Positive Caregiving Experiences Research Articles

Multi-family Therapy for Eating Disorders Across the Lifespan.

This review aims to report on recent evidence for multi-family therapy for eating disorders (MFT) across the lifespan. It is a narrative update of recent systematic, scoping and meta-analytic reviews. There has been a recent increase in published theoretical, quantitative and qualitative reports on MFT in the past few years. Recent and emerging data continues to confirm MFT can support eating disorder symptom improvement and weight gain, for those who may need to, for people across the lifespan. It has also been associated with improved comorbid psychiatric symptoms, self-esteem and quality of life. Data are also emerging regarding possible predictors, moderators and mediators of MFT outcomes, as well as qualitative data on perceived change processes. These data suggest families with fewer positive caregiving experiences at the start of treatment may particularly benefit from the MFT context. Additionally, early change in family functioning within MFT may lead to improved outcomes at end of treatment. MFT is a useful adjunctive treatment across the lifespan for people with eating disorders. It helps to promote change in eating disorder and related difficulties. It has also been shown to support and promote broader family and caregiver functioning.

Changes in Psychosocial Variables Among Caregivers of Patients With Schizophrenia: A Short-Term Follow-Up Study.

Caring for a person with schizophrenia entails considerable effort. The caregiving experience while caring for a person with schizophrenia has been described as both stressful and enriching. The literature on changes in caregiving experience with time has been fairly limited. The present analysis looks at the change in the caregiving experience of caregivers of patients with schizophrenia. This study had a sample of 50 caregivers of patients with schizophrenia who were followed up after a period of 6 to 10 months. Caregiving experience, knowledge of the mental illness, family functioning, coping, social support, psychological distress, quality of life, and spiritual, religious, and personal beliefs were assessed at the two time points. Among the negative caregiving experiences, caregivers' needfor back-upand patient dependency reduced significantly at follow-up as compared to baseline, though total negative or positive experiences of caregiving did not show a significant difference. Knowledge about mental illness did not significantly increase at follow-up, though issues related to poor communication and affective involvement in family functioning reduced over the period of time. Coping and social support remained largely the same, while psychological distress was reduced. All domains of quality of life improved over the follow-up period, while the hope, optimism, and inner peace aspects of spiritual, religious, and personal beliefs improved with time. Some aspects of caregiving experiences may change with time. As caregivers become more adjusted to caregiving roles, their distress may reduce, and their quality of life may improve.

Health conditions in spousal caregivers of people with dementia and their relationships with stress, caregiving experiences, and social networks: longitudinal findings from the IDEAL programme

ObjectivesLongitudinal evidence documenting health conditions in spousal caregivers of people with dementia and whether these influence caregivers’ outcomes is scarce. This study explores type and number of health conditions over two years in caregivers of people with dementia and subgroups based on age, sex, education, hours of care, informant-rated functional ability, neuropsychiatric symptoms, cognition of the person with dementia, and length of diagnosis in the person with dementia. It also explores whether over time the number of health conditions is associated with caregivers’ stress, positive experiences of caregiving, and social networksMethodsLongitudinal data from the IDEAL (Improving the experience of Dementia and Enhancing Active Life) cohort were used. Participants comprised spousal caregivers (n = 977) of people with dementia. Self-reported health conditions using the Charlson Comorbidity Index, stress, positive experiences of caregiving, and social network were assessed over two years. Mixed effect models were usedResultsOn average participants had 1.5 health conditions at baseline; increasing to 2.1 conditions over two years. More health conditions were reported by caregivers who were older, had no formal education, provided 10 + hours of care per day, and/or cared for a person with more neuropsychiatric symptoms at baseline. More baseline health conditions were associated with greater stress at baseline but not with stress over time. Over two years, when caregivers’ health conditions increased, their stress increased whereas their social network diminishedDiscussionFindings highlight that most caregivers have their own health problems which require management to avoid increased stress and shrinking of social networks

Trajectories of negative and positive experiences of caregiving for older adults with severe dementia: application of group-based multi-trajectory modelling.

