilities on Women’s Employment in Arab Countries

The COVID-19 pandemic has created massive challenges for women’s employment. Women’s responsibilities were exacerbated by the closure of schools and child daycare facilities. Investigating the determinants of job losses among women is critical to avoiding dropouts and supporting re-entry into the labor market. This study investigates the factors driving women’s workforce losses during the pandemic in five Arab countries (Egypt, Tunisia, Morocco, Jordan, and Sudan). The current study focuses mainly on how COVID-19-induced responsibilities affected women’s employment during the pandemic. The study depends on the COVID-19 MENA Monitor Household Survey produced by the Economic Research Forum. The factor analysis of mixed data is used to construct the women’s responsibilities index that is made up of 18 variables. The mixed-effect logistic model is used to consider changes in working arrangements across economic activities. The results indicate that women with high family caregiving responsibilities were more likely to lose their jobs. Women working in the government sector and with health insurance were protected from job losses. Telecommuting played a significant role in helping women maintain their jobs. Work arrangements should be improved to consider increased unpaid domestic work. Family-friendly policies must be activated, and childcare leave must be facilitated and funded. The private sector should also be urged to improve workplace flexibility.

Strategies to Support Faculty Caregivers at U.S. Medical Schools.

To describe the policies, processes, and programs at U.S. medical schools to support faculty caregivers before and in response to the COVID-19 pandemic. In 2021, the Doris Duke Charitable Foundation and founding members of the COVID-19 Fund to Retain Clinical Scientists (FRCS) Collaborative launched and supported the COVID-19 FRCS program to recognize medical schools and their efforts to strengthen policies, processes, and programs supporting biomedical faculty with family caregiving responsibilities in the context of COVID-19-related impacts. The authors conducted a qualitative conceptual content analysis of the deidentified, open-ended responses submitted by institutions in their applications to the COVID-19 FRCS program and summarized the reported strategies using recurring patterns and common approaches. Fifty-four institutions applied to the COVID-19 FRCS program in 2021 and were included in this study. COVID-19-related impacts on biomedical faculty included stymied career progression and academic productivity, exacerbated career-caregiving time conflicts, adverse effects on family and personal well-being and mental health, increased financial hardships, and amplified faculty caregiver stigma. The described policies, processes, and programs to support faculty caregivers fell into 4 domains: support for dependent care, career and workplace flexibility, career development support, and institutional culture change to reduce stigma. COVID-19-related modifications spanned these domains with remote and flexible work manifesting as disruptive changes. Strategies to support women and underrepresented in medicine faculty, who bear a disproportionate burden of caregiving responsibilities, centered on career development support and institutional culture change. The projected durability of the enacted changes varied by institution and across strategies. The COVID-19 pandemic presents a disruptive opportunity to translate lessons learned into positive change to better support faculty caregivers, particularly women and underrepresented in medicine faculty. This study's findings provide a framework to guide sustainable change to support equity, diversity, and vitality in the academic biomedical workforce.

Caregiver, secondary victim: outcome of caring for patients with COVID -19: a qualitative content analysis study

BackgroundConsidering the importance of caring for patients with COVID -19 at home and the majority of care being the responsibility of family caregivers, it is necessary to identify and assess the problems during the implementation of patient care in family caregivers. Therefore, the present study was conducted to discover the different consequences of caring for patients with COVID-19 in family caregivers.MethodUsing Purposive sampling, 15 female family caregivers were included in the study. This study was conducted between 2021 and 2022 in Iran. Unstructured face-to-face and virtual interviews were used to collect data until data saturation was reached. Data were analyzed through Granheim and Lundman conventional content analysis approach.ResultsThe analysis of data related to the outcome of caring for patients with COVID -19 in family caregivers, led to the extraction of six subcategories: " caregivers experiencing physical symptoms ", "perception of extra pressure and psychological symptoms in the caregiver", "disruption in marital relations", "feeling of homelessness and rejection" and " role pressure due to lack of family support". The subcategories led to the development of the main category "caregiver, the secondary victim", which is experienced by family caregivers during the provision of care for patients with COVID -19.ConclusionFamily caregivers experience high levels of negative consequences from providing care to patients with COVID-19. Therefore, more attention should be paid to all dimensions of caregiver health such as physical, mental, and marital to provide quality care to patients finally.

