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Sample records for residents family caregivers

  1. Examining trust in health professionals among family caregivers of nursing home residents with advanced dementia.

    PubMed

    Boogaard, Jannie A; Werner, Perla; Zisberg, Anna; van der Steen, Jenny T

    2017-07-20

    In a context of increasing emphasis on shared decision-making and palliative care in dementia, research on family caregivers' trust in health professionals in advanced dementia is surprisingly scant. The aim of the present study was to assess trust in nursing home health professionals of family caregivers of nursing home residents with advanced dementia, and possible correlates, such as family caregivers' satisfaction, involvement in care, care burden and patients' symptom burden. A cross-sectional study was carried out using structured questionnaires administered through the telephone. Generalized estimating equation analyses with adjustment for nursing home clustering were applied to assess the most important associations with family caregivers' trust. A total of 214 family caregivers of persons with dementia residing in 25 nursing homes participated in the study. The majority of the participants (67%) were women and adult children (75%). The majority of the family caregivers trusted physicians, nurses and nurses' aides at a moderate-to-high level. Approximately half to one-third reported moderate-to-low levels of trust. Higher levels of trust were associated with more positive care outcomes, such as higher family satisfaction with care and more positive evaluations of physician-family communication. The present study showed the importance of family caregivers trusting nursing home health professionals for their experiences as caregivers. Although causation cannot be established, increased family caregivers' trust in nursing home health professionals by improving communication and exchange of information might provide a good basis for providing optimal palliative care in advanced dementia. Geriatr Gerontol Int 2017; ••: ••-••. © 2017 Japan Geriatrics Society.

  2. Mixed Methods Research of Adult Family Care Home Residents and Informal Caregivers

    ERIC Educational Resources Information Center

    Jeanty, Guy C.; Hibel, James

    2011-01-01

    This article describes a mixed methods approach used to explore the experiences of adult family care home (AFCH) residents and informal caregivers (IC). A rationale is presented for using a mixed methods approach employing the sequential exploratory design with this poorly researched population. The unique challenges attendant to the sampling…

  3. La CLAve to Increase Psychosis Literacy of Spanish-Speaking Community Residents and Family Caregivers

    PubMed Central

    López, Steven R.; Kopelowicz, Alex; Solano, Susana; del Carmen Lara, Ma.; Foncerrada, Hector; Aguilera, Adrian

    2014-01-01

    The authors developed and tested a 35-min psychoeducational program with the goal of increasing Spanish-speaking persons’ literacy of psychosis. The program uses popular cultural icons derived from music, art, and videos, as well as a mnemonic device—La CLAve (The Clue)—to increase (a) knowledge of psychosis, (b) efficacy beliefs that one can identify psychosis in others, (c) attributions to mental illness, and (d) professional help-seeking. Assessments were conducted before and after administering the program to both community residents (n = 57) and family caregivers of persons with schizophrenia (n = 38). For community residents, the authors observed increases across the 4 domains of symptom knowledge, efficacy beliefs, illness attributions, and recommended help-seeking. For caregivers, increases were observed in symptom knowledge and efficacy beliefs. La CLAve is a conceptually informed psychoeducational tool with a developing empirical base aimed at helping Spanish-speaking Latinos with serious mental illness obtain care in a timely manner. PMID:19634968

  4. Family Caregiver Alliance

    MedlinePlus

    ... on your schedule. Look for our launch soon! FAMILY CARE NAVIGATOR ─ Click on Your State AL AK ... County Smart Patients Caregivers Community In partnership with Family Caregiver Alliance Learn more Caregiver Research Veterans suffer ...

  5. [Small-scale, homelike care environments for people with dementia: effects on residents, family caregivers and nursing staff].

    PubMed

    Verbeek, H; Zwakhalen, S M G; van Rossum, E; Kempen, G I J M; Hamers, J P H

    2013-12-01

    Institutional dementia care is increasingly directed towards small-scale and homelike care environments, in The Netherlands as well as abroad. In these facilities, a small number of residents, usually six to eight, live together, and normal daily household activities and social participation are emphasized. In a quasi-experimental study, we studied the effects of small-scale, homelike care environments on residents (n = 259), family caregivers (n = 206) and nursing staff (n = 305). We compared two types of institutional nursing care during a 1 year period (baseline assessment and follow-up measurements at 6 and 12 months): (28) small-scale, homelike care environments and (21) psychogeriatric wards in traditional nursing homes. A matching procedure was applied to increase comparability of residents at baseline regarding functional status and cognition. This study was unable to demonstrate convincing overall effects of small-scale, homelike care facilities. On our primary outcome measures, such as quality of life and behaviour of residents and job satisfaction and motivation of nursing staff, no differences were found with traditional nursing homes. We conclude that small-scale, homelike care environments are not necessarily a better care environment than regular nursing homes and other types of living arrangements should be considered carefully. This provides opportunities for residents and their family caregivers to make a choice which care facility suits their wishes and beliefs best.

  6. Perspectives and expectations for telemedicine opportunities from families of nursing home residents and caregivers in nursing homes.

    PubMed

    Chang, Jun-Yih; Chen, Liang-Kung; Chang, Chia-Ching

    2009-07-01

    nursing care for this service. The challenge for the future in this industry is to balance peoples' demands and telemedicine's associated costs. Results of this study suggest that caregivers and families of nursing home residents favour telemedicine implementation to provide enhanced care coordination in nursing homes when economic circumstances are favourable.

  7. The Stress Process of Family Caregiving in Institutional Settings.

    ERIC Educational Resources Information Center

    Whitlatch, Carol J.; Schur, Dorothy; Noelker, Linda S.; Ejaz, Farida K.; Looman, Wendy J.

    2001-01-01

    Adapts Stress Process Model (SPM) of family caregiving to examine predictors of depression in a sample of caregivers (N=133) with demented relatives residing in suburban skilled nursing facilities. Results suggest that caregiver depression is closely linked to how well resident and caregiver adjust to the nursing home environment. (BF)

  8. Collecting saliva and measuring salivary cortisol and alpha-amylase in frail community residing older adults via family caregivers.

    PubMed

    Hodgson, Nancy A; Granger, Douglas A

    2013-12-18

    Salivary measures have emerged in bio-behavioral research that are easy-to-collect, minimally invasive, and relatively inexpensive biologic markers of stress. This article we present the steps for collection and analysis of two salivary assays in research with frail, community residing older adults-salivary cortisol and salivary alpha amylase. The field of salivary bioscience is rapidly advancing and the purpose of this presentation is to provide an update on the developments for investigators interested in integrating these measures into research on aging. Strategies are presented for instructing family caregivers in collecting saliva in the home, and for conducting laboratory analyses of salivary analytes that have demonstrated feasibility, high compliance, and yield quality specimens. The protocol for sample collection includes: (1) consistent use of collection materials; (2) standardized methods that promote adherence and minimize subject burden; and (3) procedures for controlling certain confounding agents. We also provide strategies for laboratory analyses include: (1) saliva handling and processing; (2) salivary cortisol and salivary alpha amylase assay procedures; and (3) analytic considerations.

  9. Empowering Family Caregivers: The Powerful Tools for Caregiving Program

    ERIC Educational Resources Information Center

    Boise, Linda; Congleton, Leslie; Shannon, Kathy

    2005-01-01

    "Powerful Tools for Caregiving" is an education program for family caregivers of older adults. Based on a self-efficacy model, the program empowers family caregivers to reduce negative effects of caregiving and to practice self-care. Through a train-the-trainer approach, professional and community volunteers were trained as class leaders and…

  10. Caregiving for older Latinos at end of life: perspectives from paid and family (unpaid) caregivers.

    PubMed

    Carrion, Iraida V; Nedjat-Haiem, Frances R

    2013-03-01

    This study examined the various settings in which caregiving occurred for terminally ill older Latinos. Qualitative data were collected in Central Florida through in-depth, semi-structured, open-ended interviews. 20 Latinos caring for terminally ill Latinos participated in the study. N = 9 Latino family (unpaid) caregivers provided care in the terminally ill person's home, while N = 4 provided care to a family member in the caregiver's home. N = 4 paid caregivers provided care to terminally ill Latinos who reside in the caregiver's private home and N = 3 in an assisted-living facility. The themes indicate that family (unpaid) caregivers experienced changes in their financial status; they both encountered English language barriers. Geographical distance made caregiving more challenging. Paid caregivers adapted to cultural expectations and their higher income enabled them to hire assistance.

  11. Family Caregiving or Caregiving Alone: Who Helps the Helper?

    ERIC Educational Resources Information Center

    Sims-Gould, Joanie; Martin-Matthews, Anne

    2007-01-01

    This study advances the understanding of family caregiving by examining the relationship between adult children caregivers and their helpers. Specifically, it focuses on examining "who helps whom" and extends analyses beyond the dyadic focus of caregiving in later life. The focus on helping and caregiving addresses the variety of…

  12. Measuring the Caregiver Burden of Caring for Community-Residing People with Alzheimer's Disease.

    PubMed

    Yu, Hongmei; Wang, Xiaocheng; He, Runlian; Liang, Ruifeng; Zhou, Liye

    2015-01-01

    To assess the direct and indirect effects of patient or caregiver factors on caregiver burden of caring for community-residing people with mild Alzheimer's disease (AD). We conducted a cross-sectional study of patients diagnosed with AD from two hospitals and three communities in Taiyuan, China and their caregivers. For this survey, 200 patients with mild AD and their caregivers were selected. Caregivers were asked to provide sociodemographic information including age, gender, relationship with the patient, level of education, and number of contact hours per week with the patient. Caregiver burden was assessed using the Caregivers Burden Inventory. The caregivers also completed other measures including the Positive Aspects of Caregiving, the Family Adaptation, Partnership, Growth, Affection, and Resolve, and the Social Support Rating Scale. The patients with AD completed the Montreal Cognitive Assessment; their caregivers completed the Activities of Daily Living Scale and a questionnaire about the patients' Behavioral and Psychological symptoms of Dementia. The main outcome in this study was caregiver burden. The care receivers' level of cognitive function, physical function, and behavioral problems were treated as original stress; the primary appraisal variable was measured as the number of hours of caregiving in the previous week reported by the caregiver. Mediator variables included perceived social support, family function, and caregiving experience. Path analysis was used to build the interrelationship among caregiver burden and patient or caregiver factors. A lower level of cognitive function in patients (r = -0.28, p<0.001) and longer hours of caregiving (r = 0.17, p = 0.019) were related to increased caregiver burden. Greater social support (r = -0.23, p<0.001), family function (r = -0.17, p = 0.015) and caregiving experience (r = -0.16, p = 0.012) were related to decreased caregiver burden. Social support (r = 0.16, p = 0.040) and family function (r = 0

  13. R. I. Caregivers. Caring: A Training Program for Family Caregivers.

    ERIC Educational Resources Information Center

    Rhode Island State Dept. of Elderly Affairs, Providence.

    This document presents a training manual to help caregivers who provide care to older family members and friends at home. The program, which offers a practical approach to caregiving and a realistic view of the aging process, is intended to clarify the problems confronting caregivers of older people, serve as a basic source manual for training…

  14. Widening the Generational Circle: Family Caregivers.

    ERIC Educational Resources Information Center

    Smith, Bert Kruger

    This document addresses the dilemma faced by families with an aging or disabled member and the stress associated with the role of family caregiver. Emotions experienced by family caregivers, especially when the caregiver is an adult child caring for an elderly or frail parent, are discussed and feelings of desertion, dependence, and sibling…

  15. [Dependent seniors: families and caregivers].

    PubMed

    Karsch, Ursula M

    2003-01-01

    This article focuses on health care for dependent seniors in relation to chronic illnesses. Expectations about family support for the dependent elderly are related to the role of family caregivers, but care requires support from the public and private sectors. Governments throughout the developed countries are examining their role in the provision of social welfare programs, especially in the public health sector. To recommend home care and family assistance, the context of changing family structures, the type of care needed, and professional follow-up must be taken into account.

  16. Family Caregivers: Psychosocial Impacts and Clinical Needs

    ERIC Educational Resources Information Center

    Daire, Andrew P.; Torres, Jennifer; Edwards, Nivischi N.

    2009-01-01

    The authors describe how 3 groups of family caregivers (spouses, daughters, and sons) are affected by the caregiving role. In addition, clinical considerations and interventions for mental health professionals working with these different groups of family caregivers are discussed. A clinical case example is also presented. (Contains 2 tables.)

  17. Family caregiving in pulmonary arterial hypertension.

    PubMed

    Hwang, Boyoung; Howie-Esquivel, Jill; Fleischmann, Kirsten E; Stotts, Nancy A; Dracup, Kathleen

    2012-01-01

    Pulmonary arterial hypertension (PAH) is a devastating disease that places a significant burden on patients and their families. However, family caregiving, to the best of our knowledge, has never been described in this population. This study sought to describe depressive symptoms, types of performed care tasks, social support, and the impact of caregiving among family caregivers of patients with PAH. Data were obtained from 35 dyads of patients with PAH (mean age, 51 years; 63% were female; 54% had World Health Organization functional class III symptoms) and their family caregivers (mean age, 52 years; 60% were female; 68% were spouses). Five caregivers (14%) were identified as manifesting moderate to severe depressive symptoms. The majority of caregivers reported that their daily activities were centered around caregiving responsibilities. More than 85% of caregivers were involved in managing care for the patient, and more than half helped the patient with self-management activities. The level of caregivers' perceived social support was low, especially for emotional and informational support. Lower levels of social support were significantly associated with more severe depressive symptoms in caregivers (r = -.50, P = .002). Caregivers of patients with PAH play a significant role in patients' medical care and self-management, yet they lack sufficient emotional support or information to meet the demands of caregiving. These findings underscore the importance of supporting family caregivers of patients with PAH. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. How Do Family Caregivers of Older People Give Up Caregiving?

    PubMed Central

    Mortazavi, Hamed; Peyrovi, Hamid; Joolaee, Soodabeh

    2015-01-01

    Background Population aging has social, economic and political consequences. Most family caregivers prefer to care for their family member older person with chronic disease at home. Despite traditional culture within Iranian families, in some cases, hospitalization of the elderly in nursing home is inevitable, and this affects the old person and his/her family. The aim of this study was to explain how Iranian family cargivers give up caring their older person with chronic condition at home. Methods A grounded theory approach was used to conduct the study. The study setting included four nursing homes under the auspices of Iran Welfare Organization. Fourteen participants were recruited through purposive sampling. Data were collected from December 2010 to March 2011 by Semi-structured interviews lasting about 17 to 95 minutes (average 52 minutes). Constant comparative analysis was used to analyze the data. Results Three main categories appeared at the end of the analysis: “going out of the road of usual life”, “challenge of meeting older person, family and caregivers care needs”, and “the appearance of inconstancy in the family”. They explained exclusively how family caregivers of old people give up caregiving. Conclusion Health care providers are recommended to become familiar with challenges of family caregivers in taking care of older person with chronic disease at home, and then organize their supportive and consulting actions according to family situations in order to improve the life quality of older person and family caregivers. PMID:26171407

  19. The relationship between family functioning and caregiving appraisal of dementia family caregivers: caregiving self-efficacy as a mediator.

    PubMed

    Liu, Hsin-Yi; Huang, Lian-Hua

    2016-12-21

    The aim of this study was to explore caregiving self-efficacy as a mediator for the association between family functioning and caregiving appraisal of dementia family caregivers in Taiwan. This study adopted a cross-sectional correlational design. Purposive sampling was used to recruit 115 dyads of dementia patients and family caregivers from the outpatient neurological clinics of two hospitals in northern Taiwan. Data were gathered through interviews with a structured questionnaire, which included demographic characteristics for caregivers and patients, family functioning, caregiving self-efficacy, as well as positive and negative aspects of caregiving appraisal. Family functioning, patients' activities of daily living score, Neuropsychiatric Inventory caregiver distress, and three domains of self-efficacy were significantly associated with caregiver burden. Hierarchical multiple regression analyses indicated that self-efficacy for obtaining respite (SE-OR) significantly explained 20.5% of the variance in caregiver esteem. Caregiver perceived worsened health status, family functioning, and SE-OR significantly explained 59% of the variance in caregiver burden. The mediation test only supported the partially mediating role of SE-OR on the relationship between family functioning and caregiver burden, while the mediating effect of self-efficacy for responding to disruptive behaviours and controlling upsetting thoughts were insignificant. Our findings provided preliminary evidence for health professionals recommending that future studies should assess the family dynamic and health problems of caregivers, and develop appropriate family-centred interventions that focus on strengthening interfamily support and respite services to alleviate caregiver burden.

  20. Caregiving Styles: A Cognitive and Behavioral Typology Associated With Dementia Family Caregiving

    PubMed Central

    Corcoran, Mary A.

    2011-01-01

    Purpose: An increasing number of elderly individuals are diagnosed with Alzheimer’s disease and related disorders (ADRD), many of whom receive daily caregiving from spouse or adult child. Caregiving is a “cultural activity,” and as such it is strongly influenced by sociocultural beliefs about caregiving and how it should be enacted. Understanding this thinking–action process has important implications for future research and service. Reasoned action theory provides empirical evidence that attitudes and beliefs, as they are influenced by the social environment, predict intentions to act. In turn, behavioral intentions can reliably predict behaviors. This grounded theory study describes a typology of caregiving styles relevant to family members of an individual with ADRD, where caregiving style is defined as a culturally based pattern in thinking and action. The goal of this study was to characterize the relationship between caregiver intentions and care strategies. Methods: Study participants included 97 individuals residing in the Washington, DC, area, who provide daily care for a family member with ADRD. Narrative data were collected from each caregiver during three 1-hr interview sessions. A subset of 30 caregiver–care recipient (CR) dyads was videotaped during typical interactions. Results: Four caregiving styles were identified (facilitating, balancing, advocating, and directing), which differ primarily in the intended focus of care and preferred interactions with the CR. Implications: The results provide a foundation for future studies of the relationships between sociocultural context, caregiving styles and strategies, and ensuing outcomes for caregiver–CR dyads. PMID:21335422

  1. Family Caregiver Identity: A Literature Review

    ERIC Educational Resources Information Center

    Eifert, Elise K.; Adams, Rebecca; Dudley, William; Perko, Michael

    2015-01-01

    Background: Despite the multitude of available resources, family caregivers of those with chronic disease continually underutilize support services to cope with the demands of caregiving. Several studies have linked self-identification as a caregiver to the increased likelihood of support service use. Purpose: The present study reviewed the…

  2. Family Caregiver Identity: A Literature Review

    ERIC Educational Resources Information Center

    Eifert, Elise K.; Adams, Rebecca; Dudley, William; Perko, Michael

    2015-01-01

    Background: Despite the multitude of available resources, family caregivers of those with chronic disease continually underutilize support services to cope with the demands of caregiving. Several studies have linked self-identification as a caregiver to the increased likelihood of support service use. Purpose: The present study reviewed the…

  3. Seizing possibilities for positive family caregiving in nursing homes.

    PubMed

    Kellett, Ursula

    2007-08-01

    This paper explores the ways family members reconstruct meaning through seizing possibilities for positive caregiving in nursing homes. The importance of the ability of family caregivers to adapt and accommodate has been well documented in international family caregiving research. Through engagement in caregiving activities, families learn to modify, adapt and accommodate to changes in their situation and relationships. The support family caregivers experience in learning to accommodate change is crucial in enabling them to reconstruct positive aspects of caregiving in a long-term aged care context. In this study, a hermeneutic phenomenological approach was adopted informed by the philosophical world views of Heidegger and Gadamer. Data collected by in-depth interviews and participant observations, from a purposeful sample of 14 family caregivers, underwent hermeneutic analysis. Five shared meanings associated with seizing possibilities for positive caregiving were revealed: accommodating new and different ways of caring; feeling a part of the nursing home community; seeing the whole picture; learning to care in stress-reducing ways and learning to seize possibilities for self. This paper illustrates how families, through caregiving experience in nursing homes, learn to become active managers, negotiating, accommodating and redeveloping a sense of future viewed with hope, strength and positive anticipation. By highlighting what is attributed significance by families, a critical examination of the difficult issues which obstruct the development of meaningful partnerships among nurses, family and their relatives is facilitated. In particular, an examination of tensions at an ideological level supports the need for future research to focus its efforts on examining the ways of implementing nursing care that facilitates partnerships that incorporate and build upon positive and equal relations among staff, families and residents in the context of the nursing home setting.