Family caregivers of older adults with severe dementia have negative and positive experiences over the course of caregiving. We aimed to delineate joint trajectories (patterns over time) for negative and positive experiences, identify risk factors associated with membership of joint trajectories, and ascertain the association between joint trajectories and caregivers' outcomes after the death of the older adult. Two hundred fifteen family caregivers of older adults with severe dementia in Singapore were surveyed every 4 months for 2 years, and 6 months after the death of the older adult. Using group-based multi trajectory modelling, we delineated joint trajectories for positive (Gain in Alzheimer Care Instrument) and negative (sub-scales of modified Caregiver Reaction Assessment) experiences of caregiving. We identified four joint trajectories - "very high positive, low negative" (23% of caregivers), "high positive, moderate negative" (28%), "very high positive, moderate negative" (28%), and "high positive, high negative" (21%). Caregivers of older adults with more behavioural symptoms, and who did not receive strong emotional support from family were more likely to have "high positive, moderate negative" or "very high positive, moderate negative" trajectory. Compared to caregivers with "very high positive, low negative" trajectory, caregivers with "very high positive, moderate negative" or "high positive, high negative" trajectories expressed greater grief and distress, with the latter also having lower spiritual well-being and quality of life at 6 months after the death of the older adult. The caregiving experiences for older adults with severe dementia vary between caregivers but remain stable over time. Modifiable risk factors identified for trajectories involving negative experiences of caregiving may be targeted in future interventions to improve the experience of caregiving and caregiver quality of life and distress after the death of the older adult. http://www. gov (NCT03382223).

Development of a short form of the Japanese version of the Caregiver Reaction Assessment (CRA-J-10) among informal caregivers of older adults.

To support informal caregivers, a simple assessment tool capturing the multidimensional nature of caregiving experiences, including negative and positive aspects, is required. We developed a short form of the Japanese version of the Caregiver Reaction Assessment (CRA-J), a multidimensional assessment scale for caregiver experiences. The internet survey involved 934 Japanese informal caregivers aged 20-79 years (mean age = 58.8 years; 50.2% women) who completed questionnaires, including the CRA-J 18 items (CRA-J-18), consisting of five domains, such as impacts on schedule and finances and positive experiences of caregiving. A 10-item short version of the CRA-J (CRA-J-10; 0-50 points), which was prepared by selecting the two items with the highest factor loadings from each domain, was tested for model fit by confirmatory factor analysis (CFA) and was analyzed for correlations with the CRA-J-18, Zarit Burden Interview (ZBI), Positive Aspects of Caregiving Scale (PACS), Patient Health Questionnaire-9 (PHQ-9), and WHO-Five Well-Being Index (WHO-5). The area under the curve (AUC) in the receiver operating characteristic was evaluated as discriminability for depressive symptoms (PHQ-9 ≥ 10 points). The CFA indicated a good model fit in the CRA-J-10. The CRA-J-10 correlated well with the CRA-J-18 and other variables (CRA-J-18, r = 0.970; ZBI, r = 0.747; PACS, r = -0.467; PHQ-9, r = 0.582; WHO-5, r = -0.588) and showed good discriminant performance for the presence of depressive symptoms (AUC = 0.793, 95% confidence interval = 0.762-0.823). The CRA-J-10 allows a simple assessment of caregiver experiences, helping support informal caregivers. Geriatr Gerontol Int 2024; 24: 290-296.