The ACGME's New Paid Family and Medical Leave Policy: Just the Beginning.

The COVID-19 pandemic has laid bare a problem that many people have managed behind the scenes for years: how to balance work and family caregiving responsibilities. For physicians, many of whom were already experiencing burnout prior to the pandemic, the extra burden of COVID-19-related work stress combined with fewer options for childcare and other support has made coping all but untenable. In early 2022, the Accreditation Council for Graduate Medical Education (ACGME) promulgated new paid family and medical leave policy for residents and fellows. This editorial considers the importance of this step by the ACGME as well as the remaining gaps in paid leave policy in medical education, graduate training, and practice.

Older adults on the dating market: The role of family caregiving responsibilities

AbstractObjectiveThis study investigates how family care responsibilities impact older single adults' approach to and experience on the dating market.BackgroundThere is a growing population of single older adults, but very little understanding of their experiencing seeking romantic partners. Prior dating and marriage research has focused primarily on younger adults or single parents seeking remarriage. There is evidence of parenthood negatively impacting the search for a partner, but it is unclear how caregiving responsibilities impact this process for older adults.MethodHere, 100 older adults, 50 men and 50 women ages 60–83, were recruited from online dating websites and interviewed about their experiences seeking romantic partners.ResultsMany men and women postponed dating until carework was complete. Additionally, men found women with care responsibilities less desirable, but women preferred men who were close to their families. Men were only less desirable when women believed the men would increase a woman's carework responsibilities.ConclusionThis study reveals how family caregiving responsibilities have a noticeable and gendered impacted on older adults' experiences with repartnering. This study extends marriage market and marital search theories by highlighting the complicated and influential role of family, particularly family carework responsibilities, in older adults' opportunities and status on the dating and marriage market.

The Impact of Parent and Family Caregiver Roles Among Canadian Radiation Oncologists

Working parents, and a rising number of adults delivering care for aging relatives, experience numerous challenges in their personal, family, professional, and financial lives owing to multiple responsibilities. This study describes the experiences of Canadian radiation oncologist (RO) parents and family caregivers, reporting challenges that may exist in providing family care with clinical and academic work commitments. Canadian ROs, via RO heads of departments in cancer centers across Canada, and physician members of the Canadian Association of Radiation Oncology were invited to participate in an anonymous online survey between November 2021 and January 2022. The survey focused on demographics, experiences of pregnancy and leave, parenting and adult caregiving responsibilities, and self-care. A total of 103 staff ROs (38%) completed the survey and 78 (75.7%) identified as having a parental (76 [89.7%]) and/or other family caregiver (8 [10.3%]) role; 41% were female and 59% were male, with no difference between genders in the number of children (median, 2; interquartile range, 1-3; P=.17). More female respondents took parental leave for their first child compared with male respondents (mean, 29 vs 6 weeks; P < .001). Of male respondents who started caring for their first child during residency, 27% took parental leave, compared with 77% who started caring for their first child as a staff member (P=.003). The majority of respondents described "always/usually" having collegial support for each pregnancy and parental leave. Both genders described parental responsibilities as negatively affecting attendance at conferences (male, 65%; female, 77%; P=.31) and early or late work-related meetings (male, 76%; female, 79%; P=1.0). More female respondents described parental responsibilities as negatively affecting their career (50% vs 29%; P=.085). Of female respondents, 52% (vs 26% of male respondents; P=.044) identified a physician mentor or positive role model around parenting issues. Parental and other family caregiving responsibilities are not gender unique in Canadian ROs, but competing work and family roles may affect genders differently.

Dementia Spousal Caregiving.