  4. Clinical Assessment of Family Caregivers in Dementia.

    ERIC Educational Resources Information Center

    Rankin, Eric D.; And Others

    1992-01-01

    Evaluated development of integrated family assessment inventory based on Double ABCX and Circumplex models of family functioning and its clinical utility with 121 primary family caregivers from cognitive disorders program. Proposed model predicted significant proportion of variance associated with caregiver stress and strain. Several aspects of…

  5. Caregiver Burden in Fragile X Families

    PubMed Central

    Iosif, Ana-Maria; Sciolla, Andres F.; Brahmbhatt, Khyati; Seritan, Andreea L.

    2013-01-01

    Complex caregiving issues occur in multigenerational families carrying the fragile X mutation and premutation. The same family members may care for children or siblings with fragile X syndrome (FXS) and for elderly parents with fragile X-associated tremor/ataxia syndrome (FXTAS). Family caregivers experience anxiety, depression, neglect of personal health care needs, employment difficulties, and loss of social support, leading to isolation and further psychiatric consequences. There is growing awareness of caregiver burden with regard to parents of children with FXS, but much less is known about the needs of informal caregivers of patients with FXTAS. In this paper, we review the available literature to date and provide suggestions for further exploration of caregivers' needs. Evidence-based strategies to address these needs are included. Many more research studies exploring caregiver burden in multigenerational fragile X families are needed, as well as studies aimed at investigating interventions and their impact on reduction. PMID:24348279

  6. Family Caregivers of Women with Physical Disabilities

    PubMed Central

    Elliott, Timothy R.; Berry, Jack W.; Shewchuk, Richard M.; Oswald, Kimberly D.; Grant, Joan

    2008-01-01

    Cross-sectional, correlational analyses of data from two separate studies were conducted to examine the correlates of adjustment among family caregivers of women with disabilities. Participants included 40 caregivers of women with spinal cord injuries in the first study and 53 caregivers of women with cerebral palsy, traumatic brain injury, and other neuromuscular disabilities in the second study. It was hypothesized that a negative problem-solving style would be associated with greater caregiver distress in both studies, and that caregiver adjustment would be associated with care recipient depression in the second study. As expected, results indicated that a higher negative orientation toward solving problems was associated with caregiver depression and lower well-being. However, in the second study, caregiver characteristics were not associated with care recipient depression. These data indicate that considerable variability exists in caregiver adjustment. Methodological limitations and the implications for research, service, and policy formation are! discussed. PMID:18716670

  7. Assessing Impact on Family Caregivers to Alzheimer's Disease Patients.

    ERIC Educational Resources Information Center

    Talkington-Boyer, Shannon; Snyder, Douglas K.

    1994-01-01

    Examined impact of caregiving among 110 caregivers to aging family member with Alzheimer's disease. Family caregivers' appraisals along dimensions of subjective burden, negative impact, caregiving satisfaction, and caregiver mastery were correlated with extent of memory and behavior problems of patient and caregivers' coping style, locus of…

  8. Family caregivers of people with dementia

    PubMed Central

    Brodaty, Henry; Donkin, Marika

    2009-01-01

    Family caregivers of people with dementia, often called the invisible second patients, are critical to the quality of life of the care recipients. The effects of being a family caregiver, though sometimes positive, are generally negative, with high rates of burden and psychological morbidity as well as social isolation, physical ill-health, and financial hardship. Caregivers vulnerable to adverse effects can be identified, as can factors which ameliorate or exacerbate burden and strain. Psychosocial interventions have been demonstrated to reduce caregiver burden and depression and delay nursing home admission. Comprehensive management of the patient with dementia includes building a partnership between health professionals and family caregivers, referral to Alzheimer's Associations, and psychosocial interventions where indicated. PMID:19585957

  9. Strategies for sustaining self used by family caregivers for older adults with dementia.

    PubMed

    Bull, Margaret J

    2014-06-01

    The negative health consequences of caring for an older adult family member with dementia are well documented. However, not all family caregivers experience these negative health consequences. The purposes of this study were to describe strategies family caregivers use to help them continue to provide care for an older family member with dementia despite challenges and describe these family caregivers' resilience and psychological distress. A mixed methods design was used with a narrative approach dominant and standardized scales for resilience and psychological distress used to enhance the description of the sample. Data were collected through telephone interviews with 18 family caregivers residing in an urban area. The findings indicate that family caregivers used four strategies to sustain the self: drawing on past life experiences, nourishing the self, relying on spirituality, and seeking information about dementia. Understanding strategies used by family caregivers to sustain themselves is essential for providing holistic nursing care and developing effective interventions.

  10. Family Caregivers and Consumer Health Information Technology.

    PubMed

    Wolff, Jennifer L; Darer, Jonathan D; Larsen, Kevin L

    2016-01-01

    Health information technology has been embraced as a strategy to facilitate patients' access to their health information and engagement in care. However, not all patients are able to access, or are capable of using, a computer or mobile device. Although family caregivers assist individuals with some of the most challenging and costly health needs, their role in health information technology is largely undefined and poorly understood. This perspective discusses challenges and opportunities of engaging family caregivers through the use of consumer-oriented health information technology. We compile existing evidence to make the case that involving family caregivers in health information technology as desired by patients is technically feasible and consistent with the principles of patient-centered and family-centered care. We discuss how more explicit and purposeful engagement of family caregivers in health information technology could advance clinical quality and patient safety by increasing the transparency, accuracy, and comprehensiveness of patient health information across settings of care. Finally, we describe how clarifying and executing patients' desires to involve family members or friends through health information technology would provide family caregivers greater legitimacy, convenience, and timeliness in health system interactions, and facilitate stronger partnerships between patients, family caregivers, and health care professionals.

  11. Narratives of family caregiving: four story types.

    PubMed

    Ayres, L

    2000-10-01

    Researchers across disciplines have recognized considerable individual variation among caregivers in their response to the experiences of caregiving. One explanation for individual variation is that caregivers make different meanings from caregiving even under externally similar circumstances. This paper describes findings from a study that combined two qualitative strategies, across-case, thematic analysis and within-case, narrative analysis, to investigate meaning in accounts of family caregiving. Themes identified in the across-case analysis were interpreted in the context of patterns identified in the narrative analysis, as well as in the overall framework of caregivers' process of making meaning. Caregivers in this study told four types of stories: stories of ideal lives, stories of ordinary lives, stories of compromised lives, and ambiguous stories. Characteristics of each story type are described, and an example of an ambiguous story is also included as an illustration of the method. Findings suggest a new approach to understanding family caregiving that incorporates the diverse meanings caregivers make of their often similar experiences.

  12. The Relationship between Mastery and Depression among Japanese Family Caregivers

    ERIC Educational Resources Information Center

    Schreiner, Andrea S.; Morimoto, Tomoko

    2003-01-01

    The present study examined the relationship between caregiver mastery and depressive symptoms among family stroke caregivers in western Japan (N = 100). Family caregivers were identified from a sample of rehabilitation hospitals; participation rate was 100 percent for all eligible caregivers. Care-givers with high mastery were found to have…

  13. A psychoeducational program for caregivers of the chronic mentally ill residing in community residencies.

    PubMed

    Raskin, A; Mghir, R; Peszke, M; York, D

    1998-08-01

    The objective of this study was to develop a psychoeducational program for caregivers of the chronically mentally ill residing in community residencies. An evaluative component was added to determine how well the program was received by caregivers and what impact the program had on the residents. A total of 20 caregivers and 63 residents participated in the program. In general, the psychoeducational program was well received by the caregivers. They especially liked the mental health component and opportunity to meet and interact with other caregivers. There was a significant drop in hospital admissions following the program. There was also improvement in a number of quality of life activities such as trips to the local coffee shop and mall.

  14. [Family caregiver education: an Italian experience].

    PubMed

    Pennacchini, M; Petriccione, A; Sisto, A; Di Leo, I; Di Santo, S; Tartaglini, D

    2014-01-01

    The role of family caregivers is essential for optimal treatment of patients with chronic diseases since it ensures the compliance to treatment, continuity of care, emotional and social support. Despite the significant value of informal caregiving, the relatives report not to have the necessary knowledge and skills to provide ongoing support to the family member with chronic disease and, therefore, show the need to be educated in their role as caregivers. The reliance on family caregivers unprepared for the daily management of the illness patients may threaten the patients' quality of life and, moreover, contributes to increase the burden of care of the caregiver by exposing it to the risk of psychosocial distress. The Nursing Department of Campus Bio-Medico of Rome have addressed such a need promoting training courses on family caregivers since 2011 with the goal of supporting families in the acquisition of specific skills related to health care of patients with chronic conditions. The UCBM educational program has been developed in order to convey knowledge tools especially for: the role and challenges of the caregiver, the supply of health services to support patients and the family member. The UCBM educational program has been structured in lessons to analyze the deepening of chronic diseases related to different areas of medical interventions and in practical sessions guided by a nurse specialist in order to support the family in the acquisition of skills and competencies for the care management of patients at home. The positive feedback, received from users who have attended the two past editions of the UCBM educational program, demonstrates the importance of acquiring technical knowledge and practical tools that are essential to independently manage all aspects of patient care. It's important to notice, moreover, that learning these skills will support the family in the patient management, both in short and long term, and that is very relevant considering the

  15. 77 FR 66525 - National Family Caregivers Month, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-06

    ... Documents#0;#0; ] Proclamation 8900 of November 1, 2012 National Family Caregivers Month, 2012 By the... loved ones. During National Family Caregivers Month, we recognize and thank the humble heroes who do so... caregiver training and respite care. National Family Caregivers Month is a time to reflect on the...

  16. Family Caregivers in Cancer (PDQ®)—Patient Version

    Cancer.gov

    Expert-reviewed information summary about the challenges faced by family caregivers of cancer patients. This summary focuses on typical caregiver roles and concerns, and helpful interventions for caregivers.

  17. [Health decision making in AIDS family caregiver].

    PubMed

    Cazenave, Angélica; Ferrer, Ximena; Castro, Soledad; Cuevas, Sandra

    2005-03-01

    AIDS infected patients receive care at home; a family member assumes the caregiver role and takes health decisions that affect the person's life. It is important to know the conflicts that the families are confronting in relation to health decision making, in order to plan intervention strategies according with their real needs. This is a descriptive study, in which a sample of 38 family caregivers of AIDS persons receiving ambulatory care at the Clinica Familia, were used for this research. An O'Connor and Jacobsen instrument was used for this study. the family caregivers are women, the majority of them are mothers that live with their sick son or daughter, and who had assumed the role at least for 2 years. The family caregivers have conflicts about to continuing or not caring for the sick person, and of telling others about the disease. The family caregivers are in one of the phases of the changing process. Consequently, they are receptive to helping strategies that must be based in interventions oriented to listening and supporting, more than just providing information.

  18. Targeting communication interventions to decrease oncology family caregiver burden

    PubMed Central

    Wittenberg-Lyles, Elaine; Goldsmith, Joy; Oliver, Debra Parker; Demiris, George; Rankin, Anna

    2012-01-01

    Objectives The goal of this paper was to articulate and describe family communication patterns that give shape to four types of family caregivers: Manager, Carrier, Partner, and Loner. Data Sources Case studies of oncology family caregivers and hospice patients were selected from data collected as part of a larger, randomized controlled trial aimed at assessing family participation in interdisciplinary team meetings. Conclusion Each caregiver type demonstrates essential communication traits with nurses and team members; an ability to recognize these caregiver types will facilitate targeted interventions to decrease family oncology caregiver burden. Implications for Nursing Practice By becoming familiar with caregiver types, oncology nurses will be better able to address family oncology caregiver burden and the conflicts arising from family communication challenges. With an understanding of family communication patterns and its impact on caregiver burden, nurses can aid patient, family, and team to best optimize all quality of life domains for patient as well as the lead family caregiver. PMID:23107184

  19. Validation of a model of family caregiver communication types and related caregiver outcomes.

    PubMed

    Wittenberg, Elaine; Kravits, Kate; Goldsmith, Joy; Ferrell, Betty; Fujinami, Rebecca

    2017-02-01

    Caring for the family is included as one of the eight domains of quality palliative care, calling attention to the importance of the family system and family communications about cancer during care and treatment of the disease. Previously, a model of family caregiver communication defined four caregiver communication types-Manager, Carrier, Partner, Lone-each with a unique communication pattern. The purpose of the present study was to extend the model of family caregiver communication in cancer care to further understand the impact of family communication burden on caregiving outcomes. This mixed-method study employed fieldnotes from a family caregiver intervention focused on quality of life and self-reported caregiver communication items to identify a specific family caregiver type. Caregiver types were then analyzed using outcome measures on psychological distress, skills preparedness, family inventory of needs, and quality-of-life domains. Corroboration between fieldnotes and self-reported communication for caregivers (n = 21, 16 women, mean age of 53 years) revealed a definitive classification of the four caregiver types (Manager = 6, Carrier = 5, Partner = 6, Lone = 4). Mean scores on self-reported communication items documented different communication patterns congruent with the theoretical framework of the model. Variation in caregiver outcomes measures confirmed the model of family caregiver communication types. Partner and Lone caregivers reported the lowest psychological distress, with Carrier caregivers feeling least prepared and Manager caregivers reporting the lowest physical quality of life. This study illustrates the impact of family communication on caregiving and increases our knowledge and understanding about the role of communication in caregiver burden. The research provides the first evidence-based validation for a family caregiver communication typology and its relationship to caregiver outcomes. Future research is needed to develop and test

  20. Factors associated with resident aggression toward caregivers in nursing homes.

    PubMed

    Zeller, Adelheid; Dassen, Theo; Kok, Gerjo; Needham, Ian; Halfens, Ruud J G

    2012-09-01

    Caregivers in nursing homes often experience aggressive behavior of residents. The aim of this study was to explore the caregivers' experiences with aggressive behavior from residents and to identify environmental factors as well as caregiver and resident characteristics related to aggressive behavior in Swiss nursing homes. A retrospective cross-sectional survey was conducted between November 2010 and April 2011 with a sample of caregivers working in various nursing homes in the German-speaking part of Switzerland. In total, 814 caregivers (response rate 51.8%) of 21 nursing homes participated in the study. Data were collected using the German version of the Survey of Violence Experienced by Staff (SOVES-G-R). Standard descriptive statistics were used to describe and summarize the date. To identify risk factors related to the experience of aggression by residents, multilevel logistic regression analysis was applied. The prevalence of participants reporting an aggressive incident during the 12-month period prior to data collection was 81.6%. Of these, 76.5% had experienced verbal aggression, 27.6% threats, and 54.0% physical aggression. The predictive variables in the multiple regression model for physical aggression were: staff education level (odds ratio [OR]= 1.82), gender (OR = 1.82), age (< 30 years vs. 30-45 years: OR = 1.46; < 30 years vs. > 45 years: OR = 2.13), and confidence in managing physical aggression (OR = 1.49). The predictive variables for threatening behavior were staff education level (registered nurses vs. non-registered nurses: OR = 1.70; nonstudent vs. student: OR = 1.89) and age (< 30 years vs. 30-45 years: OR = 2.00; < 30 years vs. > 45 years: OR = 2.04). Caregivers in nursing homes are at high risk for experiencing aggressive behavior. The identified risk factors are in line with earlier investigations, but some contradictory results also were observed. The high risk for registered nurses exposed to aggressive behavior and the increased

  1. Identifying Changeable Barriers to Family Involvement in the Nursing Home for Cognitively Impaired Residents

    ERIC Educational Resources Information Center

    Port, Cynthia Lindman

    2004-01-01

    Purpose: Barriers to family involvement in the nursing home with the potential for change through intervention are examined, including transportation, caregiver health, relationships with staff, and resident characteristics. Design and Methods: Data were collected for 93 family caregiver-resident pairs by means of telephone interviews and chart…

  2. Identifying Changeable Barriers to Family Involvement in the Nursing Home for Cognitively Impaired Residents

    ERIC Educational Resources Information Center

    Port, Cynthia Lindman

    2004-01-01

    Purpose: Barriers to family involvement in the nursing home with the potential for change through intervention are examined, including transportation, caregiver health, relationships with staff, and resident characteristics. Design and Methods: Data were collected for 93 family caregiver-resident pairs by means of telephone interviews and chart…

  3. Conflict, Emotion, and Personal Strain among Family Caregivers.

    ERIC Educational Resources Information Center

    Sheehan, Nancy W.; Nuttall, Paul

    1988-01-01

    Examined influence of interpersonal conflict, affection, and distress concerning dependency and caregiving satisfactions in predicting caregiver strain and negative emotion in 98 family caregivers. Found that interpersonal conflict between elderly carereceiver and caregiver predicted greatest amount of variance in both caregiver strain and…

  4. Family Caregivers Define and Manage the Nursing Home Placement Process.

    PubMed

    Koplow, Sarah M; Gallo, Agatha M; Knafl, Kathleen A; Vincent, Catherine; Paun, Olimpia; Gruss, Valerie

    2015-08-01

    The nursing home placement process is complex and difficult for family caregivers. This qualitative descriptive study examines the experiences of caregivers involved in the management of care and placement of an older family member using the Family Management Style Framework. Ten caregivers were recruited from four nursing homes in the Midwest. The caregivers were interviewed shortly after placement and again 3 months post-placement. Results provide a unique understanding of care management and the nursing home placement process from the perspective of the primary family caregiver. Overall, there were similarities across the same types of caregiving dyads, for example, spousal and adult-children caregivers. Caregivers expressed the need to maintain the identity of their older family member, a familial responsibility for caregiving, and change in their family relationship over time. Appreciating caregivers' challenges and needs gives health care professionals a better understanding for how to provide assistance for a smoother nursing home transition. © The Author(s) 2015.