Effectiveness of an Integrative Empowerment Intervention for Families on Caring and Prevention of Relapse in Schizophrenia Patients

Introduction Patients with schizophrenia require extended treatment and recovery, leaving their families and support systems feeling helpless. Integrative empowerment is a strategy that utilizes outside-in and inside-out empowerment to increase the ability of families to care for their loved ones and prevent relapse. Objective This study aimed to investigate the impact of integrative empowerment intervention on enhancing the family's ability to care for and prevent relapse in patients with schizophrenia. Methods The study employed a quasi-experimental with a pre-test and post-test control group design. The research sample was comprised of 70 individuals from nuclear families residing in Semarang, all of whom were responsible for the care of individuals with schizophrenia. The participants were divided into two groups: the treatment group, consisting of 35 individuals, and the control group, also comprising 35 individuals. Participant selection was carried out using purposive sampling. Module and booklet were produced as an intervention tools. The integrative empowerment intervention program spanned a period of 5 weeks, involving one session per week, each lasting approximately 60–90 min. Data analysis was conducted through the utilization of the Wilcoxon and Mann–Whitney tests. The significance level for the study was set at p<.05. Results There was a significant change in the family's ability to care for patients with schizophrenia before and after the integrative empowerment intervention ( p<.001), while there was no change in the control group's ability to care for patients with schizophrenia ( p>.05). Integrative empowerment had a significant impact on increasing the family's ability to care for and prevent relapse in patients with schizophrenia ( p<.001). Conclusions Nurses can help families strengthen their positive caregiving experiences through the home visit program by utilizing integrative empowerment. This study's findings highlight the importance of integrative empowerment in enhancing the family's ability to care for and prevent relapse in patients with schizophrenia.

THE “GOOD” CAREGIVER: DOES FILIAL PIETY NECESSITATE SELF-SACRIFICE?

Abstract Family caregiving policies that amplify the enactment of ‘filial piety’ – respect and care towards parents, grandparents and older persons – are especially pronounced in Asian societies, where caring for older family members is culturally expected and appraised yet is associated with stress and burden. Numerous studies have shown that fulfilment of filial piety contributes to better psychological outcomes for caregivers while mismatched filial expectations contribute to poorer psychological outcomes. However, few studies acknowledge how filial care varies according to individual resources and socio-cultural contexts. We seek to understand how family caregivers negotiate their self-determination through filial care, which contributes to positive and negative caregiving experiences. We conducted in-depth interviews with 34 caregivers of older persons with functional limitations in Singapore, purposefully selected based on varying positive and negative caregiving experiences. For caregivers with predominantly negative caregiving experiences, filial care was seen as an act of sacrifice and expectation of duty, with low autonomy to exercise self-determination. In comparison, caregivers with predominantly positive caregiving experiences described filial care as an act of sincere love cultivated through close relationships with their care-recipient, and aligned to their self-determination. Strong family support was also evident in the latter. Treating filial piety as a ‘natural desire to care for parents’ obscures efforts required to amplify positive caregiving experiences while normalisation of self-sacrifice and suffering hinders caregivers from expressing burden and accessing support. A nuanced understanding of how caregivers negotiate filial care can inform policy interventions to empower caregivers and care-recipients and enhance intergenerational relationships.

EFFECT OF A COVID-19-RELATED LOCKDOWN ON MIDDLE-AGED AND OLDER FAMILY CAREGIVERS IN SINGAPORE

Abstract Lockdowns, while limiting COVID-19 transmission, can affect care provision by family caregivers and their caregiving experience. We assessed, among 1094 family caregivers aged 50-79 years in Singapore, the (1) perceived effect of nationwide lockdown on their care provision, (2) correlates of different perceptions, and (3) association of the perceptions with negative and positive caregiving experiences. Caregivers reported whether their care provision became harder, easier, or remained the same during versus before the lockdown. Multinomial logistic regression assessed the association of caregiver, care-recipient, and caregiving-context characteristics with their perceptions. Linear regression models examined the association of their perceptions with subsequent negative and positive caregiving experiences. Care provision became harder for 36%, easier for 18% and remained the same for 46% caregivers. Care provision becoming harder (versus same) was more likely for caregivers who were male, Chinese, in worse health, caring for care-recipients with functional limitations, without caregiving support from cohabiting family before the lockdown, and with caregiving support from non-cohabiting family before the lockdown. Care provision becoming easier (versus same) was less likely among caregivers who were of higher age, unemployed, socially isolated and whose care-recipients had functional limitations. Caregivers for whom care provision became harder were worse off in negative caregiving experiences. A nationwide lockdown did not make care provision harder for all caregivers. However, those for whom it did had greater negative caregiving experiences. Heterogeneity of the effect of lockdowns and offering flexibility to non-cohabiting family who support caregiving should be considerations when implementing such disruptions.