Dementia family caregiving has been linked to depression, anxiety, insomnia, and other negative mental health symptoms, particularly among spousal caregivers who are most likely to have higher levels of caregiving hours. Further, depressive symptoms often present differently based on caregiver race and ethnicity. This study aimed to examine the association between spousal caregiving hours and self-reported depressive symptoms as well as identify any racial/ethnic disparities in depression self-reporting. Data was drawn from Wave 9 (2008) of the Health and Retirement Study and included 10,120 participants. Linear regression was used to evaluate the relationships between caregiving hours and depression symptoms. Further, a negative binomial model was used to test whether race/ ethnicity moderated the relationship between caregiving hours and self-reported depressive symptoms. As expected, self-reported depressive symptoms increased as caregiving hours increased (1.65, SD = 2.02, p <0.01). Among the racial and ethnic groups evaluated, Latinx participants experienced the highest levels of depressive symptoms relative to caregiving hours. Dementia affects families. Care and consideration of the family are as important as the care of the individual affected by a dementia-related diagnosis. Depression is a serious anticipated mental health outcome linked to dementia family caregiving responsibilities. As such, there is a need for increased culturally responsive professional screening and treatment for depression among family caregivers. Relatedly, primary care providers play an important role in identifying patients serving as family caregivers and offering necessary supports and referrals.

I’ll Take a Year Off and Look What Happened’: How Family Caregiving Responsibilities Influence Educational Trajectories in the United States

Higher educational attainment has been linked to better health and economic outcomes. However, little is known about how family caregiving responsibilities influence individuals’ educational trajectories in the United States (U.S.). Currently, 26% of U.S. undergraduates have at least one dependent child. While some literature describes the experiences of college-student parents, few studies examine the myriad ways family caregiving may singly or simultaneously present, including caregiving for children, relatives, household members, and older adults. The literature shows that caregiving for relatives, household members, and older adults is a common experience, with 20% of Americans providing care for an adult. Guided by social reproduction theory and reproductive labor, this paper examined qualitative interviews (n=31) from the Educational Trajectories & Health study to understand how caregiving responsibilities, broadly defined, influenced educational trajectories. Participants who identified as women discussed bearing disproportionate expectations to take on family caregiving responsibilities, including caregiving for siblings and aging parents. For most participants, family caregiving responsibilities substantially influenced educational decisions. Some experienced additional caregiving responsibilities but still attained their educational goals; others with family caregiving responsibilities discussed stretching and substituting resources in an effort to manage but ultimately having to step back from their stated educational pursuits. Situating these findings within broader social and structural contexts, this analysis examines educational disruption when family caregiving responsibilities arise. Findings have implications for policies that support students with family caregiving responsibilities at school, state, and federal levels.

Predictors of delayed retirement intention in older Chinese workers

AbstractThe aim of the current study was to explore delayed retirement intention and its influencing factors in a large sample of older Chinese workers. A cross‐sectional questionnaire survey was conducted among a convenience sample of 2776 older Chinese workers. Multinomial logistic regression analyses were performed separately for male and female workers to examine the association between work characteristics, family factors, personal health and the neuroticism trait and delayed retirement intention. Results showed that workers had low delayed retirement intention, while female workers were more reluctant to delay retirement than male workers. Job demand‐control, job satisfaction, family economic status, family caregiving responsibilities, chronic diseases, physical health, mental health and neuroticism were predictors of male workers' delayed retirement intention, while job effort‐reward imbalance, job satisfaction, family caregiving responsibilities and neuroticism were predictors of female workers' delayed retirement intention after controlling for demographic factors.

Preferred Place of Death Discussions: Are They Informing and Empowering Patients and their Family Caregivers?

Factors influencing preferred place of death (PPoD) are variable between individuals. However, there is little understanding of how these preferences are formed and how consistent they are in the final months of life. In particular, the expectation and responsibility of family caregivers to provide unpaid caregiving support to their dying loved one in the home is often overlooked. There is a need for clinicians to take an individualised approach to PPoD conversations that is inclusive of the needs of both the patient and the family caregiver. More Good Deaths - A Change Programme responds to this gap in care by advancing the skills of clinicians having PPoD conversations with patients and their family caregivers. This paper describes the programme, providing insight into its benefits to advanced care planning and communication, as well as to our newest service - Cottage Hospice.