  5. Family Caregivers' Perspectives on Institutionalization Decisions.

    ERIC Educational Resources Information Center

    Townsend, Aloen L.

    Family caregivers may face ethical dilemmas when deciding whether a parent or spouse should enter a nursing home. There is considerable evidence that decisions about institutionalization are usually stressful and difficult for family members. This study obtained qualitative and quantitative data from two studies conducted at the Margaret Blenkner…

  6. A Model of Health for Family Caregivers of Elders

    PubMed Central

    Weierbach, Florence M.; Cao, Yan

    2016-01-01

    Family members who provide care to their loved ones experience changes in their own health. The caregiver health model (CGHM) is a new model that identifies health holistically and identifies four determinant(s) that contribute to the health status of the family caregiver. The purpose is to introduce the CGHM: Hypothesis 1: the determinants of health in the CGHM contribute to the health of the Caregiver, Hypothesis 2: the determinants of health contribute to changes in the caregivers’ health at 8 and 16 weeks, and Hypothesis 3: a change in health occurs from baseline to 8 and 16 weeks. Methods: A descriptive, longitudinal design used three data collection points and five survey instruments. Community recruitment (N = 90) occurred through word of mouth and newspapers. Inclusion criteria consisted of being a family caregiver, living in a rural residence, and providing care to elders with necessary activities of daily living (ADLs) and/or instrumental ADLs (IADLs). Following a participant generated phone call to provide consent, caregivers received an initial study packet, additional packets were sent upon return of the previous packet. Analysis for the three hypotheses included multiple backwards stepwise linear regression, generalized estimating equations (GEE), and analysis of variance (ANOVA) α = 0.05. Results: A significant decrease in mental (p < 0.01) but not physical health at 8 weeks (p = 0.38) and 16 weeks (p = 0.29) occurred over time. Two determinants displayed significant (p < 0.05 or less) changes in mental and/or physical health at one or more time points. Study limitations include caregiver entry at varying times and self-report of elder nursing needs and medical conditions. Conclusions: Findings support two of the four determinants contributing to caregiver health. PMID:28025490

  7. Caregiving Statistics

    MedlinePlus

    ... on Family Caregivers and Family Caregiving Caregiving Population Economics of Caregiving Impact on Family Caregiver's Health Caregiving ... services combined ($158 billion). Evercare Survey of the Economic Downturn and Its Impact on Family Caregiving; National ...

  8. Family Caregiver Research and the HIPAA Factor

    ERIC Educational Resources Information Center

    Albert, Steven M.; Levine, Carol

    2005-01-01

    Research in family caregiving recently has become more challenging because of the strict protection of privacy mandated in the Health Insurance Portability and Accountability Act (HIPAA) of 1996. We ask when should Institutional Review Boards (IRBs) follow HIPAA rules to the letter and when might they use the waiver option? What is the appropriate…

  9. Dementia: The Experience of Family Caregivers.

    ERIC Educational Resources Information Center

    Chenoweth, Barbara; Spencer, Beth

    1986-01-01

    Caregivers of family members with dementia of the Alzheimer's type were surveyed for their experiences with early symptoms, obtaining a diagnosis, home care, and institutionalization. At each stage in the process of providing care there are new and different stresses that can be ameliorated by appropriate professional assistance. (Author)

  10. Family caregiving for dependent older adults in Thai families.

    PubMed

    Wongsawang, Nongnuch; Lagampan, Sunee; Lapvongwattana, Punyarat; Bowers, Barbara J

    2013-12-01

    The aim of this study was to understand how Thai families care for dependent older adults. The methodology used for the study was grounded dimensional analysis. Participants were 30 adult family members from 15 families who were involved in caregiving. A total of 46 interviews were conducted. Data were collected and analyzed in three phases: (a) calling up dimensions, (b) assigning relative value to each of the dimension considers, and (c) inferring. In Thai families, "natural caregiving" precedes care of dependent older persons (dependent caregiving). Dependent caregiving begins when dependency is first noticed and care needs are identified. Dependent caregiving is a dynamic process integrating three major processes: (a) mobilizing family members, (b) performing dependent care, and (c) maintaining continuity of care. The consequences of performing dependent care and unpredictable changes lead to care remobilizing. Dependent care for older adults varies across and is influenced by many conditions. Health personnel need to assess and monitor these varying conditions in order to support Thai families caring for dependent older adults. The conceptual model developed from the findings of this study provide a starting place for increasing our understanding of how to help Thai families care effectively and continuously for their older family members. © 2013 Sigma Theta Tau International.

  11. 76 FR 68621 - National Family Caregivers Month, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-04

    ... Documents#0;#0; ] Proclamation 8748 of November 1, 2011 National Family Caregivers Month, 2011 By the... National Family Caregivers Month, we pay tribute to the individuals throughout America who ensure the... observe National Family Caregivers Month, we honor the tireless compassion of Americans who heal,...

  12. Understanding social support burden among family caregivers.

    PubMed

    Wittenberg-Lyles, Elaine; Washington, Karla; Demiris, George; Oliver, Debra Parker; Shaunfield, Sara

    2014-01-01

    Despite the abundance of research on social support, both as a variable in larger studies and as a central focus of examination, there is little consensus about the relationship between social support and health outcomes. Current social support measures typically account only for frequency and size of network, and a paucity of research exists that has explained social support burden, defined as the burden associated with accessing and receiving support from others. We analyzed audio-recorded discussions by hospice family caregivers about their caregiving problems and potential solutions to examine social relationships within networks and identify the processes that influence social support seeking and receiving. Using qualitative thematic analysis, we found that caregivers providing hospice care experience social support burden resulting from perceived relational barriers between friends and family, the inclination to remain in control, recognition of the loss of the patient as a source of social support and guidance in decision making, family dynamics, and decreased availability of emotional support. Social support researchers should consider how the quality of communication and relationships within social networks impacts the provision and subsequent outcomes of social support in varying contexts. Findings from this study suggest that hospice social support resources should be tailored to the caregiver's support needs and include assessment on the type of support to be offered.

  13. A Pilot Evaluation of the Family Caregiver Support Program

    ERIC Educational Resources Information Center

    Chen, Ya-Mei; Hedrick, Susan C.; Young, Heather M.

    2010-01-01

    The purposes of this study were to evaluate a federal and state-funded Family Caregiver Support Program (FCSP) and explore what types of caregiver support service are associated with what caregiver outcomes. Information was obtained on a sample of 164 caregivers' use of eleven different types of support service. Descriptive and comparative…

  14. Typical and Atypical Dementia Family Caregivers: Systematic and Objective Comparisons

    ERIC Educational Resources Information Center

    Nichols, Linda O.; Martindale-Adams, Jennifer; Burns, Robert; Graney, Marshall J.; Zuber, Jeffrey

    2011-01-01

    This systematic, objective comparison of typical (spouse, children) and atypical (in-law, sibling, nephew/niece, grandchild) dementia family caregivers examined demographic, caregiving and clinical variables. Analysis was of 1,476 caregivers, of whom 125 were atypical, from the Resources for Enhancing Alzheimer's Caregivers Health (REACH I and II)…

  15. Typical and Atypical Dementia Family Caregivers: Systematic and Objective Comparisons

    ERIC Educational Resources Information Center

    Nichols, Linda O.; Martindale-Adams, Jennifer; Burns, Robert; Graney, Marshall J.; Zuber, Jeffrey

    2011-01-01

    This systematic, objective comparison of typical (spouse, children) and atypical (in-law, sibling, nephew/niece, grandchild) dementia family caregivers examined demographic, caregiving and clinical variables. Analysis was of 1,476 caregivers, of whom 125 were atypical, from the Resources for Enhancing Alzheimer's Caregivers Health (REACH I and II)…

  16. Caregiver Opinion of In-Hospital Screening for Unmet Social Needs by Pediatric Residents.

    PubMed

    Colvin, Jeffrey D; Bettenhausen, Jessica L; Anderson-Carpenter, Kaston D; Collie-Akers, Vicki; Chung, Paul J

    2016-03-01

    Child health is strongly influenced by social determinants. Little is known about the opinions of primary caregivers regarding the physicians' role in addressing social needs. Our objective was to examine caregivers' opinions about that role and any associations between those opinions, previous exposure to screening for needs by pediatric residents, and socioeconomic status (SES). Cross-sectional survey study of caregivers of hospitalized children. The survey collected information on caregiver opinion regarding their ability to ask physicians for help with social needs, whether physicians know how to help with those needs, and whether physicians should ask about social needs. The chi square test was used to identify associations between caregiver opinions, prior screening by a resident at admission, and SES (determined by census tract median household income). Surveys were completed by 143 caregivers (79% participation). Most respondents agreed that they could ask their physician for help (54.5%), that their physician knows how to help (64.3%), and that physicians should ask about social needs (71.3%). Previously screened caregivers had more favorable opinions about asking for help (76.2% vs 45.5%, P < .01), whether their physician knows how to help (81.0% vs 57.4%, P = .02), and physician screening for unmet needs (85.7% vs 65.3%, P = .03). There were no SES differences in opinion. Caregivers have favorable opinions of the physician's role in addressing the social determinants of health, especially after being screened. Physicians should be confident in the acceptability of screening families for social needs. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  17. Family caregiver communication in oncology: advancing a typology.

    PubMed

    Goldsmith, Joy; Wittenberg, Elaine; Platt, Christine Small; Iannarino, Nicholas T; Reno, Jenna

    2016-04-01

    The quality of communication between the patient and family caregiver impacts quality of life and well-being for the two; however, providers have few tools to understand communication patterns and assess the communication needs and preferences of caregivers. The aims of this study were to examine family communication patterns among oncology patients and their caregivers and to identify common characteristics among four different types of family caregivers. Nurses recruited oncology patient-caregiver dyads through a large cancer treatment center in the Southeast. Patients and caregivers were separated from one another and interviewed during chemotherapeutic infusions. Interviews were recorded, transcribed, coded, and thematized. A sample of 24 patients and their caregivers (n = 48) were interviewed. The majority of dyads (21, 88%) shared the same family communication pattern. Common caregiver communication features support previous work identifying four caregiver communication types: Manager, Carrier, Partner, and Lone caregivers. Manager caregivers lead patients by utilizing extensive medical knowledge, whereas Carrier caregivers were led by patients and described tireless acts to maintain the family and avoid difficult conversations. Partner caregivers facilitated family involvement and open communication on a variety of topics, while Lone caregivers focused solely on biomedical matters and a hope for cure. Caregiver communication types were corroborated by patient-caregiver descriptions of caregiving. However, more information is needed to ascertain the variables associated with each caregiver type. Future work to improve identification of caregiver types and create targeted caregiver care plans will require further study of health literacy levels and tested communication interventions per type. Copyright © 2015 John Wiley & Sons, Ltd.

  18. Caregiving for Dementia in Family Members: Caregiving Burden and Prospects for Effective Intervention.

    ERIC Educational Resources Information Center

    Maiden, Robert J.; And Others

    Caring for a family member with dementia is a major source of stress for the caregiver. To assess the impact of caring for an impaired family member and to evaluate the effectiveness of intervention programs, 34 caregivers of relatives with dementia completed an amended form of the Philadelphia Geriatric Center's Caregiver Survey and two…

  19. Zoning, accessory dwelling units, and family caregiving: issues, trends, and recommendations.

    PubMed

    Liebig, Phoebe S; Koenig, Teresa; Pynoos, Jon

    2006-01-01

    This article explores the relationship between zoning regulations and co-residential family caregiving in the United States. It first provides an overview of U.S. housing policies, especially zoning. We then describe major changes in family structure and composition in the United States with their implications for caregiving and discuss how multigenerational housing options, particularly accessory dwelling units (ADUs) in single-family homes, can help support family caregiving. After an overview of zoning policies and actions that inhibit ADU production, we document current trends, incorporating information from a small non-random study of ADU activity we conducted in 2004. Finally, we present recommendations for promoting more multigenerational housing as a supplement to other family support programs (e.g., dependent care assistance, family caregiver payments) and as a source of affordable, supportive housing for those families choosing co-residence as their eldercare solution.

  20. Making sense of sibling responsibility for family caregiving.

    PubMed

    Willyard, Jennifer; Miller, Katherine; Shoemaker, Martha; Addison, Penny

    2008-12-01

    As the population in the United States and around the globe ages, families are faced with decisions about caregiving for elderly parents. Research suggests that daughters often take on these stressful caregiving responsibilities, with varying levels of help from siblings. In this article, we examine these sibling relationships within the caregiving context, considering the ways in which siblings negotiate the division of tasks for elderly parents and make sense of siblings who provide little help in caregiving activities. Our content analysis of interviews with 25 family caregivers indicated that there was little negotiation of caregiving tasks. Furthermore, family caregivers make sense of sibling participation in caregiving in three ways. First, some caregivers account for caregiving as an individual activity for which they are especially suited. Second, some caregivers see caregiving as stemming from values about family life, but excuse nonparticipant siblings by defining them as outside family boundaries. Finally, caregivers with strong family values who could not make sense of siblings through an exclusionary frame engaged in verbal backtracking during the telling of their stories as a way of making sense of personal caregiving responsibilities.

  1. Family caregivers' role implementation at different stages of dementia.

    PubMed

    Huang, Huei-Ling; Shyu, Yea-Ing L; Chen, Min-Chi; Huang, Chin-Chang; Kuo, Hung-Chou; Chen, Sien-Tsong; Hsu, Wen-Chuin

    2015-01-01

    The purpose of this study was to explore family caregivers' role-implementation experiences at different stages of dementia. For this cross-sectional, exploratory study, 176 dyads of family caregivers and their community-dwelling elderly relatives with dementia were recruited from the neurological clinics of a medical center in Taiwan. The Family Caregiving Inventory was used to assess family caregivers for caregiving activities, role strain, role preparation, and help from others at different stages of care receivers' dementia. Family caregivers' caregiving activities were related to patients' stages of dementia. For patients with mild dementia, caregivers provided more assistance in transportation and housekeeping. In addition to these two activities, family caregivers of patients with moderate dementia provided more assistance with mobility and protection. For patients with severe dementia, family caregivers provided more assistance with personal care, mobility and protection, transportation, and housekeeping. Overall, family caregivers reported having some preparation to provide care; the most difficult caregiving activity was identified as managing behavioral problems. This study's results provide a knowledge base for designing dementia stage-specific interventions in clinical practice and developing community-based, long-term care systems for families of patients with dementia.

  2. [A Prediction Model for Unmet Needs of Elders with Dementia and Caregiving Experiences of Family Caregivers].

    PubMed

    Choi, Sora; Park, Myonghwa

    2016-10-01

    The purposes of this study were to develop and test a prediction model for caregiving experiences including caregiving satisfaction and burden in dementia family caregivers. The stress process model and a two factor model were used as the conceptual frameworks. Secondary data analysis was done with 320 family caregivers who were selected from the Seoul Dementia Management Survey (2014) data set. In the hypothesis model, the exogenous variable was patient symptomatology which included cognitive impairment, behavioral problems, dependency in activity of daily living and in instrumental activity of daily living. Endogenous variables were caregiver's perception of dementia patient's unmet needs, caregiving satisfaction and caregiving burden. Data were analysed using SPSS/WINdows and AMOS program. Caregiving burden was explained by patient symptomatology and caregiving satisfaction indicating significant direct effects and significant indirect effect from unmet needs. The proposed model explained 37.8% of the variance. Caregiving satisfaction was explained by patient symptomatology and unmet needs. Mediating effect of unmet needs was significant in the relationship between patient symptomatology and caregiving satisfaction. Results indicate that interventions focusing on relieving caregiving burden and enhancing caregiver satisfaction should be provided to caregivers with high levels of dementia patients' unmet needs and low level of caregiving satisfaction.

  3. Family Caregiving. A Manual for Caregivers of Older Adults.

    ERIC Educational Resources Information Center

    Mehrotra, Chandra, Ed.; And Others

    This manual provides caregivers with practical knowledge and suggestions that could be of help to them in this important role. Chapter 1 gives an overview of the volume and tells how to use it. Chapter 2 identifies who caregivers are, what they do, and what changes have taken place in their lives since they became caregivers. Chapter 3 begins with…

  4. Classification of caregiving families according to the Family Caregivers' Appraisal Checklist.

    PubMed

    Horiguchi, Kazuko; Iwata, Noboru; Matsuda, Nobuko

    2013-04-05

    This study aimed to classify caregiving families according to the Family Caregivers' Appraisal Checklist (FACL; Horiguchi et al., 2012), which was originally developed to evaluate the probability of continuing caregiving. After nationwide targeting in Japan, the selected survey candidates included 1279 families utilizing domiciliary nursing services chosen by stratified two-stage sampling, and available data were obtained from 945 out of 1020 returned responses (return ratio: 79.8%). Scores for the seven components of FACL were cluster analyzed, and the following six clusters were extracted: Cluster A (12.8%) yielded high scores for all components; Cluster B (34.0%) yielded average scores; Cluster C (20.7%) scored mostly average but low for "quality of care service"; Cluster D (15.8%) showed relatively low scores for all components; Cluster E (11.4%) yielded low scores for all components except for "quality of care service" and "preparedness for emergencies"; and Cluster F (5.3%) scored significantly poorly for all components except for "preparedness for emergencies". Significant intercluster differences were observed for care recipient's age, the number of medical care, employment status, principal caregiver's subjective health, and the advice from family and friends. Caregiving duration was significantly associated with "positive appraisal of family caregiving", the number of medical care and the number of care types, and marginally with the level of care stipulated by the public long-term care insurance program (p < 0.07). Implications of classification of family type according to the FACL and the importance of positive appraisal of caregiving are discussed along with the future direction of use of the FACL.