Moderators of treatment effect in a randomised controlled trial of single- and multi-family therapy for anorexia nervosa in adolescents and emerging adults.

Multi-family therapy for anorexia nervosa (MFT-AN) is a novel, group-based intervention that intensifies single-family therapy for anorexia nervosa (FT-AN), with the aim of improving outcomes. The current study explored treatment moderators in a randomised controlled trial (N=167) of FT-AN and MFT-AN for young people (adolescents/emerging adults aged 13-20years) with anorexia nervosa. Data were analysed using multiple linear regression. Six hypothesised baseline participant and parent factors were tested as possible moderators of treatment effect on end-of-treatment and follow-up percentage of median Body Mass Index (%mBMI); age, eating disorder symptom severity, perceived family conflict (young person and parent ratings) and parent-rated experiences of caregiving (positive and negative). Greater parent-rated positive caregiving experiences moderated treatment outcomes at follow-up (β=-0.47, 95%CI: -0.91, -0.03, p=0.04), but not end-of-treatment. Participants who had fewer parent-rated positive caregiving experiences at baseline had higher weight at follow-up if they had MFT-AN compared to FT-AN. No other hypothesised baseline factors moderated treatment outcome (p's>0.05). The current study suggests MFT-AN may be indicated for families who present with fewer positive caregiving experiences to treatment. The MFT-AN group context may help to promote mentalisation and hope for these families, which may be harder to achieve in single-family treatment. Future research is needed to empirically evaluate how and why MFT-AN supports this group more. ISRCTN registry: ISRCTN11275465, registered 29 January 2007.

Impact of a COVID-19-Related Lockdown on the Experience of Informal Caregiving in Singapore

Introduction: Lockdowns, while limiting COVID-19 transmission, can affect provision of care by informal caregivers and their caregiving experience. We assessed, among informal caregivers in Singapore, (a) the perceived impact of a 2-month (April to May 2020) nationwide lockdown on their care provision, (b) correlates of different perceptions of the impact of the lockdown on care provision, and (c) association of different perceptions of the impact with negative and positive experiences of caregiving. Methods: In the August 2020 wave of the Singapore Life Panel (SLP; nationally representative, longitudinal monthly survey of Singapore citizens and permanent residents aged 50–70 years at baseline), 1,094 participants identified as informal caregivers reported whether their care provision became easier, remained the same, or became harder during the lockdown, compared to before the lockdown. We used multinomial logistic regression to assess the association of caregiver, care recipient, and caregiving context characteristics with their perceptions. Linear regression models examined the association of their perceptions with negative and positive experience domains of the modified Caregiver Reaction Assessment. Results: Just over one-third (36.1%) of the informal caregivers reported that their care provision became harder during the lockdown compared to before the lockdown. However, nearly one-fifth (18.0%) said that it became easier, and the rest (45.9%) said that it remained the same. Care provision was more likely to be perceived as having become harder among caregivers who were male, of Chinese ethnicity, in worse health, whose care recipients had functional limitations, who did not have caregiving support from cohabiting family members before the lockdown, and who had caregiving support from non-cohabiting family members before the lockdown. The perception that care provision became easier was less likely among caregivers who were of higher age, were unemployed, were socially isolated, and whose care recipients had functional limitations. Caregivers who perceived that care provision became harder during the lockdown were worse-off in negative experiences of caregiving. Conclusion: A nationwide lockdown did not make care provision harder for all informal caregivers. However, informal caregivers for whom it did were more likely to have greater negative experiences of caregiving. The heterogeneity of the impact of lockdowns and the possibility of offering flexibility to non-cohabiting family members who support caregiving should be important considerations when planning for such disruptions.