Making it work: a qualitative study of the work-care reconciliation strategies adopted by family carers in Ireland to sustain their caring role

ABSTRACT While work-care reconciliation strategies can benefit family carers, employers, wider society and the economy, juggling family caregiving responsibilities with paid employment can lead to role strain. Family carers frequently find themselves engaged in role decisions and role negotiations and being faced with decisions to alter their work commitments in order to fulfil their caregiving responsibilities. The purpose of this study was to explore family carers’ experiences of modifying work arrangements to accommodate caregiving responsibilities for an ill or dependant family member. Ten face-to-face, semi-structured interviews were conducted with family carers in Ireland, which were audio-recorded, transcribed verbatim and analysed using thematic content analysis. The findings highlighted the value placed on work by family carers, but despite this, the caring role always took precedence over the employee role. Family carers adopted a combination of strategies, and where possible, carved out a carer-friendly career for themselves. The findings also revealed the key triggers for work alterations and the sacrifices made by family carers. It is important that family carers are supported by employers to successfully balance work with caregiving responsibilities and that an array of work options are available to them, so that they can make better-informed choices regarding work-care reconciliation.

Predictors of Participation Restriction in Midlife Caregivers: An Exploratory Study

Mid-life family caregivers (CGs) are at risk for participation restrictions (reduced engagement in valued roles and activities) due to competing demands of work, parenting, and family caregiving responsibilities. When CGs experience participation restrictions, quality of care for care recipients (CR) decreases, yet CG burden and risk for poor health increases. The purpose of this study was to identify the factors contributing to decreased participation in mid-life CGs. Participants were CGs aged 45-64 years (n = 677) from the National Study of Caregiving/National Health and Aging Trends Study. We used multivariate logistic regression to determine attributes of CGs, CRs, and the care situation that independently contribute to participation restrictions. We found that negative aspects of caregiving (OR = 1.51, 95% CI = 1.33, 1.71) and CR depression and anxiety (OR = 0.90, 95% CI = 0.83, 0.99) significantly predicted participation restrictions (p < 0.05). Positive aspects of care (OR = 0.87, 95% CI = 0.74, 1.01), frequency of helping with chores (OR = 1.30, 95% CI = 0.98, 1.70), frequency of providing personal care (OR = 1.24, 95% CI = 0.97, 1.59), and frequency of providing help getting around the home (OR = 1.30, 95% CI = 0.97, 1.75) showed trends for association with participation restrictions (p < 0.10). We identified factors that are related to participation restriction in mid-life CGs. Some of these factors (e.g., positive and negative aspects of caregiving, frequency of assistance provided) are potentially modifiable intervention targets that could bolster participation in this at-risk group.

Identifying and Addressing Social Determinants of Learning During the COVID-19 Pandemic.

The COVID-19 pandemic has negatively impacted the health of people from communities of color and people of limited socioeconomic means in a disproportionate way due to social determinants of health (SDoH). The Centers for Disease Control defines SDoH as the “conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of life-risks and outcomes.” A related construct, social determinants of learning (SDoL), includes contextual conditions and variables that impact students’ ability to optimally participate in their education, including academic and clinical development. SDoL directly impact students’ ability to participate in the educational process. During the COVID-19 pandemic, students struggling with SDoH and, by extension SDoL, may be more likely to have sick family members, caregiving responsibilities, food and housing insecurity, and obligations to supplement lost family wages. SDoL are also influenced by individual experiences within and outside of the classroom. Beyond bringing this matter to the attention of our profession, especially clinical and academic educators, we must take action to reach and support students who are at higher academic risk due to the SDoL. The purpose of this paper is to: (1) define SDoL, (2) explain how SDoL are impacting DPT and physical therapist assistant students, and (3) discuss actions that physical therapists and physical therapist assistants can take to mitigate the effects of SDoL on current DPT and physical therapist assistant students.

Institutional imperatives for the advancement of women in medicine and science through the COVID-19 pandemic

Institutional imperatives for the advancement of women in medicine and science through the COVID-19 pandemic

The Relations Among Types of Parentification, School Achievement, and Quality of Life in Early Adolescence: An Exploratory Study.

Children who experience parentification may have trouble performing developmental tasks due to being overwhelmed by their family caregiving roles and responsibilities. Past studies have found that parentification is negatively associated with academic achievement. However, most of these studies are limited in that they are retrospective and examine the association but not the mechanisms shaping them. The aim of the study was to explore to what extent diverse types of parentification relate to academic achievement and to what extent these relations are mediated by self-reported quality of life among adolescents. The study sample was composed of Polish early adolescents (N = 191; age: M = 14.61; SD = 1.26). Types of parentification were measured with the Parentification Questionnaire for Youth, and quality of life was assessed with KidScreen27. School achievement was measured based on mean semester grade. We explored the associations among study variables and performed six mediation models in the planned analyses. Overall, bivariate relations were significant in a theoretically expected way, although the effect sizes for these associations were rather small. In the mediation analyses, the results showed that four of the six models were not significant. Different from previous studies, instrumental parentification was positively related to school achievement. Additionally, this positive association was mediated by adolescents’ general quality of life. Taken together, the findings were similar and different from the empirical literature base on types of parentification and select outcomes.