  5. Choosing family medicine residency programs

    PubMed Central

    Lee, Joseph; Alfieri, Marg; Patel, Tejal; Lee, Linda

    2011-01-01

    Abstract Objective To describe key determinants for residents’ selection of a new community-based, interprofessional site for their family medicine training, and to evaluate residents’ satisfaction with their programs. Design Combined qualitative and quantitative methods using in-depth interviews and a survey. Setting McMaster University, including the new site of the Centre for Family Medicine in Kitchener-Waterloo, Ont, and a long-established site in Hamilton, Ont. Participants Eleven first-year and second-year family medicine residents from the Kitchener-Waterloo site participated in in-depth interviews. Forty-four first-year and second-year family medicine residents completed the survey, 22 in Kitchener-Waterloo and 22 in Hamilton. Methods Kitchener-Waterloo residents participated in in-depth interviews during their residency programs in 2008 to 2009 using a semistructured format to explore their choice of site and the effect of an interprofessional environment on their education. Common themes were established using qualitative analysis techniques; based on these themes, a survey was developed and distributed to residents from both sites to further explore factors influencing site selection, satisfaction, and effects of interprofessional education. Main findings Residents identified several reasons for selecting a new community-based, interprofessional family medicine residency program. Reasons included preference for the location and opportunities to learn in an interprofessional teaching environment. A less hierarchical structure and greater opportunities for one-on-one teaching also influenced their choices. Perception of poor communication from the well established site was identified as a challenge. Residents at both sites indicated similarly high levels of program satisfaction. Conclusion Residents selected the new community-based family medicine site for reasons of geographic location and the potential for clinical learning experiences and

  6. Understanding Social Support Burden Among Family Caregivers

    PubMed Central

    Washington, Karla; Demiris, George; Parker Oliver, Debra; Shaunfield, Sara

    2014-01-01

    Despite the abundance of research on social support, both as a variable in larger studies and as a central focus of examination, there is little consensus about the relationship between social support and health outcomes. Current social support measures typically account only for frequency and size of network and a paucity of research exists that has explained social support burden, defined as the burden associated with accessing and receiving support from others. We analyzed audio-recorded discussions by hospice family caregivers about their caregiving problems and potential solutions to examine social relationships within networks and identify the processes that influence social support seeking and receiving. Using qualitative thematic analysis, we found that caregivers providing hospice care experience social support burden resulting from perceived relational barriers between friends and family, the inclination to remain in control, recognition of the loss of the patient as a source of social support and guidance in decision-making, family dynamics and decreased availability of emotional support. Social support researchers should consider how the quality of communication and relationships within social networks impacts the provision and subsequent outcomes of social support in varying contexts. Findings from this study suggest that hospice social support resources should be tailored to the caregiver’s support needs and include assessment on the type of support to be offered. PMID:24345081

  7. Caregiver Opinion of In-Hospital Screening for Unmet Social Needs by Pediatric Residents

    PubMed Central

    Colvin, Jeffrey D.; Bettenhausen, Jessica L.; Anderson-Carpenter, Kaston D.; Collie-Akers, Vicki; Chung, Paul J.

    2016-01-01

    Objective Child health is strongly influenced by social determinants. Little is known about the opinions of primary caregivers regarding the physicians’ role in addressing social needs. Our objective was to examine caregivers’ opinions about that role and any associations between those opinions, previous exposure to screening for needs by pediatric residents, and socioeconomic status (SES). Methods Cross-sectional survey study of caregivers of hospitalized children. The survey collected information on caregiver opinion regarding their ability to ask physicians for help with social needs, whether physicians know how to help with those needs, and whether physicians should ask about social needs. The chi square test was used to identify associations between caregiver opinions, prior screening by a resident at admission, and SES (determined by census tract median household income.) Results Surveys were completed by 143 caregivers (79% participation). Most respondents agreed that they could ask their physician for help (54.5%), that their physician knows how to help (64.3%), and that physicians should ask about social needs (71.3%). Previously screened caregivers had more favorable opinions about asking for help (76.2% vs. 45.5%, P<0.01), whether their physician knows how to help (81.0% vs. 57.4%, P=0.02), and physician screening for unmet needs (85.7% vs. 65.3%, P=0.03). There were no SES differences in opinion. Conclusions Caregivers have favorable opinions of the physician’s role in addressing the social determinants of health, especially after being screened. Physicians should be confident in the acceptability of screening families for social needs. PMID:26946270

  8. Family caregivers of patients with frontotemporal dementia: An integrative review.

    PubMed

    Caceres, Billy A; Frank, Mayu O; Jun, Jin; Martelly, Melissa T; Sadarangani, Tina; de Sales, Paloma Cesar

    2016-03-01

    The purpose of this integrative review is to: (1) identify the characteristics of family caregivers of patients with frontotemporal dementia, (2) explore the impact of providing care on family caregivers' health and well-being, and (3) identify coping strategies used by family caregivers. Frontotemporal dementia is thought to be the second most common form of dementia after Alzheimer's disease. Family caregivers of patients with frontotemporal dementia face unique challenges due to its early onset, behavioral symptoms, and slow progression of decline. However, there is a dearth of research evaluating the health and wellbeing of family caregivers of patients with frontotemporal dementia. An integrative review was conducted using the Whittemore and Knafl methodology. An electronic search of the literature was conducted using four electronic databases: PubMed, Embase, CINAHL, and Web of Science. The Crowe Critical Appraisal tool was used to evaluate the quality of the selected articles. Findings of 11 articles informed this integrative review. Family caregivers of patients with frontotemporal dementia identify behavioral disturbances as most troubling. Spouses and female caregivers experience greater caregiver burden, distress, increased rates of depression, as well as decreased sleep related to behavior disturbances. Though less explored, providing care to those with behavioral disturbances may also impact caregiver physical health. Additionally, female caregivers are most likely to employ coping strategies, most commonly, adaptation and reframing. Effective interventions to reduce family caregiver burden are poorly understood but family caregivers suggest education and internet-based support groups are most helpful. Family caregivers of patients with frontotemporal dementia experience significant distress, which impacts their health and wellbeing. It is important for healthcare providers who care for patients with frontotemporal dementia to recognize the unique

  9. Preparing family caregivers for death and bereavement. Insights from caregivers of terminally ill patients.

    PubMed

    Hebert, Randy S; Schulz, Richard; Copeland, Valire C; Arnold, Robert M

    2009-01-01

    Many family caregivers are unprepared for the death of their loved one and may suffer from worse mental health as a result. We therefore sought to determine the factors that family caregivers believe are important to preparing for death and bereavement. Focus groups and ethnographic interviews were conducted with 33 family caregivers (bereaved or current) of terminally ill patients. The interviews were audiotaped, transcribed, and analyzed using the constant comparative method. Life experiences such as the duration of caregiving/illness, advance care planning, previous experiences with caregiving or death, and medical sophistication all impacted preparedness, or the degree to which a caregiver is ready for the death and bereavement. Regardless of life experiences, however, all caregivers reported medical, practical, psychosocial, and religious/spiritual uncertainty. Because uncertainty was multidimensional, caregivers often needed more than prognostic information in order to prepare. Communication was the primary mechanism used to manage uncertainty. Good communication included clear, reliable information, combined with relationship-centered care from health care providers. Finally, preparedness had cognitive, affective, and behavioral dimensions. To prepare, some caregivers needed information tailored to their uncertainty (cognitive), others needed to "mentally" or "emotionally" prepare (affective), and still others had important tasks to complete (behavioral). In order to better prepare family caregivers for the death of a loved one, health care providers must develop a trusting relationship with caregivers, provide them with reliable information tailored to their uncertainty, and allow time for caregivers to process the information and complete important tasks.

  10. Diabetes mellitus patients' family caregivers' subjective quality of life.

    PubMed Central

    Awadalla, Abdel W.; Ohaeri, Jude U.; Al-Awadi, Shafika A.; Tawfiq, Adel M.

    2006-01-01

    OBJECTIVES: To assess the subjective quality of life (QOL) of family caregivers of Sudanese type-1 and type-2 diabetic outpatients, using the WHO 26-item QOL instrument, compared with a general population sample; and to examine the factors associated with caregiver QOL. METHOD: Responses of caregivers of 105 outpatients with type-1 diabetes and 135 with type-2 diabetes were compared with 139 general population subjects. RESULTS: Caregivers were satisfied with the content of items related to general social supports. Type-1 caregivers had significantly lower QOL scores than type-2 caregivers and the general population. Parents and siblings had lowest scores compared with other family groups. Caregivers scored higher than patients. Patients' age and duration of illness, and caregivers' education, marital status and state of health were positively associated with caregiver QOL. Caregivers' QOL was predicted by their appraisal of patients' QOL. CONCLUSIONS: Caregivers who were sick, younger, single, less educated and caring for patients with more recent illness appeared relatively vulnerable. Clinicians should be interested in the dynamics of the family caregiving situation--as it impacts QOL--and in promoting caregiver awareness of diabetes in order to enhance the caregiving role, quality of care and QOL. PMID:16749648

  11. [Terminal patient home care: the family caregivers perspective].

    PubMed

    Oliveira, Stefanie Griebeler; Quintana, Alberto Manuel; Denardin-Budó, Maria de Lourdes; de Moraes, Natália de Andrade; Lüdtke, Manoela Fonseca; Cassel, Paula Argemi

    2012-09-01

    This study was aimed at getting to know the relationships built among patients, family caregivers and the health care team, during home care,from the perspective of the family caregiver It is a qualitative study with 11 family caregivers of terminal patients, registered on a home care service of a university hospital in the South of Brazil. Data collection was carried out through narrative interviews that were recorded transcribed and analyzed through content analysis. Three categories were built from data analysis: relationships among the family caregiver, the patient and the health care team; awareness of the patient's terminal condition. the caregiver's perspective; and situation in which patients are unaware of their terminal condition. They approach how the home care relationships are established among the caregivers, such as health care professionals and family caregivers, and the people who are taken care of such as the patients, highlighting the importance of communication in such care related context.

  12. Family caregivers' experiences during transitions out of hospital.

    PubMed

    Coleman, Eric A; Roman, Sarah P

    2015-01-01

    Family caregivers play a central yet under recognized role in ensuring quality and safety during a loved one's transition out of the hospital. To explore facilitators and challenges family caregivers face in assuming postdischarge family caregiving roles and completing complex care tasks. A qualitative study recruited 32 participants from 4 sites. Participants were unpaid family caregivers whose loved one was recently discharged from an acute care hospital. A modified Grounded Theory approach was used. Five central themes emerged from the analysis: (1) family caregivers' contributions to the care of their loved one unfold along on a spectrum where the readiness, willingness, and ability of both parties are often dynamic; (2) family caregivers have unique and potentially incongruent goals from those of the patient; (3) family caregivers feel unprepared for postdischarge medication management; (4) family caregivers encouragement to assert an identity; (5) family caregivers often assume the responsibility for the sequencing of posthospital care plan tasks and anticipating next steps. Family caregivers provided valuable insights into the challenges they face facilitating their loved ones' transitions. These findings may directly inform the design and testing of an evidence-based intervention to enhance their roles.

  13. [The meaning of caregiving experience lived by Lebanese family caregivers of stroke survivors at home].

    PubMed

    Taha, Samy; Kazan, Rima Sassine

    2015-03-01

    Introduction six million of deaths are due today to stroke, while stroke survivors will depend on their caregivers at home. As the literature noted in, these caregivers meet challenges and satisfactions, encouraging them to resort to adaptation strategies in order to cope with their care situation. The purpose of this article is to describe and understand the experience of Lebanese family caregivers who take care at home of a relative stroke survivor. Using the phenomenological approach of Giorgi (1997), twelve interviews were conducted with six family caregivers who have been recruited through a rehabilitation center in Beirut. Eight themes have emerged from the phenomenological analysis: the family caregiver burden, the missing social support, the learning through his experience of a family caregiver, the contribution to caregiving survivor, the selflessness in the caregiving, the gratitude in the caregiving, the familiarization with new routines and reconciliation with new lifestyle. The proposed essence from this phenomenological analysis is: the satisfaction in taking care of the stoke survivor by facing challenges and bringing order into the chaos caused by the stroke. The knowledge gained from this study would allow nurses to identify family caregivers at risk in order to help them to adapt to their new role as caregivers, and to develop health promotion strategies, taking into consideration their experience.

  14. Family caregiving for adults with schizophrenia and diabetes mellitus.

    PubMed

    El-Mallakh, Peggy; Yates, Brittany Evans; Adkins, Sarah

    2013-08-01

    Diabetes mellitus (DM) is common among those with schizophrenia, but little is known about family members' roles in the care of relatives who have both schizophrenia and DM. The purpose of this descriptive correlational study was to examine DM knowledge and caregiver burden among 27 family caregivers of people with schizophrenia and DM. Findings indicate that DM knowledge was low. Objective caregiver burden was highest for providing assistance with daily living activities. Subjective burden was highest for preventing the care recipient from keeping people awake at night and dealing with the care recipient's non-adherence to DM care. Family caregivers are in need of education and support in the caregiving role.

  15. The Impact of Family Functioning on Caregiver Burden among Caregivers of Veterans with Congestive Heart Failure

    ERIC Educational Resources Information Center

    Moore, Crystal Dea

    2010-01-01

    A cross-sectional study of 76 family caregivers of older veterans with congestive heart failure utilized the McMaster model of family functioning to examine the impact of family functioning variables (problem solving, communication, roles, affective responsiveness, and affective involvement) on caregiver burden dimensions (relationship burden,…

  16. Association of impairments of older persons with caregiver burden among family caregivers: Findings from rural South India.

    PubMed

    Ajay, Shweta; Kasthuri, Arvind; Kiran, Pretesh; Malhotra, Rahul

    In India, owing to cultural norms and a lack of formal long-term care facilities, responsibility for care of the older person falls primarily on the family. Based on the stress process model, we assessed the association of type and number of impairments of older persons (∼primary stressors) with caregiver burden among their family caregivers in rural South India. All impaired older persons (aged ≥60, with impairment in activities of daily living (ADL) or cognition or vision or hearing) residing in 8 villages in Bangalore district, Karnataka, India, and their primary informal caregivers were interviewed. Caregiver burden was measured using the Zarit Burden Interview (ZBI; higher score indicating greater perceived burden). Linear regression models, adjusting for background characteristics of older persons and caregivers, assessed the association of type of impairment (physical [Yes/No], cognitive [Yes/No], vision [Yes/No] and hearing [Yes/No]) and number (1 or 2 or 3 or 4) of older person impairments with caregiver burden. A total of 140 caregivers, caring for 149 older persons, were interviewed. The mean (standard deviation) ZBI score was 21.2 (12.9). Of the various older person impairments, ZBI score was associated only with physical impairment (β=6.6; 95% CI: 2.1-11.1). Relative to caregivers of older person with one impairment, those caring for an older person with all 4 impairments had significantly higher ZBI score (β=13.9; CI: 2.5-25.4). Caregivers of older persons with multiple impairments, especially physical impairment, are vulnerable. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Female caregivers' perceptions of reasons for violent behaviour among nursing home residents.

    PubMed

    Graneheim, U H; Hörnsten, Å; Isaksson, U

    2012-03-01

    Threats and violence against professional caregivers present a growing health and safety problem in elderly care. We aimed to explore female caregivers' perceptions of reasons for violent behaviour among nursing home residents. Forty-one caregivers at three nursing homes were interviewed and their responses were subjected to qualitative content analysis, which revealed three content areas of perceived reasons for patient violence: patient characteristics, caregiver approach and environmental aspects. The caregivers' perceptions were formulated in three core statements: 'they (the residents) are not who they used to be', 'we (the caregivers) have acted inappropriately' and 'we (residents and caregivers) are all surrounded by disorder'. Our findings indicate that the reasons for violence are complex and multifactorial, so interventions should be individually tailored. Caregivers involved in a violent situation need to see the person behind the behaviour, try to interpret what the behaviour is meant to communicate and adjust the intervention according to individual need. © 2011 Blackwell Publishing.

  18. Assessing family caregiver skill in managing behavioral symptoms of Alzheimer’s disease

    PubMed Central

    Farran, Carol J.; Fogg, Louis G.; McCann, Judith J.; Etkin, Caryn; Dong, Xinqi; Barnes, Lisa L.

    2011-01-01

    Objectives This measurement study operationalized family caregiver skill in managing behavioral symptoms associated with Alzheimer’s disease (AD) by testing a Caregiver Assessment of Behavioral Skill-Self Report measure (CAB-SR). Method A cross-sectional design was used. Caregivers had a family member with possible/probable AD, resided at home with the care recipient and provided the majority of care (N=82). The mail-administered assessment included the CAB-SR and other care recipient and caregiver measures. Results Preliminary CAB-SR reliability and validity were determined, using reliability, factor analytic and correlational procedures. Conclusion This measure provides a preliminary assessment of caregiver skill in managing behavioral symptoms of AD and shows promise for use in research and clinical intervention settings. PMID:21500018

  19. Cancer Communication and Family Caregiver Quality of Life

    PubMed Central

    Wittenberg, Elaine; Borneman, Tami; Koczywas, Marianna; Del Ferraro, Catherine; Ferrell, Betty

    2017-01-01

    Family caregivers have enormous communication responsibilities tied to caregiving, such as sharing the patient’s medical history with providers, relaying diagnosis and prognosis to other family members, and making decisions about care with the patient. While caregiver stress and burden has been widely documented in the caregiving literature, little is known about how communication burden, real or perceived communication challenges, impacts caregiver quality of life. In family caregiving, the City of Hope (COH) Quality of Life model proposes that the caregiving experience is reciprocal to the patient experience, impacting physical, social, psychological, and spiritual quality of life. We used data from a pilot study testing a communication coaching call intervention with family caregivers of lung cancer patients to analyze caregiver reported communication burden and quality of life. We found variances in each quality of life domain, suggesting that caregiver interventions should range from self-care skill building for physical care to psycho-educational interventions that support caregiver coping and communication skill building. These findings demonstrate the importance of caregiver assessment and attention to communication burden in quality cancer care. PMID:28257110

  20. Transnational caregiving: Part 1, caring for family relations across nations.

    PubMed

    Dhar, V Erica

    2011-01-01

    This article concerns how globalization and the aging of the world's population are affecting the already complex issue of intergenerational transnational caregiving. Globalization has caused an increase in workforce mobility with large numbers of individuals seeking employment overseas. This, coupled with increased longevity globally, has resulted in many workers leaving their elderly parents in need of care in their home countries. This has spawned caregiving across national borders, or caring for family relations across nations. Currently in the United States, not enough emphasis is given to family caregiving. Data compiled by AARP and the National Alliance for Caregiving estimate the economic value for this group of family caregivers in 2007 to be $375 billion, accounting for 34-52 million family caregivers per given year. This does not include those families who are transnational caregivers. The seminal work in this emerging field has been done by social anthropologists Loretta Baldassar, Cora Velekoop Baldock, and Raelene Wilding, who have defined the components of transnational caregiving based on an ethnographic study using qualitative data to study nine immigrant communities in Western Australia. Although their research focused on caregiving from a distance, additional work has been added to the discussion by introducing the element of "care drain" and further cultural perspectives. Therefore, this research is an exploratory study on intergenerational transnational caregiving within the context of the changing world and its demographics. Within the context of globalization and global aging, the following questions are addressed: What is the significance of family caregiving? What is a transnational? How has technology changed "transnationalism" today? What are the elements that comprise transnational caregiving? How does culture play a role in transnational caregiving? What are some of the national initiatives undertaken by governments to aid in workforce

  1. 38 CFR 52.71 - Participant and family caregiver responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Participant and family....71 Participant and family caregiver responsibilities. The program management has a written statement of participant and family caregiver responsibilities that are posted in the facility and provided...