Stressor Trajectories among Older Adults with Disabilities and Positive Caregiving Experiences among Family Caregivers in Urban China

This study investigated the trajectory patterns of activities of daily living (ADLs) and cognitive function among older urban Chinese adults with disabilities and their influence on their family caregivers’ (i.e., spouse and adult children) positive caregiving experiences. Data were derived from the three-wave longitudinal panel study titled “Longitudinal Study on Family Caregivers for Frail Older Adults Aged 75 or Above in Shanghai.” A total of 251 older adults and their spouse/adult child caregivers participated in the 2010, 2013, and 2016 waves and were included in the final analytic sample. Growth curve modeling was applied to examine the proposed model. The findings suggest that ADLs and cognitive function trajectories declined over six years. Changes were predicted based on the older adults’ age and education levels. In 2016, the change rate of cognitive function trajectory was associated with self-affirmation and life enrichment. Neither the initial status (intercept) nor the change rates (slope) of the ADLs’ trajectory were associated with the two dimensions of positive caregiving experiences. This study extended the stress process model by demonstrating the trajectory patterns of stressors and their influence on positive caregiving experiences. Change rates in older adults’ cognitive function were key risk factors for positive caregiving experiences. This finding has important implications for family-based care systems in China.

Caregiving burden and positive aspects of caregiving in schizophrenia: Mediating roles of hope and social support

Caring for an ill relative with schizophrenia can lead to both negative and positive experiences. The study aimed to determine the relationship between caregiving burden and positive caregiving experiences and evaluate the roles of hope and social support as possible mediators in this relationship. This study included 344 Chinese family caregivers of adults with schizophrenia. Instruments included Positive Aspects of Caregiving, Herth Hope Index, Caregiver Burden Inventory, and Multidimensional Scale of Perceived Social Support. Data was analysed by Mann-Whitney U tests, Kruskal-Wallis H tests, Spearman correlation, and a serial mediation model. Results showed that hope and social support separately and serially mediated the relationship between caregiving burden and positive caregiving experiences. The mediation effect of hope was stronger than that of social support and their serial mediation effect. Increasing hope and social support of family caregivers may alleviate caregiving burden and improve positive caregiving experiences.

A Profile of Positive and Negative Caregiving Experiences Among Canadian Older Adults: The Relevance of Demographic and Care Contexts.

This study examines the predictors of burdens and benefits of informal caregiving to caregivers by examining how demographic characteristics and care contexts simultaneously predict separate scales of positive and negative caregiving experiences. The Caregiving, Aging, and Financial Experiences study is a national survey which examines a representative sample of 4010 Canadians between the ages of 65 and 85, including 1641 informal caregivers that are the focus of the current analysis. Seemingly unrelated regression analyses show that there are similarities as well as differences in predictors between the two caregiving experiences. More frequent involvement in caregiving is associated with greater negative caregiving experiences but those are not significant predictors for less positive caregiving experiences. This study demonstrates that there are some overlaps of determinants of the two caregiving experiences, and a few of them are distinct. Further studies should warrant to identify additional, unobserved factors explaining variance in positive caregiving experience.

The indirect effect of positive aspects of caregiving on the relationship between cognitive decline and dementia caregiver burden.