How work and family caregiving responsibilities interplay and affect registered dietitian nutritionists and their work: A national survey.

Healthcare professionals provide paid care at work and potentially have caregiving responsibilities outside of work; work responsibilities in addition to child and/or elder care is considered double- or triple-duty care. Employees may experience conflict and/or enrichment as their work and family responsibilities interface. This study’s purpose is to explore the work and family interface of Registered Dietitian Nutritionists (RDNs), determine the prevalence of work-family conflict and enrichment, and identify characteristics associated with higher work-family conflict and enrichment scores. A survey instrument assessing caregiving responsibilities and work-family conflict and enrichment was distributed electronically to 4,900 RDNs throughout the United States. Frequencies, means, correlative relationships, and ANCOVA were calculated using SAS software 9.04. Of 1,233 usable responses, nearly two-thirds of RDNs (65.5%) reported providing either double-duty or triple-duty care. About half of RDNs (47.2%) reported work-family conflict and fewer (14.8%) reported family-work conflict. Additionally, most RDNs (79.4%) reported work-family enrichment and even more (85.2%) reported family-work enrichment. Higher work-family conflict scores had correlative relationships with higher levels of burnout, lower life satisfaction, and higher intent to quit. Higher work-family enrichment scores had correlative relationships with lower burnout, higher job satisfaction, higher career satisfaction, higher life satisfaction, and lower intent to quit. Understanding the unpaid caregiving responsibilities of RDNs and the interface of work/family responsibilities may provide insight into career planning for RDNs and guide managers of RDNs in efforts to amplify the contribution of RDNs.

Mental Health Among Employed Family Caregivers: A Gender-Based Analysis on the Role of Workplace Support

Compared to men, women undertake more family caregiving responsibilities, and thus take more toll in health and wellbeing when they are employed. The current study examined the gender difference in mental health among employed family caregivers, focusing on the role of workplace support in balancing work and caregiving roles. Guided by the social role theory and the moderated-mediation model of employment adjustment and mental health, we analyzed a nationally representative data from the 2012 Canada General Social Survey - Caregiving and Care Receiving with a sample of 2,426 participants selected. Moderated-mediation analysis based on the SPSS macro PROCESS 3.3 was used. Women employed family caregivers are more likely to undertake higher intensive caregiving, make more employment adjustment, and further report worse mental health status than their men counterparts. Gender difference was apparent in regards to the workplace support. For women, the moderating effect of workplace support is significant only when there are at least 5 different types of workplace support available at their workplaces, while for men, the moderating effect is significant when there are at least 2-3 different types of workplace support available. Women employed family caregivers experience worse mental health when employment adjustment is needed for their care responsibility. Findings have implications for providing workplace support for family caregivers given that women benefit less from workplace support compared to men. Further study is needed to explore the impact of various types of workplace support for women employed family caregivers, and to provide tailored support to them.

Enrolling Incident Caregivers and Matched Controls From a Nationwide Epidemiological Study

Participants in the national Reasons for Geographic and Racial Differences in Stroke (REGARDS) study were asked about family caregiving responsibilities at enrollment (2003-2007). Among the 88% of participants who were not caregivers at enrollment, 1,229 reported becoming caregivers before a follow-up interview 12 years later. The Caregiving Transitions Study screened these participants and enrolled 251 as incident caregivers. All reported 5 or more hours of care per week, provided assistance with at least one ADL or IADL, and were caregivers for at least 3 months before a 2nd blood sample was obtained in the REGARDS study. A total of 251 noncaregiving control participants who reported no caregiving responsibilities over this 12-year period were also enrolled. Each control was matched to a caregiver on age (+ 5 years), sex, race, other demographics, and baseline (pre-caregiving) health variables. Descriptive analyses confirm the unique comparability of the samples compared to previous caregiving studies.