  2. Development of the Family Caregiver Medication Administration Hassles Scale

    ERIC Educational Resources Information Center

    Travis, Shirley S.; Bernard, Marie A.; McAuley, William J.; Thornton, Megan; Kole, Tristen

    2003-01-01

    Purpose: "Medication administration hassles" are the minor daily irritants that family caregivers experience when they assist a dependent family member with medication regimens. This study was designed to develop and test a multidimensional measure of the hassles in family caregiver medication administration. Design and Method: The authors…

  3. 38 CFR 52.71 - Participant and family caregiver responsibilities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Participant and family....71 Participant and family caregiver responsibilities. The program management has a written statement of participant and family caregiver responsibilities that are posted in the facility and provided to...

  4. 38 CFR 52.71 - Participant and family caregiver responsibilities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Participant and family....71 Participant and family caregiver responsibilities. The program management has a written statement of participant and family caregiver responsibilities that are posted in the facility and provided to...

  5. 38 CFR 52.71 - Participant and family caregiver responsibilities.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Participant and family....71 Participant and family caregiver responsibilities. The program management has a written statement of participant and family caregiver responsibilities that are posted in the facility and provided to...

  6. 38 CFR 52.71 - Participant and family caregiver responsibilities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Participant and family....71 Participant and family caregiver responsibilities. The program management has a written statement of participant and family caregiver responsibilities that are posted in the facility and provided to...

  7. Development of the Family Caregiver Medication Administration Hassles Scale

    ERIC Educational Resources Information Center

    Travis, Shirley S.; Bernard, Marie A.; McAuley, William J.; Thornton, Megan; Kole, Tristen

    2003-01-01

    Purpose: "Medication administration hassles" are the minor daily irritants that family caregivers experience when they assist a dependent family member with medication regimens. This study was designed to develop and test a multidimensional measure of the hassles in family caregiver medication administration. Design and Method: The authors…

  8. Ethical Concerns of Family Caregivers to Dementia Patients.

    ERIC Educational Resources Information Center

    Pratt, Clara; And Others

    1987-01-01

    Identified concerns in statements of 116 family caregivers to dementia patients. Concerns included ethical issues of family obligations for caregiving; conflicts with responsibilities to family, career or personal well-being; financing health care; standards of care; and patient roles in planning care. (Author/ABL)

  9. Family-based therapy for dementia caregivers: clinical observations

    PubMed Central

    MITRANI, V. B.; CZAJA, S. J.

    2008-01-01

    Family caregiving for dementia patients is a major social and clinical problem. Family caregivers face major stressful emotional, social and economic burdens, and the negative consequences associated with caregiving are well documented. Given the projected increase in the number of people with dementia, there is a need to identify approaches that will help families manage the challenges of caregiving. Social support from friends and family members has consistently been found to mediate caregiver outcomes, yet many caregivers face problems with isolation and estrangement from family members. In this regard, family-based therapy is a promising intervention for increasing social support for caregivers, and enhancing their quality of life and ability to provide care.This paper will discuss how family-based therapy can be applied as an intervention for family caregivers of dementia patients.The clinical implications of specific interactional patterns will be presented via case examples from an ongoing clinical trial with white American and Cuban American caregivers of dementia patients.The intent is to demonstrate how identification of interactional patterns is a valuable tool for implementing family-based interventions. PMID:18548132

  10. Mutuality and preparedness moderate the effects of caregiving demand on cancer family caregiver outcomes.

    PubMed

    Schumacher, Karen L; Stewart, Barbara J; Archbold, Patricia G

    2007-01-01

    Family caregiving researchers have explored the moderating or stress-buffering effects of variables such as coping and social support. However, the quality of the family caregiver-patient relationship and preparedness for caregiving have received little attention as potential moderators. To explore whether relationship quality and preparedness moderate the effects of caregiving demand on caregiver outcomes during cancer treatment. Eighty-seven family caregivers of patients receiving treatment for cancer completed the Demand and Difficulty subscales of the Caregiving Burden Scale, Mutuality and Preparedness Scales of the Family Care Inventory, and the short form of the Profile of Mood States. Using hierarchical multiple regression analyses, caregiving difficulty and total mood disturbance were regressed on two- and three-way interaction terms for demand, mutuality, and preparedness, controlling for caregiver age and gender, and the simple effect of each independent variable. Negligible effects for two-way interactions were found. However, the three-way interaction between demand, mutuality, and preparedness explained statistically significant variance in both perceived difficulty of caregiving and total mood disturbance. High mutuality in combination with high preparedness protected caregivers from adverse outcomes when demand was high. When either mutuality or preparedness was low, caregivers were at greater risk for negative outcomes when demand was high, but not when demand was low. When both mutuality and preparedness were low, caregivers were at risk for mood disturbance even when demand was low. Analysis of three-way interactions provided new theoretical insights into the protective effects of mutuality and preparedness and demonstrated conditions under which caregivers are at increased risk for negative outcomes.

  11. Family Dynamics and Personal Strengths among Dementia Caregivers in Argentina

    PubMed Central

    Elnasseh, Aaliah G.; Trujillo, Michael A.; Peralta, Silvina Victoria; Stolfi, Miriam E.; Morelli, Eliana; Perrin, Paul B.

    2016-01-01

    This study examined whether healthier family dynamics were associated with higher personal strengths of resilience, sense of coherence, and optimism among dementia caregivers in Argentina. Caregivers are usually required to assist individuals with dementia, and family members have typically fulfilled that role. Personal strengths such as resilience, sense of coherence, and optimism have been shown to protect caregivers from some of the negative experiences of providing care, though the family-related variables associated with these personal strengths are largely unknown. Hierarchical multiple regressions investigated the extent to which family dynamics variables are associated with each of the caregiver personal strengths after controlling for demographic and caregiver characteristics. A sample of 105 caregivers from Argentina completed a set of questionnaires during a neurologist visit. Family dynamics explained 32% of the variance in resilience and 39% of the variance in sense of coherence. Greater family empathy and decreased family problems were uniquely associated with higher resilience. Greater communication and decreased family problems were uniquely associated with higher sense of coherence. Optimism was not found to be significantly associated with family dynamics. These results suggest that caregiver intervention research focused on the family may help improve caregiver personal strengths in Argentina and other Latin American countries. PMID:27413574

  12. Family Dynamics and Personal Strengths among Dementia Caregivers in Argentina.

    PubMed

    Elnasseh, Aaliah G; Trujillo, Michael A; Peralta, Silvina Victoria; Stolfi, Miriam E; Morelli, Eliana; Perrin, Paul B; Arango-Lasprilla, Juan Carlos

    2016-01-01

    This study examined whether healthier family dynamics were associated with higher personal strengths of resilience, sense of coherence, and optimism among dementia caregivers in Argentina. Caregivers are usually required to assist individuals with dementia, and family members have typically fulfilled that role. Personal strengths such as resilience, sense of coherence, and optimism have been shown to protect caregivers from some of the negative experiences of providing care, though the family-related variables associated with these personal strengths are largely unknown. Hierarchical multiple regressions investigated the extent to which family dynamics variables are associated with each of the caregiver personal strengths after controlling for demographic and caregiver characteristics. A sample of 105 caregivers from Argentina completed a set of questionnaires during a neurologist visit. Family dynamics explained 32% of the variance in resilience and 39% of the variance in sense of coherence. Greater family empathy and decreased family problems were uniquely associated with higher resilience. Greater communication and decreased family problems were uniquely associated with higher sense of coherence. Optimism was not found to be significantly associated with family dynamics. These results suggest that caregiver intervention research focused on the family may help improve caregiver personal strengths in Argentina and other Latin American countries.

  13. Caregiver burden among Iranian heart failure family caregivers: A descriptive, exploratory, qualitative study

    PubMed Central

    Bahrami, Masoud; Etemadifar, Shahram; Shahriari, Mohsen; Farsani, Alireza Khosravi

    2014-01-01

    Background: Living with patients of chronic diseases such as heart failure (HF) is a difficult situation for the caregivers. This study explored the Iranian family caregivers’ burden of caregiving for patients with HF. Materials and Methods: Eighteen family caregivers of the HF patients from two governmental medical training centers in Isfahan, Iran were recruited using purposive sampling. Data were collected through face-to-face semi-structured interviews. Each interview was transcribed verbatim and was thematically analyzed concurrently. Results: Four major themes emerged from the analysis of the transcripts: Lack of care-related knowledge, physical exhaustion, psychosocial exhaustion, and lack of support. Family caregivers believed that they have little knowledge about the patients’ disease, drugs, and how to perform caregiving roles. They experienced negative physical and psychosocial consequences of full-time and highly extended caregiving roles, such as musculoskeletal disorder, fatigue, and sleep disturbance, and a high level of anxiety, stress, and social isolation. Caregivers believed that they receive little familial and organizational support on the emotional and financial dimensions of caregiving. Conclusions: The findings of this study can be used by healthcare providers, especially nurses, to provide more effective social, informational, and professional support for family caregivers. PMID:24554961

  14. Family Caregiver's Perception of Alzheimer's disease and caregiving in Chinese culture.

    PubMed

    Dai, Baozhen; Mao, Zongfu; Wu, Bei; Mei, Y John; Levkoff, Sue; Wang, Huali

    2015-01-01

    This study examined the perception of Alzheimer's disease (AD) and caregiving among family caregivers of individuals with mild cognitive impairment (MCI) and AD in China. In-depth semistructured interviews were conducted with 46 family caregivers of individuals with cognitive impairment in 2009 in Wuhan and Beijing, China. Participants included 38 spouses, 7 adult children, and 1 sibling, aged between 41 and 85 years old. The findings showed that all family caregivers thought the Chinese terminology of AD laonian chidai, brought discrimination to individuals with cognitive impairment. Caregivers of individuals with AD experienced burden and desired an increase of formal services. Traditional beliefs of respecting elders and caring for extended family members were held among family caregivers of individuals with cognitive impairment, and there was nearly no difference found between caregivers of AD and those of MCI. It implied that traditional culture provided positive influences on caring for elders with cognitive impairment. An alternative term for MCI may contribute to further reducing the discrimination brought by the old Chinese terminology of AD laonian chidai. Development of formal services for elders with cognitive impairment may contribute to reducing caregivers' worries about future caregiving.

  15. Family Caregiver Training Program (FCTP): A Randomized Controlled Trial.

    PubMed

    DiZazzo-Miller, Rosanne; Winston, Kristin; Winkler, Sandra L; Donovan, Mary L

    The purpose of this study was to examine the effectiveness of the Family Caregiver Training Program (FCTP) for caregivers of people with dementia. A random assignment control group research design with a 3-mo follow-up was implemented. Thirty-six family caregivers of people with dementia demonstrated an increase in activity of daily living (ADL) knowledge (p < .001) and maintenance of that knowledge 3 mo posttest. Caregiver confidence, regardless of group assignment, improved; however, it was not maintained. Burden, depression, and occupational performance and satisfaction remained unchanged for the intervention group; however, physical health as it pertained to quality of life improved 3 mo posttest (p < .001). Findings demonstrate that the FCTP can effectively provide knowledge to family caregivers on how to assist people with dementia with ADLs. Even when standard care was provided, there was limited information on ADLs that family caregivers faced daily.

  16. The Caregiving Experience in a Racially Diverse Sample of Cancer Family Caregivers

    PubMed Central

    Siefert, Mary Lou; Williams, Anna-leila; Dowd, Michael F.; Chappel-Aiken, Lolita; McCorkle, Ruth

    2009-01-01

    The literature supports a variety of predictor variables to account for the psychological and stress burden experienced by cancer family caregivers. Missing among the predictor variables are the differences by or influence of race/ethnicity. The purpose of this study was to describe the sample, explore differences in outcomes by patient and family caregiver characteristics, and determine if any of the patient and family characteristics, including race/ethnicity, predicted outcomes. Cross-sectional surveys were used to determine sociodemographics, psychological and physical health, and burdens of caregiving among 54 caregivers. The analysis consisted of descriptive methods, including frequencies and t tests, and regression modeling. The sample was 35% African American or Hispanic. African American and Hispanic caregivers were younger than white caregivers and more often women, were rarely the spouse of the patient, and frequently had other dependents, including children and older parents. African American and Hispanic caregivers reported lower incomes and more burden related to finances and employment than did white caregivers. When controlling for sociodemographic factors, there was no difference by race/ethnicity on the outcome measures. The experience of caregiving may supersede race/ethnicity and may be its own cultural entity. Areas of concern include the interrelationship between socioeconomic status and race/ethnicity, the absence of cultural frameworks to direct caregiver research, and the question of cultural relevance of measurement tools. PMID:18772665

  17. Lived experiences of family caregivers of mentally ill relatives.

    PubMed

    Chang, Kam Hock; Horrocks, Stephen

    2006-02-01

    The aim of this paper is to report a study conducted to explore the meanings of the lived experiences that Chinese family caregivers in Malaysia ascribed to the care they provided to relatives with severe and persistent mental illness. In the past, many researchers have used quantitative approaches to explore the experiences of family caregivers of relatives with severe and persistent mental illness. However, the results of these studies have been far from conclusive because of serious methodological flaws. In addition, a large majority of these studies were conducted in western cultures, and it has been difficult to transfer the results to family caregivers in oriental cultures. The philosophy of Martin Heidegger underpinned the study. Qualitative data were collected mainly through in-depth interviews with 19 criterion-selected Chinese family caregivers of relatives with severe and persistent mental illness in 2002. We present the emergent themes reflecting the meaning structures of managing, enduring, and surviving the day-to-day experiences of the Chinese family caregivers. The impact of the stigma of the relatives' mental illness on family caregivers and families is pervasive and strong. As a result, family caregivers tried to avoid talking about their relative's mental illness with extended family or friends in order to protect their families from 'losing face'. In addition, most family caregivers believed that adopting positive behaviours and attitudes helped them cope with caregiving. Mental health nurses need to help Chinese family caregivers to cope with the stresses and stigmas of their relatives' mental illnesses through psychosocial education or family intervention, and to provide them with culturally-congruent care. They should also educate the public about mental health and ill health through health promotion and education.

  18. Potentially preventable hospitalizations in dementia: family caregiver experiences.

    PubMed

    Sadak, Tatiana; Foster Zdon, Susan; Ishado, Emily; Zaslavsky, Oleg; Borson, Soo

    2017-07-01

    Health crises in persons living with dementia challenge their caregivers to make pivotal decisions, often under pressure, and to act in new ways on behalf of their care recipient. Disruption of everyday routines and heightened stress are familiar consequences of these events. Hospitalization for acute illness or injury is a familiar health crisis in dementia. The focus of this study is to describe the lived experience of dementia family caregivers whose care recipients had a recent unplanned admission, and to identify potential opportunities for developing preventive interventions. Family caregivers (n = 20) of people with dementia who experienced a recent hospitalization due to an ambulatory care sensitive condition or fall-related injury completed phone interviews. Interviews used semi-structured protocols to elicit caregivers' reactions to the hospitalization and recollections of the events leading up to it. Analysis of interview data identified four major themes: (1) caregiver is uncertain how to interpret and act on the change; (2) caregiver is unable to provide necessary care; (3) caregiver experiences a personal crisis in response to the patient's health event; (4) mitigating factors may prevent caregiver crises. This study identifies a need for clinicians and family caregivers to work together to avoid health crises of both caregivers and people with dementia and to enable caregivers to manage the health of their care recipients without sacrificing their own health and wellness.

  19. Nutrition Education for Family Practice Residents.

    ERIC Educational Resources Information Center

    Dappen, Alan; And Others

    1986-01-01

    The American Academy of Family Practice requires that nutrition be taught to residents throughout their three-year residencies, although it does not specify a block of nutrition instruction. The nutrition knowledge of residents in eight family practice residencies in California were examined. (MLW)

  20. Caregiving activities closely associated with the development of low-back pain among female family caregivers.

    PubMed

    Suzuki, Kishiko; Tamakoshi, Koji; Sakakibara, Hisataka

    2016-08-01

    To describe what effects low back pain has on the daily lives of female family caregivers and to elucidate the caregiving factors associated with its development. Low back pain is a common musculoskeletal symptom in caregivers. However, few detailed studies have examined the association of low back pain with the daily lives of female family caregivers or which caregiving activities lead to their low back pain. The elucidation of these issues will contribute to the prevention and treatment of their low back pain. A cross-sectional study. Japanese female family caregivers (n = 156) completed a self-administered questionnaire assessing lifestyle, health status, daily activity and caregiving situation. Correlation analysis measured the association between low back pain and daily activity. Logistic regression analysis identified care activities related to low back pain. Thirty-five (22·4%) participants almost always experienced low back pain. The severity of low back pain was significantly and positively associated with difficulty in daily activities, especially bending and extending the lower back. As for care situation factors and caregiving activities, night care, assisting the family member to stand up and to lie down, dealing with problem behaviours, and taking medication were associated with the development of low back pain. After reclassifying the respective caregiving activities, those involving body repositioning and those mainly performed in a static position showed significant associations. Low back pain in female family caregivers negatively affects their daily activities and certain caregiving activities are involved in the development of low back pain. Clinical nurses understand the situation of female caregivers and could prevent the development of low back pain with early intervention by providing adequate strategies to alleviate the burden of identified care activities related to low back pain. © 2016 John Wiley & Sons Ltd.

  1. Compassion fatigue in family caregivers: a Wilsonian concept analysis.

    PubMed

    Lynch, Susan H; Lobo, Marie L

    2012-09-01

    An analysis of the concept of compassion fatigue in family caregivers. The term 'compassion fatigue' is predominantly used with professional caregivers, such as nurses, doctors and social workers. Secondary traumatic stress, burnout, and other related terms are often cited in the literature in conjunction with compassion fatigue. Although compassion fatigue is linked to professional caregivers as a result of exposure to traumatizing events, minimal knowledge has been developed regarding its presence in family caregivers. Literature published between 1980-2010 from the humanities, nursing and the social sciences, including psychology, sociology, social work, and religion, was reviewed. Data sources included dictionaries, newspapers and multiple academic databases, such as Academic Search Complete, Atla, CINAHL, PsychInfo, and PubMed. Wilson's concept analysis strategy was employed to frame the analysis of compassion fatigue, using model, contrary, related, and borderline cases to illustrate the concept's meaning in relation to family caregivers. Analysis revealed that the concept is predominantly used in relation to healthcare providers. Parallels are drawn between the role of healthcare providers and family caregivers. Compassion fatigue occurs when a care-giving relationship founded on empathy potentially results in a deep psychological response to stress that progresses to physical, psychological, spiritual, and social exhaustion in the family caregiver. This concept analysis clarified the definition and revealed that the concept of compassion fatigue has potential use with family caregivers. Implications for practice and research are identified. © 2012 Blackwell Publishing Ltd.