Research has linked increased cognitive decline in a dementia care recipient to worsening caregiver burden, but the presence of positive aspects of caregiving is associated with better outcomes. As cognitive decline worsens, a lack of positive caregiving experiences could lead to burden for the caregiver. This study investigated relationships among dementia caregiver burden, cognitive decline, and positive aspects of caregiving in dementia, predicting an indirect effect of positive aspects of caregiving. Data from 724 patients of an outpatient memory clinic in Ohio were examined and dyads included based on clinically supported patient diagnoses on the dementia spectrum. Caregivers completed the Zarit Burden Interview (ZBI) and Positive Aspects of Caregiving (PAC) measures. The Montreal Cognitive Assessment and Mini-Mental State Examination were used to estimate cognitive decline, standardized to create a single variable. Multiple potential covariates were considered for inclusion in the model. A cross-sectional mediation analysis using the Hayes PROCESS macro explored the presence of an indirect effect of PAC on the relationship between cognitive decline and ZBI using 5000 bootstrap samples. Only the potential covariate caregiver age was correlated with any of the primary variables; this variable was controlled in analyses. Significant relationships emerged between cognitive decline and ZBI (r = -0.12, P < 0.001), between PAC and ZBI (r = -0.23, P < 0.001), and between cognitive decline and PAC (r = -0.07, P < 0.05). An indirect effect of positive aspects of caregiving on the relationship between cognitive decline and ZBI was statistically significant (B = 0.0092, 95% bias-corrected confidence interval: 0.0008, 0.0185), accounting for 14.4% of the variance in the model. A lack of positive aspects of caregiving could be partially responsible for development of dementia caregiver burden as cognitive decline worsens. Longitudinal examination of these relationships is needed to understand causality fully. Findings may help healthcare providers tailor treatment to alleviate caregiver burden.

How Can I Trust You? The Role of Facial Trustworthiness in the Development of Epistemic and Interpersonal Trust

Recently, researchers from developmental and clinical psychology highlighted epistemic trust (ET) as a key factor for personality disorders. ET is intended as the mental openness to information coming from others during social exchanges. ET develops from signals called ostensive cues, delivered through facial expressions during interactions in a secure attachment context. Similarly, interpersonal trust (IT) refers to the perception of others as not harmful, which is also developed through secure attachment relationships. Our purpose was to suggest a conceptualization of ET as a specific facet of IT. We hypothesize that positive experiences of caregiving promote IT development that includes a specific sense of trust toward others’ knowledge. Moreover, we suggest that the early ability to infer a judgment of trustworthiness from facial cues is the starting point for developing both IT and ET. This conceptualization supports the role of considering both IT and ET in the development of borderline pathology.

"Parenting my parents": Perspectives of adult children on assuming and remaining in the caregiver's role.

Family caregivers are essential when responding to the long-term care needs of aging societies. The complex and multifaceted caregiver's role encompasses a unique set of challenges and strains, however, it can be a rewarding experience with many benefits and positive outcomes. Moreover, there is a link between the caregiver's wellbeing, quality of care, and the quality of life of the care recipient. Thus, the current study aimed to explore why adult children are assuming and remaining in the caregiver's role despite its challenges. Research data was collected through the use of qualitative semi-structured interviews from September 2021 to July 2022. In total 16 Lithuanian and Italian caregivers were recruited through convenience/snowball sampling. The study utilized the constructivist grounded theory for data analysis and self-determination theory for data interpretation. Adult children's caregiving experiences revealed three themes related to the motivation to assume and continue with family care: (1) believing in the inherent value of family care; (2) making sense of the changing nature of caregiving; and (3) "making the best of it". Key motivational drivers of these decisions were associated with the satisfaction of the three basic psychological needs - autonomy, competence, and relatedness. Results show that finding meaning and making sense of the caregiving role when responding to a parent's increased care needs may result in positive caregiving experiences and outcomes even at rather low levels of the care recipient's autonomy. Caregivers were able to experience family care as a meaningful and rewarding experience while acknowledging its challenges and limitations. Implications for family caregiving decisions and experiences, social policy, and future research are discussed in more depth in the paper.