  2. Trends Impacting Public Policy Support for Caregiving Families

    ERIC Educational Resources Information Center

    Singer, George H. S.; Biegel, David E.; Ethridge, Brandy L.

    2010-01-01

    Public policy aimed at supporting the caregiving capacity of families has risen to prominence on the public agenda in the United States. Initiatives at the state and federal levels have created some initial services. Three trends that are pushing the issue of family caregiving to the surface are discussed, including large-scale social,…

  3. 78 FR 66617 - National Family Caregivers Month, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-05

    ... Documents#0;#0; ] Proclamation 9053 of October 31, 2013 National Family Caregivers Month, 2013 By the... Family Caregivers Month, we thank these tireless heroes for the long, challenging work they perform... system, our workplaces, and our communities. This month, as we reflect on the generosity, grace,...

  4. Trends Impacting Public Policy Support for Caregiving Families

    ERIC Educational Resources Information Center

    Singer, George H. S.; Biegel, David E.; Ethridge, Brandy L.

    2010-01-01

    Public policy aimed at supporting the caregiving capacity of families has risen to prominence on the public agenda in the United States. Initiatives at the state and federal levels have created some initial services. Three trends that are pushing the issue of family caregiving to the surface are discussed, including large-scale social,…

  5. Family Caregivers' Patterns of Positive and Negative Affect

    ERIC Educational Resources Information Center

    Robertson, Suzanne M.; Zarit, Steven H.; Duncan, Larissa G.; Rovine, Michael J.; Femia, Elia E.

    2007-01-01

    Stressful and positive family caregiving experiences were examined as predictors of caregivers' patterns of positive and negative affect in a sample of families providing care for a relative with dementia (N = 234). Four affect pattern groups were identified: (a) Well Adjusted (i.e., high positive affect, low negative affect); (b) Ambiguous (i.e.,…

  6. Feasibility of a multidisciplinary caregiving training protocol for young caregivers in families with ALS.

    PubMed

    Kavanaugh, Melinda S; Howard, Megan; Banker-Horner, Lori

    2017-09-22

    Feasibility of a multidisciplinary caregiving training protocol for young caregivers in families with ALS. To assess the feasibility of a multidisciplinary young caregiver group training protocol for children and youth who provide care to a family member with ALS. Peer group experiential young caregiver model based on theories of self-management and self-efficacy. Training conducted by a multidisciplinary team of therapists in ALS (PT, OT, Speech and social work), as well as assistive device vendors. Demographic data, caregiving tasks and evaluations were collected. The model is feasible for both youth and therapists. Youth found benefit, skill acquisition, and mastery by asking questions, teaching back skills to the group and engaging with peers. This project demonstrates young caregivers will participate in training, and engage with "like" peer group. Future projects will focus on developing a structured survey and observation, testing efficacy in larger groups.

  7. Relationships Between Caregiver Violence Exposure, Caregiver Depression, and Youth Behavioral Health Among Homeless Families

    PubMed Central

    McGuire-Schwartz, Mandy; Small, Latoya A.; Parker, Gary; Kim, Patricia; McKay, Mary

    2015-01-01

    Homelessness affects a large and increasing number of families in the United States, and exposure to violence and other potentially traumatic events is common among homeless families. It is important to understand more about this population and, more specifically, about the relationship between youth mental health and caregiver mental health and trauma exposure among homeless families, in order to better serve the needs of this vulnerable population. The objective of this study is to explore the relationships between caregiver exposure to violence, caregiver depression, and youth depression and behavioral problems among homeless families. Preliminary findings indicate that among this sample of homeless families, caregiver violence exposure has statistically significant relationships with both youth behavioral problems and youth depression symptoms, as mediated by caregiver depression. These findings indicate that youth behavioral health is associated with caregiver mental health, which, in turn, is associated with caregiver trauma exposure. This highlights the importance of taking into account adult mental health while treating youth externalizing and internalizing behaviors and ensuring that caregivers, too, have access to adequate treatment and supports. Furthermore, this treatment should be trauma informed, given the link between trauma and mental health. PMID:26420978

  8. Conveying empathy to hospice family caregivers: Team responses to caregiver empathic communication

    PubMed Central

    Wittenberg-Lyles, Elaine; Oliver, Debra Parker; Demiris, George; Rankin, Anna; Shaunfield, Sara; Kruse, Robin L.

    2012-01-01

    Objective The goal of this study was to explore empathic communication opportunities presented by family caregivers and responses from interdisciplinary hospice team members. Methods Empathic opportunities and hospice team responses were analyzed from biweekly web-based videoconferences between family caregivers and hospice teams. The authors coded the data using the Empathic Communication Coding System (ECCS) and identified themes within and among the coded data. Results Data analysis identified 270 empathic opportunity-team response sequences. Caregivers expressed statements of emotion and decline most frequently. Two-thirds of the hospice team responses were implicit acknowledgments of caregiver statements and only one-third of the team responses were explicit recognitions of caregiver empathic opportunities. Conclusion Although hospice team members frequently express emotional concerns with family caregivers during one-on-one visits, there is a need for more empathic communication during team meetings that involve caregivers. Practice implications Hospice clinicians should devote more time to discussing emotional issues with patients and their families to enhance patient-centered hospice care. Further consideration should be given to training clinicians to empathize with patients and family caregivers. PMID:22554387

  9. Self-Evaluation for Family Day Caregivers.

    ERIC Educational Resources Information Center

    Rodriguez, Dorothy; Albert, Marilyn

    1981-01-01

    Presents an instrument which home-based day caregivers can use to evaluate their caregiving roles. The instrument was derived from criteria field-tested in day care homes. Advice on improving scores is given. (Author/DB)

  10. Family needs and TBI caregiver mental health in Guadalajara, Mexico.

    PubMed

    Leibach, Gillian G; Trapp, Stephen K; Perrin, Paul B; Everhart, Robin S; Cabrera, Teresita Villaseñor; Jimenez-Maldonado, Miriam; Arango-Lasprilla, Juan Carlos

    2014-01-01

    Traumatic brain injury (TBI) is a leading cause of death in Mexico, and Mexican TBI caregivers have been shown to experience significant mental health problems and high levels of family needs. This study investigated the associations between family needs and Mexican TBI caregiver mental health. Ninety TBI caregivers from Guadalajara, Mexico completed measures assessing their own mental health (depression, anxiety, burden, satisfaction with life, and self-esteem) and family needs (physical health, informational, financial, social support, and household). Family health needs were uniquely associated with all indices of caregiver mental health, and household needs were uniquely associated with caregiver depression, burden, and anxiety. Additionally, social support needs were related to caregiver satisfaction with life, informational needs to burden, and financial needs to self-esteem. Interventions for TBI caregivers in Mexico-and likely in other global regions with high levels of familism-should include an emphasis on overall family health, the delineation of family roles regarding household responsibilities, the improvement of social support networks and the social presence of family members, and the provision of complete and relevant information regarding TBI. When these needs are more comprehensively met, caregiver mental health will likely improve.

  11. The Effects of Caregiving on the Family.

    ERIC Educational Resources Information Center

    Bailey, Eric J.; Young, Rosalie F.

    The topic of caregiving was investigated with respect to the burden experienced by primary caregivers of older persons who had recently suffered a myocardial infarction. Structured interviews were completed with 104 primary care providers who were part of a larger National Institute on Aging funded survey. The caregivers were of both sexes and…

  12. The Effects of Caregiving on the Family.

    ERIC Educational Resources Information Center

    Bailey, Eric J.; Young, Rosalie F.

    The topic of caregiving was investigated with respect to the burden experienced by primary caregivers of older persons who had recently suffered a myocardial infarction. Structured interviews were completed with 104 primary care providers who were part of a larger National Institute on Aging funded survey. The caregivers were of both sexes and…

  13. Family caregivers and cancer pain management: a review.

    PubMed

    Meeker, Mary Ann; Finnell, Deborah; Othman, Areej K

    2011-02-01

    Due to the critical role of family caregivers in cancer pain management, this systematic review was undertaken to examine what is known about of their experiences and needs. Searches were conducted using electronic databases, and research reports from 1991 to 2007 were analyzed using a matrix method. Family caregivers were actively engaged in assisting with pain management and experienced significant needs and concerns related to this role. Myths and fears about opioid use remain widespread across cultures studied and across care settings. Family caregivers need education about pain management, training in problem-solving skills, and recognition from providers about their role in pain management. When clinicians better understand and respond to the needs of the family caregivers, they can enhance the quality of life and care outcomes for both patients and their caregivers.

  14. Essential knowledge for family caregivers: a qualitative study.

    PubMed

    Angelo, Jennifer K; Egan, Richard; Reid, Kate

    2013-08-01

    Family caregivers are the backbone of the social care delivery system. With cancer and other life-limiting diseases on the rise, the need for well-informed informal/family caregivers has never been greater. To uncover the information that palliative care teams routinely provide to family caregivers. The methodology used was the nominal group technique, a type of focus group. A total of 17 community palliative care health professionals participated in one of three focus groups. Three themes emerged as dominant priorities for the education of family caregivers: caring for oneself physically, emotionally, and spiritually; learning practical skills; and knowing what to expect and plan for as the family member's health declines. The participants encourage caregivers to meet their own needs as well as care for family members. They help to empower family caregivers by encouraging them to take time for themselves, providing practical information for individual situations, and educating them on the signs and symptoms of approaching death. Successful terminal home care is possible through family caregiver support and empowerment.

  15. Perceived Stress in Family Caregivers of Individuals With Mental Illness.

    PubMed

    Masa'Deh, Rami

    2017-06-01

    The current study aimed to measure the stress levels of family caregivers of individuals with mental illness and compare their stress levels according to the diagnosis and other sociodemographic characteristics. The sample comprised 310 family caregivers of individuals with mental illness in Jordan. Family caregivers completed a demographic checklist and the Arabic version of the Perceived Stress Scale 10-Item (PSS-10) questionnaire. A significant difference was found in PSS-10 levels among family caregivers according to gender, diagnosis of their family member, and time since diagnosis. Female caregivers reported significantly higher stress levels than male caregivers. Family members of individuals with schizophrenia reported the highest stress levels (p < 0.001). Results also indicated that there was a significant negative correlation between PSS-10 levels of family caregivers and time since diagnosis. Investigating stress levels in family members of individuals with mental illness may be helpful when designing interventions to reduce such stress. [Journal of Psychosocial Nursing and Mental Health Services, 55(6), 30-35.]. Copyright 2017, SLACK Incorporated.

  16. [Structural equation model for caregiving experience of families providing care for family members with mental disorders].

    PubMed

    Oh, In Ohg; Kim, Sunah

    2015-02-01

    This study was done to develop and test a structural model for caregiving experience including caregiving satisfaction and caregiving strain in families providing care for family members with a mental disorder. The Stress-appraisal-coping model was used as the conceptual framework and the structural equation model to confirm the path that explains what and how variables affect caregiving experience in these families. In this hypothesis model, exogenous variables were optimism, severity of illness and uncertainty. The endogenous variables were self efficacy, social support, caregiving satisfaction and caregiving strain. Data were collected using structured questionnaires. Optimism and caregiving self-efficacy had significant direct and indirect effects on caregiving satisfaction. Optimism, severity of illness and uncertainty had significant direct and indirect effects on caregiving strain. The modified path model explained effects of optimism on caregiving self-efficacy with social support in the path structure as a mediator. Also, there were direct and indirect effects of optimism and uncertainty on caregiving satisfaction with social support and caregiving self-efficacy in the path structure as a mediators. Results suggest the need to improve caregiving self-efficacy of these families, establish support systems such as a mental health professional support programs for caregiving self-efficacy. Optimism, severity of illness and uncertainty perceived by families need to be considered in the development of support programs in order to increase their effectiveness.

  17. The role of family caregivers in HIV medication adherence.

    PubMed

    Beals, K P; Wight, R G; Aneshensel, C S; Murphy, D A; Miller-Martinez, D

    2006-08-01

    This study examines the role that mid-life and older wives and mothers play in promoting medication adherence among their HIV-infected husbands or adult sons who require daily living assistance. Interviews were conducted with 112 caregiving dyads, with caregivers reporting on their own behaviours and attitudes towards medications, and care-recipients (persons living with HIV [PLH]) providing information about their own adherence practices. By examining how caregiver characteristics, behaviours, and attitudes may influence PLH adherence it is explicitly recognized that caregivers and PLH are linked within a caregiving dyad. Findings indicate that caregivers often remind PLH to take medications, but these reminders are not significantly associated with adherence. Caregivers also report strong attitudes about medication hassles, concerns over treatment failure and general concerns about adherence. Controlling for background characteristics, high perceived adherence hassles on the part of the caregiver were associated with low PLH adherence, providing evidence of shared influence within the caregiving dyad. Adherence interventions may maximize their effectiveness if they consider the role of the family caregiver because these data suggest that caregiver attitudes are linked with PLH adherence behaviours.

  18. Does race influence conflict between nursing home staff and family members of residents?

    PubMed

    Abrahamson, Kathleen; Pillemer, Karl; Sechrist, Jori; Suitor, Jill

    2011-11-01

    This study examines the influence of race on perceived similarity and conflict between nursing home staff and family members of residents. Despite evidence that the caregiving experience varies by race for both family and professional caregivers, little is known about how race plays a role in staff conflict with residents' family members. We used a representative sample of Certified Nursing Assistants (CNAs) to test relationships between race, treatment from family members, similarity to family members in expectations for care by CNAs, and conflicts with family members concerning aspects of resident care. Results of structural equation modeling indicated that race was not a predictor of staff perception of conflict with family members or of poor treatment from residents' families. However, Black nursing assistants were more likely to perceive that their own expectations of nursing care are dissimilar from those of residents' family members. Dissimilarity predicted reports of poor treatment from family members, and poor treatment was a positive predictor of perception of conflict. The personal long-term nature of nursing home care necessitates a high level of connectedness between family caregivers and nursing home staff. Results highlight the importance of establishing organizational pathways for communication of expectations between nursing staff and residents' families.

  19. Caregiving Practice Patterns of Asian, Hispanic, and Non-Hispanic White American Family Caregivers of Older Adults Across Generations.

    PubMed

    Miyawaki, Christina E

    2016-03-01

    This study is a cross-sectional investigation of caregiving practice patterns among Asian, Hispanic and non-Hispanic White American family caregivers of older adults across three immigrant generations. The 2009 California Health Interview Survey (CHIS) dataset was used, and 591 Asian, 989 Hispanic and 6537 non-Hispanic White American caregivers of older adults were selected. First, descriptive analyses of caregivers' characteristics, caregiving situations and practice patterns were examined by racial/ethnic groups and immigrant generations. Practice patterns measured were respite care use, hours and length of caregiving. Three hypotheses on caregiving patterns based on assimilation theory were tested and analyzed using logistic regression and generalized linear models by racial/ethnic groups and generations. Caregiving patterns of non-Hispanic White caregivers supported all three hypotheses regarding respite care use, caregiving hours and caregiving duration, showing less caregiving involvement in later generations. However, Asian and Hispanic counterparts showed mixed results. Third generation Asian and Hispanic caregivers used respite care the least and spent the most caregiving hours per week and had the longest caregiving duration compared to earlier generations. These caregiving patterns revealed underlying cultural values related to filial responsibility, even among later generations of caregivers of color. Findings suggest the importance of considering the cultural values of each racial/ethnic group regardless of generation when working with racially and ethnically diverse populations of family caregivers of older adults.

  20. Family Stigma and Caregiver Burden in Alzheimer's Disease

    ERIC Educational Resources Information Center

    Werner, Perla; Mittelman, Mary S.; Goldstein, Dovrat; Heinik, Jeremia

    2012-01-01

    Purpose: The stigma experienced by the family members of an individual with a stigmatized illness is defined by 3 dimensions: caregiver stigma, lay public stigma, and structural stigma. Research in the area of mental illness suggests that caregivers' perception of stigma is associated with increased burden. However, the effect of stigma on…

  1. Equity Matters: Doing Fairness in the Context of Family Caregiving

    ERIC Educational Resources Information Center

    Lashewicz, Bonnie; Manning, Gerald; Hall, Margaret; Keating, Norah

    2007-01-01

    Although family scholars conceptualize caregiving in terms of networks of carers, little attention has been given to equity within these groups. Siblings comprise a prevalent caregiving network of members who feel responsible for parent care, expect to share these responsibilities with each other, and look to each other to evaluate the fairness of…

  2. Clinical Efficacy of Psychoeducational Interventions with Family Caregivers

    ERIC Educational Resources Information Center

    Limiñana-Gras, Rosa M.; Colodro-Conde, Lucía; Cuéllar-Flores, Isabel; Sánchez-López, M. Pilar

    2016-01-01

    The goal of this study is to investigate the efficacy of psychoeducational interventions geared to reducing psychological distress for caregivers in a sample of 90 family caregivers of elderly dependent (78 women and 12 men). We conducted an analysis of the statistical and clinical significance of the changes observed in psychological health…

  3. Family Stigma and Caregiver Burden in Alzheimer's Disease

    ERIC Educational Resources Information Center

    Werner, Perla; Mittelman, Mary S.; Goldstein, Dovrat; Heinik, Jeremia

    2012-01-01

    Purpose: The stigma experienced by the family members of an individual with a stigmatized illness is defined by 3 dimensions: caregiver stigma, lay public stigma, and structural stigma. Research in the area of mental illness suggests that caregivers' perception of stigma is associated with increased burden. However, the effect of stigma on…

  4. Equity Matters: Doing Fairness in the Context of Family Caregiving

    ERIC Educational Resources Information Center

    Lashewicz, Bonnie; Manning, Gerald; Hall, Margaret; Keating, Norah

    2007-01-01

    Although family scholars conceptualize caregiving in terms of networks of carers, little attention has been given to equity within these groups. Siblings comprise a prevalent caregiving network of members who feel responsible for parent care, expect to share these responsibilities with each other, and look to each other to evaluate the fairness of…

  5. Clinical Efficacy of Psychoeducational Interventions with Family Caregivers

    ERIC Educational Resources Information Center

    Limiñana-Gras, Rosa M.; Colodro-Conde, Lucía; Cuéllar-Flores, Isabel; Sánchez-López, M. Pilar

    2016-01-01

    The goal of this study is to investigate the efficacy of psychoeducational interventions geared to reducing psychological distress for caregivers in a sample of 90 family caregivers of elderly dependent (78 women and 12 men). We conducted an analysis of the statistical and clinical significance of the changes observed in psychological health…

  6. Young Caregivers: Effect of Family Health Situations on School Performance

    ERIC Educational Resources Information Center

    Siskowski, Connie

    2006-01-01

    Recognition, assessment, education, support, and research of young caregivers is yet to be well established throughout the United States. Studies show that as a result of family caregiving, employees miss work, arrive late, have telephone interruptions, and pass up promotions. Education is essentially the work-life of a student. Research among…

  7. Physical and Mental Health Effects of Family Caregiving

    ERIC Educational Resources Information Center

    Schulz, Richard; Sherwood, Paula R.

    2008-01-01

    The associations between physical and psychological health and being an informal caregiver are well established. In this article, "caregiving" denotes care that is provided by a family member or friend rather than by a professional who is reimbursed for services. Clinical observation and early empirical research showed that assuming a caregiving…

  8. Caring for the Family Caregiver: Lessons Learned in Child Health.

    PubMed

    Keilty, Krista; Cohen, Eyal

    2015-01-01

    Policy to support informal caregivers is a critical health policy issue in Canada. Lessons may be learned from the perspectives and experience in the child health field with applicability for all cared-for persons and their informal caregivers. Familycentred care addresses the centrality of the family caregiver in the design and delivery of health services. A life course approach focuses on key periods of transition and downstream effects facing caregivers over their lifetime. The medical home model where care delivery is more coordinated offers potential direct cost savings for both family caregivers and the healthcare system. Models of pediatric home care that focus on promoting caregiver capacity and integration of unregulated providers show the promise of being acceptable and sustainable solutions to increasing demands for caregiver respite. Finally, a number of assumptions that are somewhat unique to the pediatric caregiver experience are explored and/or challenged. These lessons and assumptions may provide insight for policymakers in the development of systems and supports for all cared-for persons and their caregivers in Canada.

  9. Behavioral and Psychosocial Interventions for Family Caregivers

    ERIC Educational Resources Information Center

    Zarit, Steven; Femia, Elia

    2008-01-01

    Gerontologic research in the past 40 years has shown that caring for an older, disabled person affects the health and well-being of the caregiver. This important contribution led to a wide range of programs and services designed to buffer caregivers from the effects of stressors. Many of these programs have been quite innovative. Although…

  10. [Care and chronic illness: family caregiver's viewpoint in northeast Brazil].

    PubMed

    Pinto, Juliana Maria de Sousa; Nations, Marilyn Kay

    2012-02-01

    The provision of care causes stress in everyday family dynamics leading to physical, mental and emotional complications in caregivers and spouses' loss of liberty and/or overwork. Between March and November 2006, this anthropological research examined family caregiving in the context of Chronic Obstructive Pulmonary Disease (COPD). By means of ethnographic interviews, illness narratives and participant observation, the scope was to describe family reorganization and coexistence with the disease and its evolution, caregiver perceptions about patient difficulties and limitations experienced and strategies employed to tackle their illness. Six low-income family caregivers, living in poor, urban areas in the outskirts of the capital city, Fortaleza, Ceará, Brazil, participated in the study. From the Content Analysis, two categories arose: "sharing suffering" and "attitudes and behavior perceived and experienced by caregivers." In-depth narratives revealed marked affection between patients and their family caregivers. Despite poverty, structural violence, unemployment, social prejudice and low salaries endemic in the Northeast of Brazil, the caregivers find effective ways to cope with chronic illness besides creating strategies to diminish suffering caused by the illness.

  11. Family caregivers voice their needs: a photovoice study.

    PubMed

    Angelo, Jennifer; Egan, Richard

    2015-06-01

    Caregivers often are unprepared for their role yet serve as the frontline in the provision of palliative care services. The aim of our study was to explore family caregivers' experiences from their perspective as they cared for dying relatives. Using the Photovoice methodology, ten unpaid family caregivers took photographs depicting issues they experienced as informal caregivers of an ill family member who had less than a year to live. Each participant met with the first author individually four to six times and explained their role as caregiver through photographs and stories. The results were clustered into seven themes: physical demands, emotional/spiritual stress, preparing for the future, securing help, medication management, navigating the agencies, and relationships. Caregivers perform a variety of tasks, often under stress. This study highlights the main areas where problems lie and the areas that palliative care health professionals need to be aware of so they can assist and educate caregivers, with the goal of finding solutions to the burdens of care. The themes were found to be intertwined, showing the complexity of the caregiving role.

  12. Relationships between quality of life and family function in caregiver

    PubMed Central

    2011-01-01

    Background There are caregivers who see their quality of life (QoL) impaired due to the demands of their caregiving tasks, while others manage to adapt and overcome the crises successfully. The influence of the family function in the main caregiver's situation has not been the subject of much evaluation. The aim of this study is to analyse the relationship between the functionality of the family and the QoL of caregivers of dependent relatives. Methods We conducted a cross-sectional study including 153 caregivers. Setting: Two health centers in the city of Salamanca(Spain). Caregiver variables analysed: demographic characteristics, care recipient features; family functionality (Family APGAR-Q) and QoL (Ruiz-Baca-Q) perceived by the caregiver. Five multiple regressions are performed considering global QoL and each of the four QoL dimensions as dependent variables. The Canonical Correspondence Analysis (CCA) was used to study the influence of the family function questionnaire on QoL. Results Family function is the only one of the variables evaluated that presented an association both with global QoL and with each of the four individual dimensions (p < 0.05). Using the CCA, we found that the physical and mental well-being dimensions are the ones which present a closer relationship with family functionality, while social support is the quality dimension that is least influenced by the Family APGAR-Q. Conclusion We find an association between family functionality and the caregiver's QoL. This relation holds for both the global measure of QoL and each of its four individual dimensions. PMID:21496270

  13. Pharmacists teaching in family medicine residency programs

    PubMed Central

    Jorgenson, Derek; Muller, Andries; Whelan, Anne Marie; Buxton, Kelly

    2011-01-01

    Abstract Objective To determine the percentage of family medicine residency programs that have pharmacists directly involved in teaching residents, the types and extent of teaching provided by pharmacists in family medicine residency programs, and the primary source of funding for the pharmacists. Design Web-based survey. Setting One hundred fifty-eight resident training sites within the 17 family medicine residency programs in Canada. Participants One hundred residency program directors who were responsible for overseeing the training sites within the residency programs were contacted to determine the percentage of training sites in which pharmacists were directly involved in teaching. Pharmacists who were identified by the residency directors were invited to participate in the Web-based survey. Main outcome measures The percentage of training sites for family medicine residency that have pharmacists directly involved in teaching residents. The types and the extent of teaching performed by the pharmacists who teach in the residency programs. The primary source of funding that supports the pharmacists’ salaries. Results More than a quarter (25.3%) of family medicine residency training sites include direct involvement of pharmacist teachers. Pharmacist teachers reported that they spend a substantial amount of their time teaching residents using a range of teaching modalities and topics, but have no formal pharmacotherapy curriculums. Nearly a quarter (22.6%) of the pharmacists reported that their salaries were primarily funded by the residency programs. Conclusion Pharmacists have a role in training family medicine residents. This is a good opportunity for family medicine residents to learn about issues related to pharmacotherapy; however, the role of pharmacists as educators might be optimized if standardized teaching methods, curriculums, and evaluation plans were in place. PMID:21918131

  14. Caregiving by Teens for Family Members With Huntington Disease

    PubMed Central

    Williams, Janet K.; Ayres, Lioness; Specht, Janet; Sparbel, Kathleen; Klimek, Mary Lou

    2016-01-01

    The purpose of this report is to describe caregiving by teens for family members with Huntington disease (HD). Thirty-two teens in HD families in the United States and Canada participated in focus groups from 2002 to 2005 in a study to identify concerns and strategies to manage concerns. An unexpected finding was 24 (77%) described caregiving activities. Descriptive analysis of caregiving statements identified themes of Tasks and Responsibilities, Subjective Burden, Caregiving in Context of Personal Risk for HD, and Decisional Responsibility. Teens took an active part in nearly all aspects of care with the exception of contacting health care providers and attending doctors’ appointments. Some described emotional distress, and many provided care knowing they had the potential to develop HD. Teens recognized the need for decisions but lacked the authority to make these decisions. Findings may be relevant for other teens who strive to meet caregiver and student roles and developmental tasks. PMID:19465560

  15. Innovative Program Aims to Improve Support for Cancer Family Caregivers

    Cancer.gov

    An article about an educational program at the City of Hope Cancer Center intended to provide health professionals with the tools and information needed to help family caregivers care for themselves and their loved ones with cancer.

  16. Family caregiver recruitment via social media: challenges, opportunities and lessons.

    PubMed

    Hansen, Dana; Sheehan, Denice K; Stephenson, Pam

    2017-02-02

    Illness blogs are a way seriously ill people communicate publicly about their illness journey. As communication about serious illness increases on social media, it is important to evaluate how this affects the family caregiver. However, identifying and accessing family caregivers remains challenging, especially via social media. The aim of this article is to report the opportunities, challenges and lessons learned from using social media to recruit family caregivers. Recruitment methods included posting study invitations on illness blogs, advertising through Facebook and placing study fliers in the community. Using social media to recruit was inexpensive and provided a wide geographical reach. One important finding was discovering the importance of using language in the recruitment materials that family caregivers could identify with to help deem themselves as eligible to participate in the study.

  17. Gender differences in caregiving among family - caregivers of people with mental illnesses

    PubMed Central

    Sharma, Nidhi; Chakrabarti, Subho; Grover, Sandeep

    2016-01-01

    All over the world women are the predominant providers of informal care for family members with chronic medical conditions or disabilities, including the elderly and adults with mental illnesses. It has been suggested that there are several societal and cultural demands on women to adopt the role of a family-caregiver. Stress-coping theories propose that women are more likely to be exposed to caregiving stressors, and are likely to perceive, report and cope with these stressors differently from men. Many studies, which have examined gender differences among family-caregivers of people with mental illnesses, have concluded that women spend more time in providing care and carry out personal-care tasks more often than men. These studies have also found that women experience greater mental and physical strain, greater caregiver-burden, and higher levels of psychological distress while providing care. However, almost an equal number of studies have not found any differences between men and women on these aspects. This has led to the view that though there may be certain differences between male and female caregivers, most of these are small in magnitude and of doubtful clinical significance. Accordingly, caregiver-gender is thought to explain only a minor proportion of the variance in negative caregiving outcomes. A similar inconsistency characterizes the explanations provided for gender differences in caregiving such as role expectations, differences in stress, coping and social support, and response biases in reporting distress. Apart from the equivocal and inconsistent evidence, there are other problems in the literature on gender differences in caregiving. Most of the evidence has been derived from studies on caregivers of elderly people who either suffer from dementia or other physical conditions. Similar research on other mental illnesses such as schizophrenia or mood disorders is relatively scarce. With changing demographics and social norms men are increasingly

  18. A spiritually based caregiver intervention with telephone delivery for family caregivers of veterans with dementia.

    PubMed

    Bormann, Jill; Warren, Kathleen A; Regalbuto, Laura; Glaser, Dale; Kelly, Ann; Schnack, Judy; Hinton, Lakemba

    2009-01-01

    Caring for veterans with dementia is burdensome for family caregivers. This exploratory study tested the efficacy of an innovative, spiritually based mantram caregiver intervention delivered using teleconference calls. A prospective, within-subjects, mixed-methods, and 3-time repeated-measures design with 36-week follow-up telephone interviews was conducted. Sixteen caregivers (94% women, 94% Whites with mean age 69.2 years, SD = 10.35 years) completed the intervention. Significant effects for time and linear terms were found for decreasing caregiver burden, perceived stress, depression, and rumination and for increasing quality of life enjoyment and satisfaction, all with large effect sizes. Findings suggest that teleconference delivery of a spiritually based caregiver intervention is feasible.

  19. Family caregivers' support needs after brain injury: a synthesis of perspectives from caregivers, programs, and researchers.

    PubMed

    Gan, Caron; Gargaro, Judith; Brandys, Clare; Gerber, Gary; Boschen, Kathryn

    2010-01-01

    There is a dearth of support for family members who assume caregiving responsibilities following acquired brain injury (ABI). This qualitative study broadens the understanding of ABI caregiver support needs through data triangulation from multiple interview sources across different settings. Thirty-nine caregivers across urban and rural settings in Ontario participated in focus groups. Interviews focused on ABI support services received, their utility, access barriers, needed supports, and suggestions for service delivery. Key informant interviews were also held with four US researchers funded through the TBI Model Systems, one Canadian provincial government health official, and representatives from 11 Ontario ABI programs including two brain injury associations. Interviews focused on existing or proposed caregiver programs and gaps in services. A coding framework was developed through content analysis, centring on five themes: coping, supports that worked, supports needed, barriers, and ideal world recommendations. Perspectives from those involved in receiving, providing and researching caregiver interventions following ABI were synthesized to provide a thorough, detailed depiction of the ongoing support needs of caregivers. This convergence of evidence underscores that caregiver support needs transcend geographical boundaries and must be comprehensive, accessible, long-term, and encompass education, emotional, and instrumental support. Recommendations for ABI caregiver support services are offered.

  20. Family, religion, and depressive symptoms in caregivers of disabled elderly

    PubMed Central

    Zunzunegui, M. V.; Beland, F.; Llacer, A.; Keller, I.

    1999-01-01

    STUDY OBJECTIVE: To explain the variations in depressive symptomatology among primary caregivers of community dwelling activities of daily living disabled elderly and to evaluate the role of family and religiosity on the mental health consequences of caregiving in Spain. DESIGN: Cross sectional study. SETTING: City of Leganes in the metropolitan area of Madrid, Spain. PARTICIPANTS: All caregivers of a representative sample of community dwelling activities of daily living disabled persons, aged 65 and over were approached. The response rate was 85% (n = 194). Depression was assessed by the Center for Epidemiologic Studies Depression (CES-D) Scale. MAIN RESULTS: Controlling for caregivers' income, education, health status, and caregiving stress, religiosity was associated with more depressive symptoms among children caregivers while for spouses the association was negative. Emotional support was negatively associated with depression, but instrumental support was not significant. CONCLUSIONS: Depressive symptomatology is frequent among Spanish caregivers of disabled elderly. This study concludes that religiosity and family emotional support play an important part in the mental health of Spanish caregivers. The role of religiosity may be different according to kinship tie and needs further investigation.   PMID:10396484

  1. Interactive use of genograms and ecomaps in family caregiving research.

    PubMed

    Rempel, Gwen R; Neufeld, Anne; Kushner, Kaysi Eastlick

    2007-11-01

    This article argues for the concurrent and comparative use of genograms and ecomaps in family caregiving research. A genogram is a graphic portrayal of the composition and structure of one's family and an ecomap is a graphic portrayal of personal and family social relationships. Although development and utilization of genograms and ecomaps is rooted in clinical practice with families, as research tools they provide data that can enhance the researcher's understanding of family member experiences. In qualitative research of the supportive and nonsupportive interactions experienced by male family caregivers, the interactive use of genograms and ecomaps (a) facilitated increased understanding of social networks as a context for caregiving, (b) promoted a relational process between researcher and participant, and (c) uncovered findings such as unrealized potential in the participant's social network that may not be revealed with the use of the genogram or ecomap alone, or the noncomparative use of both.

  2. American Indian Family Caregivers' Experiences with Helping Elders

    PubMed Central

    Jervis, Lori L.; Boland, Mathew E.; Fickenscher, Alexandra

    2011-01-01

    Abstract In recent years, a vast literature has accumulated on the negative effects on family caregivers of providing care to elders, while relatively little research has explored caregiving as a positive experience. Only a handful of studies have examined any aspect of informal caregiving among American Indians. This mixed methods study explores the negative and positive aspects of providing elder care among 19 northern plains American Indian family members. These caregivers described low levels of burden and high levels of reward, attributable to cultural attitudes toward elders and caregiving, collective care provision, strong reciprocal relationships with elders, enjoyment of elders, and relatively low levels of care provision. Caregiving manifested as part of a complex exchange of assistance rather than a unidirectional provision of assistance from the family member to the elder. That caregiving emerged as such an overwhelmingly positive experience in a community faced with poverty, alcohol disorders, trauma, and cultural traumatization is testimony to the important roles that elders often continue to play in these communities. PMID:21063902

  3. Partners in Caregiving in a Special Care Environment: Cooperative Communication between Staff and Families on Dementia Units

    ERIC Educational Resources Information Center

    Robison, Julie; Curry, Leslie; Gruman, Cynthia; Porter, Martha; Henderson, Charles R., Jr.; Pillemer, Karl

    2007-01-01

    Purpose: This article reports the results of a randomized, controlled evaluation of Partners in Caregiving in a Special Care Environment, an intervention designed to improve communication and cooperation between staff and families of residents in nursing home dementia programs. Design and Methods: Participants included 388 family members and 384…

  4. Partners in Caregiving in a Special Care Environment: Cooperative Communication between Staff and Families on Dementia Units

    ERIC Educational Resources Information Center

    Robison, Julie; Curry, Leslie; Gruman, Cynthia; Porter, Martha; Henderson, Charles R., Jr.; Pillemer, Karl

    2007-01-01

    Purpose: This article reports the results of a randomized, controlled evaluation of Partners in Caregiving in a Special Care Environment, an intervention designed to improve communication and cooperation between staff and families of residents in nursing home dementia programs. Design and Methods: Participants included 388 family members and 384…

  5. Using Narrative Approach for Anticipatory Grief Among Family Caregivers at Home

    PubMed Central

    Toyama, Hiroko; Honda, Akiko

    2016-01-01

    Family caregivers of patients with terminal-stage cancer have numerous roles as caregivers, which can influence their anticipatory grief. The purpose of this study was to clarify how talking to family caregivers of patients with terminal illness using the narrative approach can influence such caregivers’ process of anticipatory grief. We conducted the narrative approach as an intervention with two family caregivers several times and qualitatively analyzed their narratives. The results indicated that these family caregivers had two primary roles—family member and caregiver—and that family caregivers felt trapped in their caregiver role. The narrative approach helped them transition into the role needed for coping with the loss. PMID:28462354

  6. Relationships between Caregiver Violence Exposure, Caregiver Depression, and Youth Behavioral Health among Homeless Families

    ERIC Educational Resources Information Center

    McGuire-Schwartz, Mandy; Small, Latoya A.; Parker, Gary; Kim, Patricia; McKay, Mary

    2015-01-01

    Homelessness affects a large and increasing number of families in the United States, and exposure to violence and other potentially traumatic events is common among homeless families. It is important to understand more about this population and, more specifically, about the relationship between youth mental health and caregiver mental health and…

  7. Relationships between Caregiver Violence Exposure, Caregiver Depression, and Youth Behavioral Health among Homeless Families

    ERIC Educational Resources Information Center

    McGuire-Schwartz, Mandy; Small, Latoya A.; Parker, Gary; Kim, Patricia; McKay, Mary

    2015-01-01

    Homelessness affects a large and increasing number of families in the United States, and exposure to violence and other potentially traumatic events is common among homeless families. It is important to understand more about this population and, more specifically, about the relationship between youth mental health and caregiver mental health and…

  8. Future directions in family and professional caregiving for the elderly.

    PubMed

    Zarit, Steven H; Reamy, Allison M

    2013-01-01

    As the population ages and the expected wave of baby boomers settles into old age, there is a pressing need to examine the people and institutions that care for elders and the ways in which the system will need to adapt during the next 5-10 years to accommodate the needs of the elderly and of their caregivers. This paper examines future directions in this field, identifying the major issues from two perspectives: family caregiving and professional caregiving. Despite extensive research on caregiving, more attention to a series of methodological issues is needed, as is more extensive evaluation of promising intervention models in community and institutional settings. Effective strategies to lower caregiver distress and improve the quality of care can be implemented in efficient ways that manage costs, but the argument for innovations must be made based on efficacy. Copyright © 2012 S. Karger AG, Basel.