Social support, positive caregiving experience, and caregiver burden in informal caregivers of older adults with dementia.

Dementia is currently one of the major causes of disability and dependency among older adults worldwide. Cognitive dysfunction, neuropsychiatric symptoms, somatic complaints, and functional impairment fundamentally affect not only a person living with dementia (PLwD), but also his/her informal caregiver(s), often resulting in a high caregiver burden. A number of variables, including the caregiver's sociodemographic characteristics, the clinical characteristics of PLwD, social support, and the caregiver's personal resources determine the caregiver's burden. The aim of this study was to investigate the associations of caregiver burden in informal caregivers of PLwD with perceived social support, positive caregiving experience, and applying therapeutic communication methods. The data were collected from September 2021 to February 2022 among 115 "PLwD-informal caregiver" dyads in the community settings in Slovakia. Measures included the Zarit Burden Interview (ZBI-12), the Oslo Social Support Scale (OSSS-3), the Positive Aspects of Caregiving Scale (PACS), and two questions on applying therapeutic communication methods-reminiscence and validation according to Naomi Feil. The Short IQCODE was used for assessing cognitive decline in PLwD. Pearson's and Spearman's correlations, t-tests, Chi-square, ANOVA, and linear multiple regression analyses were used to analyze the data (IBM SPSS 27). The mean age of informal caregivers was 54 ± 12.4 years (81.7% of women) and the mean caregiving duration was 4.8 ± 4.8 years. The mean age of PLwD was 80.5 ± 8.3 years (73.0% of women) and their Short IQCODE mean score was 4.1 ± 1.0. Lower caregiving burden was significantly associated with higher perceived social support (β = 0.33, p < 0.01), with higher positive caregiving experience (β = 0.33, p < 0.01), and higher caregiving intensity (β = 0.24, p < 0.05) among informal caregivers of PLwD. The associations between caregiver burden and applying two therapeutic communication methods were not significant. Implementing psycho-social and educational public health interventions focused on strengthening social support and maintaining positive perceptions of caregiving can help reduce the increased risk of caregiver burden in informal caregivers of older adults with dementia.

UNCOVERING THE POSITIVE ASPECTS OF CAREGIVING: A PROFILE OF CAREGIVERS’ DEMOGRAPHIC AND CARE CONTEXTS

Abstract Burden and benefits of caregiving experiences can coexist. The objective of this research is to describe and compare the predictors of the two intertwined caregiving experiences. This study examines how the variations in caregiving experiences can be explained in terms of both positive and negative aspects of caregiving, respectively by demographic characteristics and care related contexts. The Caregiving, Aging, and Financial Experiences study is a national survey intended to examine social conditions and well-being among a representative sample of 4,010 Canadians between age 65 and 85. Within the sample, 1,641 informal caregivers are the focus of the current analysis. Scales of positive and negative caregiving experiences are employed. Findings based on principal axis factor analysis shows that there is clear separate factor loadings between the positive and negative caregiving experiences. Subsequent seemingly unrelated regression analysis shows that there are similarities as well as differences in predictors between the two caregiving experiences. Lastly, the variance explained differs markedly between the two measures, with over 26% of the variance in negative caregiving accounted for by demographic and caregiving factors, but less than 4% of the variance in positive caregiving. This study demonstrates that positive aspects of caregiving is not simply the flip-side of negative caregiving. Standard predictors do not sufficiently explain positive caregiving as well as negative caregiving. Consequently, greater attention to factors that account for positive aspects of caregiving is warranted for an inclusive understanding of caregiving experiences.

Preliminary Analysis of Aspects of Caregiving among Spousal Caregivers and Adult Child Caregivers for Persons with Dementia

AbstractBackgroundWhile dementia caregiving experiences may vary across individuals, many studies have focused on the negative aspects of caregiving and reducing caregiver burden and stress. Understanding both positive and negative aspects of caregiving is essential, particularly between different caregiver types. This study aimed to compare positive and negative caregiving experiences between spousal and adult child caregivers. We also examined whether the caregiver type (spousal caregivers vs. adult child caregivers) is a significant factor predicting these caregiving experiences.MethodWe analyzed baseline data from an ongoing trial to manage sleep problems among persons with dementia (PwD) and their caregivers. Demographic data, Positive Aspects of Caregiving (PAC), Zarit Burden Interview (ZBI), and Center for Epidemiological Studies of Depression (CESD) data were collected from 39 caregivers (n = 27 spouses, n = 12 adult children; 82% women, 54% Whites). Descriptive and bivariate analyses and multiple regression models were conducted.ResultAdult child caregivers reported that providing care for their loved one made them feel more appreciated than spousal caregivers (4.25±1.21 vs. 3.48±0.97, respectively); however, they felt more stress when caring for the PwD and trying to meet other family and work responsibilities (2.75±0.86 vs. 2.07±0.99, respectively) and felt they should be doing more for the PwD (2.17±0.71 vs. 1.30±1.07, respectively; all p&lt;0.05) than did spousal caregivers. No significant differences were found in the PAC and the ZBI total scores by caregiver type. In a separate regression model, CESD total score was the only significant factor predicting PAC and ZBI total scores, controlling for caregiver type, race (Whites vs. others), level of education, employment status, and years of caregiving. However, only the model predicting the ZBI total score was statistically significant (p&lt;0.01, adjusted R2 = 54%).ConclusionThese preliminary findings suggest a critical need to better understand positive and negative caregiving experiences, particularly among adult child caregivers. Assessment of depressive symptoms should be included when examining caregiving experiences among spousal and adult child caregivers. Future studies are warranted to test whether characteristics of PwD or support received by caregivers would contribute to positive or negative caregiving experiences across caregiver types.

Negative and positive experiences of caregiving among family caregivers of older blunt trauma patients.

ObjectivesFamily caregivers play a fundamental role in the care of the older blunt trauma patient. We aim to identify risk factors for negative and positive experiences of caregiving among family caregivers.DesignProspective, nationwide, multi-center cohort study.Setting and participants110 family caregivers of Singaporeans aged≥55 admitted for unintentional blunt trauma with an Injury Severity Score (ISS) or New Injury Severity Score (NISS)≥10 were assessed for caregiving-related negative (disturbed schedule and poor health, lack of family support, lack of finances) and positive (esteem) experiences using the modified-Caregiver Reaction Assessment (m-CRA) three months post-injury.MethodsThe association between caregiver and patient factors, and the four m-CRA domains were evaluated via linear regression.ResultsCaregivers of retired patients and caregivers of functionally dependent patients (post-injury Barthel score <80) reported a worse experience in terms of disturbed schedule and poor health (β-coefficient 0.42 [95% Confidence Interval 0.10, 0.75], p = .01; 0.77 [0.33, 1.21], p = .001), while male caregivers and caregivers who had more people in the household reported a better experience (-0.39 [-0.73, -0.06], p = .02; -0.16 [-0.25, -0.07], p = .001). Caregivers of male patients, retired patients, and patients living in lower socioeconomic housing were more likely to experience lack of family support (0.28, [0.03, -0.53], p = .03; 0.26, [0.01, 0.52], p = .05; 0.34, [0.05, -0.66], p = .02). In the context of lack of finances, caregivers of male patients and caregivers of functionally dependent patients reported higher financial strain (0.74 [0.31, 1.17], p = .001; 0.84 [0.26, 1.43], p = .01). Finally, caregivers of male patients reported higher caregiver esteem (0.36 [0.15, 0.57], p = .001).Conclusions and implicationsNegative and positive experiences of caregiving among caregivers of older blunt trauma patients are associated with pre-injury disability and certain patient and caregiver demographics. These factors should be considered when planning the post-discharge support of older blunt trauma patients.