  9. Symptom experience of family caregivers of patients with cancer.

    PubMed

    Swore Fletcher, Barbara A; Dodd, Marylin J; Schumacher, Karen L; Miaskowski, Christine

    2008-03-01

    To review the literature on depression, anxiety,sleep disturbance, fatigue, and pain in family caregivers of patients with cancer in the context of the Symptom Management Model (SMM)developed at the University of California, San Francisco (UCSF). Published research studies and systematic reviews from 1990-2007. Studies of depressive symptoms in caregivers of patients with cancer were the most numerous. A limited number of studies examined anxiety, fatigue, sleep disturbance, and pain. Most studies focused on the symptom experience dimension of the UCSF SMM. Based on the small sample sizes, cross-sectional nature of the studies, and lack of comparison groups, little is known about the prevalence and effects of symptoms in caregivers of patients with cancer. Additional research is needed to determine the prevalence, severity, and effects of symptoms on caregivers. Better descriptive, correlational studies will lead to the development of interventions to improve symptom management for this group of caregivers.

  10. The Role of Family Functioning in the Stress Process of Dementia Caregivers: A Structural Family Framework

    ERIC Educational Resources Information Center

    Mitrani, Victoria B.; Lewis, John E.; Feaster, Daniel J.; Czaja, Sara J.; Eisdorfer, Carl; Schulz, Richard; Szapocznik, Jose

    2006-01-01

    Purpose: The purpose of the study was to evaluate the role of family functioning in the stress process in a sample of caregivers of dementia patients by using a structural family framework. The stress-process model of caregiver distress included family functioning as an intervening variable in the relationship between objective burden and…

  11. Fatigue in Family Caregivers of Adult Intensive Care Unit Survivors

    PubMed Central

    Choi, JiYeon; Tate, Judith A.; Hoffman, Leslie A.; Schulz, Richard; Ren, Dianxu; Donahoe, Michael P.; Given, Barbara A.; Sherwood, Paula R.

    2014-01-01

    Context Family caregivers are a vital resource in the recovery of intensive care unit (ICU) survivors. Of concern, the stress associated with this role can negatively affect caregiver health. Fatigue, an important health indicator, has been identified as a predictor of various illnesses, greater use of health services, and early mortality. Examining the impact of fatigue on caregivers’ physical health can assist in identifying critical time points and potential targets for intervention. Objectives To describe self-reported fatigue in caregivers of ICU survivors from patients’ ICU admission to ≤ two weeks, two- and four-months post-ICU discharge. Methods Patient-caregiver pairs were enrolled from a medical ICU. Caregiver fatigue was measured using the Short-Form-36 Health Survey Vitality subscale (SF-36 Vitality). Caregiver psychobehavioral stress responses included depressive symptoms, burden, health risk behaviors, and sleep quality. Patient data included self-reported physical symptoms and disposition (home vs. institution). Results Forty seven patient-caregiver pairs were initially enrolled. Clinically significant fatigue (SF-36 Vitality ≤ 45) was reported by 43% to 53% of caregivers across the time points and these caregivers reported worse scores in measures of depressive symptoms, burden, health risk behaviors and sleep quality, and patients’ symptom burden. In 26 caregivers with data for all time points (55% of the total sample), SF-36 Vitality scores showed trends of improvement when the patient returned home and greater impairment when institutionalization continued. Conclusion In caregivers of ICU survivors, fatigue is common and potentially linked with poor psychobehavioral responses. Worsening fatigue was associated with greater symptom distress and long-term patient institutionalization. PMID:24439845

  12. Ranked motives of long-term care providing family caregivers.

    PubMed

    Beneken Genaamd Kolmer, Deirdre; Tellings, Agnes; Gelissen, John; Garretsen, Henk; Bongers, Inge

    2008-03-01

    Family caregivers provide long-term care to their chronically ill loved ones and as a consequence they experience physical, relational and financial problems. This study investigates how long-term family caregivers rank 12 motives for caregiving. Motives are derived from the views of four philosophical anthropologists and are related to self-reported stress and joy and to several different background characteristics of respondents. Motives that focus on feelings concerning the relationship between caregiver and care recipient are more popular as a first choice than motives stemming from feelings of obligation or a general feeling of happiness and are also more popular than more self-directed motives. An analysis of full ranking data shows that two groups can be distinguished, one group of family caregivers with mixed motives and one group of family caregivers with motives that focus on reciprocal mutually equal relationships. The latter are mainly women taking care for a partner or a child, the former report high levels of stress. Implications for intervention programmes and health policy are being discussed.

  13. The Sociocultural Context of Caregiving Experiences for Vietnamese Dementia Family Caregivers

    PubMed Central

    Nguyen, Kim Hanh; Dao, To Nhu; Vu, Phuoc; Arean, Patricia; Hinton, Ladson

    2015-01-01

    The goal of this qualitative study was to describe the beliefs and experiences of Vietnamese caregivers caring for a family member with dementia and to elicit their ideas about promising interventions. We recruited 10 caregivers from support groups, the Alzheimer’s Association, and local community-based organizations in Northern California. We conducted semi-structured in-depth interviews with all caregivers, as well as a focus group to obtain ideas about supportive strategies. Several themes emerged from the data: (1) Filial piety was influential in caregiving; (2) A sense of loss/grief or trauma was pervasive; and (3) Caregivers had clear sources of stress and sources of support. An overarching theme underlying these three topics was that cultural beliefs, values, and expectations impacted the caregiving experience. Suggestions for promising interventions included education, language-congruent and/or telephone support groups, case management, inclusion of the care recipient in the intervention, and importance of credibility of the intervention. It also may be valuable to include an understanding of cultural values and promotion of spirituality and religion as key components. Findings highlight targets for dementia caregiver interventions to reduce burden and distress in an understudied population. PMID:26617956

  14. Family practice clinics. Survey of family practice residents' attitudes.

    PubMed Central

    Rubenstein, H.; Levitt, C.

    1993-01-01

    All residents of McGill University's Department of Family Medicine were surveyed by mail about their family practice clinic experience. Residents were generally satisfied with their training site and their supervision, but noted problems with volume and diversity of patients, learning certain procedures, and knowledge of community resources. They did not want more family medicine clinic time. PMID:8219838

  15. Caring for bereaved family caregivers: analyzing the context of care.

    PubMed

    Holtslander, Lorraine F

    2008-06-01

    Deaths from cancer will continue to rise with an increasing and aging population. Family caregivers of patients with cancer will face loss, grief, and bereavement as a result. As mandated by cancer and palliative care clinical practice guidelines, support for family caregivers continues through the processes of grief and bereavement to facilitate a positive transition through loss. To provide evidence-based nursing with this population, an analysis of their context of care was undertaken. Key health policies, characteristics of the healthcare delivery system, and the results of research with bereaved palliative caregivers are described. A model of effectiveness, efficiency, and equity is used to examine the situation of bereaved caregivers and to suggest research questions to fill the gaps in what is known about their needs and experience. Bereaved caregivers are at high risk for many distressing symptoms, including depression and sleeplessness, related to a range of complex variables, such as age, gender, social support, resources, and their experiences during caregiving. Current systems of support have not been adequate to meet the needs of this population and very little is known about the caregivers' quality of life, well-being, and health outcomes or how best to provide compassionate and effective nursing care.

  16. Family Caregivers in Cancer: Roles and Challenges (PDQ®)—Health Professional Version

    Cancer.gov

    Expert-reviewed information summary about the challenges faced by family caregivers of cancer patients. This summary focuses on typical caregiver roles and concerns, and helpful interventions for caregivers.

  17. Family Caregivers in Cancer: Roles and Challenges (PDQ®)—Health Professional Version

    Cancer.gov

    Expert-reviewed information summary about the challenges faced by family caregivers of cancer patients. This summary focuses on typical caregiver roles and concerns, and helpful interventions for caregivers.

  18. Social network of family caregivers of disabled and dependent patients.

    PubMed

    Yamashita, Cintia Hitomi; Gaspar, Jaqueline Correia; Amendola, Fernanda; Alvarenga, Márcia Regina Martins; Oliveira, Maria Amélia de Campos

    2014-08-01

    Cross-sectional study that used the Social Network Index and the genogram to assess the social network of 110 family caregivers of dependent patients attended by a Home Care Service in São Paulo, Brazil. Data were analyzed using the test U of Mann-Whitney, Kruskal-Wallis and Spearman correlation. Results were considered statistically significant when p<0,05. Few caregivers participated in activities outside the home and the average number of people they had a bond was 4,4 relatives and 3,6 friends. Caregivers who reported pain and those who had a partner had higher average number of relatives who to trust. The average number of friends was higher in the group that reported use of medication for depression. Total and per capita incomes correlated with the social network. It was found that family members are the primary caregiver's social network.

  19. The Family Caregiver Activation in Transitions (FCAT) Tool: A New Measure of Family Caregiver Self-Efficacy.

    PubMed

    Coleman, Eric A; Ground, Kelly L; Maul, Andrew

    2015-11-01

    Family caregivers play an instrumental role in executing the care plan of patients during care transitions and yet may lack preparation and confidence to be effective. Yet there has been little attempt by health care professionals to identify and strengthen family caregivers' sense of preparation and confidence. The Family Caregiver Activation in Transitions™ (FCAT™) tool was developed to guide the care team in better understanding patient and family needs and deploying appropriate resources accordingly. The development and psychometric testing of the FCAT tool was guided by a "partial credit" Rasch model. The validation was completed in three phases. In Phase 1, cognitive testing was conducted in convenience samples of family caregivers (N=54) participating in support groups in two geographic locations. In Phase 2, pilot testing was conducted (N=50) to determine item fit and item difficulty. In Phase 3, the tool's psychometric properties were examined in two waves of recruitment (N=187; N=247) from Web-based national samples. Participants recommended revising the script, reducing redundancy, and simplifying item structure and language. Analysis of item fit and difficulty guided subsequent item reduction. The estimated person-separation reliability was 0.84. The FCAT tool was developed to foster more productive interactions between health care professionals and family caregivers. Because it was developed with direct input from family caregivers, the items are both relevant to actual experience and relatively easy to understand. Psychometric testing supports the hypothesis that the FCAT tool items function as a unidimensional construct with a high level of reliability. The FCAT tool has the potential to guide interventions intended to enhance family caregiver preparation and confidence, and thereby positively influence clinical practice during care transitions.

  20. Relationships between nurses and family caregivers: partners in care?

    PubMed

    Ward-Griffin, C; McKeever, P

    2000-03-01

    Increasing reliance on family care of elderly people at home calls for a critical analysis of the relationship between formal and informal caregivers. Although much has been written about how health professionals and family caregivers should relate to one another, we know very little about the relationships that develop between them. Using data from a qualitative study, this article illustrates that relationships between community nurses and family members caring for frail elders are complex, dynamic, and multifaceted. Shifting boundaries in caring work leads to changes in nurse-family caregiver relationships, which can be categorized as four distinct, yet interconnected, types: (1) nurse-helper, (2) worker-worker, (3) manager-worker, and (4) nurse-patient. Each type is described, and implications for nursing practice and research are discussed.

  1. Information needs of family caregivers regarding liver transplant candidates.

    PubMed

    Sá, Amanda Silva; Ziviani, Luciana Costa; Castro-E-Silva, Orlando; Galvão, Cristina Maria; Mendes, Karina Dal Sasso

    2016-03-01

    Objective To assess the information needs of family caregivers of candidates on the waiting list for a liver transplant. Methods It is a cross-sectional study conducted in a transplant center in São Paulo State in the period between April and October of 2012. For the assessment of information needed, an instrument submitted to face and content value was used. The caregivers put 10 subjects in order according to their importance and the amount of interest they had in learning about each, prior to the transplant their family member would be subjected to. Sociodemographic characteristics were also recorded. For data analysis, descriptive statistics were used. Results 42 families participated in the study. The information need about liver disease complications, complications after transplantation and care needed after surgery had higher averages. Conclusions Knowing the information needs of caregivers is important to plan teaching-learning strategies aimed at improving assistance to patients and families in transplant programs.

  2. Health of Elderly Mexican American Adults and Family Caregiver Distress

    PubMed Central

    Rote, Sunshine; Angel, Jacqueline L.; Markides, Kyriakos

    2016-01-01

    Using newly available data on family caregivers from a large epidemiological study of elderly Mexican-origin adults (Hispanic Established Population for the Epidemiologic Study of the Elderly [HEPESE], 2010/2011), we identify which types of impairment (functional, psychological, and cognitive) in the elderly individual are associated with family caregiver depressive symptoms. Results from ordinary least squares regressions using 626 caregiver–care recipient dyads demonstrate that more severe mobility limitations (Performance-Oriented Mobility Assessment), social disability (instrumental activities of daily living), neuropsychiatric disturbances related to cognitive decline (Neuropsychiatric Inventory), and depressive symptoms in the elderly subject are positively associated with caregiver psychological distress. Perceived social stress partially accounts for these associations. We also identify certain segments of this caregiver population that are especially vulnerable to burden when caring for a family member with high levels of impairment, namely female and low-income caregivers. These vulnerabilities should be the focus of intervention efforts to reduce stress and improve the emotional and psychological well-being of Mexican-origin caregivers. PMID:25651573

  3. Motivating adult children to provide support to a family caregiver.

    PubMed

    Gopalan, Neena; Miller, Megan M; Brannon, Laura A

    2013-10-01

    This study compared altruistically and egoistically framed messages for encouraging adult children to support a parent providing care for an elderly relative. Undergraduate students imagined their mother filling a caregiving role while reading a message about family caregiving and the physical and psychological stresses it involves. The message encouraged participants to support the caregiver either for altruistic (other-oriented) or egoistic (self-oriented) reasons. Thereafter, participants completed self-assessment surveys of attachment style and willingness to provide support. Securely attached (less self-oriented) participants were not differentially influenced by the two messages. However, insecurely attached (more self-oriented) participants were more willing to help if they received the egoistic message than if they received the altruistic message. Thus, knowledge of a family member's attachment style can be useful for selecting an appropriate method for encouraging caregiver support. Whereas the type of message used does not matter for securely attached individuals, an egoistically framed message may be more influential than an altruistically framed message among insecurely attached individuals. It is important that clinicians work with families to establish appropriate levels of individual commitment to caregiving responsibilities or supportive behaviours such that involvement is beneficial to the health of the caregiver, the care recipient and supporters. Copyright © 2013 John Wiley & Sons, Ltd.

  4. Assisting Cognitively Impaired Nursing Home Residents with Bathing: Effects of Two Bathing Interventions on Caregiving

    ERIC Educational Resources Information Center

    Hoeffer, Beverly; Talerico, Karen Amann; Rasin, Joyce; Mitchell, C. Madeline; Stewart, Babara J.; McKenzie, Darlene; Barrick, Ann Louise; Rader, Joanne; Sloane, Philip D.

    2006-01-01

    Purpose: When cognitively impaired nursing home residents exhibit agitated and aggressive behaviors during bathing, nursing home caregivers are in a unique position to improve residents' experience. This report addresses whether certified nursing assistants (CNAs) who received training in a person-centered approach with showering and with the…

  5. Effects of Guided Care on Family Caregivers

    ERIC Educational Resources Information Center

    Wolff, Jennifer L.; Giovannetti, Erin R.; Boyd, Cynthia M.; Reider, Lisa; Palmer, Sara; Scharfstein, Daniel; Marsteller, Jill; Wegener, Stephen T.; Frey, Katherine; Leff, Bruce; Frick, Kevin D.; Boult, Chad

    2010-01-01

    Purpose: Guided Care (GC) is a model of health care for multimorbid older adults that is provided by a registered nurse who works with the patients' primary care physician (PCP). The purpose of this study was to determine whether GC improves patients' primary caregivers' depressive symptoms, strain, productivity, and perceptions of the quality of…

  6. Effects of Guided Care on Family Caregivers

    ERIC Educational Resources Information Center

    Wolff, Jennifer L.; Giovannetti, Erin R.; Boyd, Cynthia M.; Reider, Lisa; Palmer, Sara; Scharfstein, Daniel; Marsteller, Jill; Wegener, Stephen T.; Frey, Katherine; Leff, Bruce; Frick, Kevin D.; Boult, Chad

    2010-01-01

    Purpose: Guided Care (GC) is a model of health care for multimorbid older adults that is provided by a registered nurse who works with the patients' primary care physician (PCP). The purpose of this study was to determine whether GC improves patients' primary caregivers' depressive symptoms, strain, productivity, and perceptions of the quality of…

  7. [Family caregiver issues: gender, privacy, and public policy perspectives].

    PubMed

    Lee, I; Chou, Fan-Hao; Chen, Chung-Hey

    2011-04-01

    Due to the phenomenon of Taiwan'saging population has made, long-term care has become an issue of increasingly emphasized importance. According to the statistics, the family takes responsibility for most long-term care duties and more than 70% of primary family caregivers are female. In the past, because of gender-based divisions of labor and gender role expectations made, it was taken for granted that females would be the socially preferred family caregivers. Those men who devoting in themselves to such work were regarded as a rare precious. As such, family care signified entailed different life experiences for males and females. Over the years, amendments to the civil code have recognized family care contributions, and the allowance for caregivers underlines that care responsibilities have shifted away from the family to society. Traditional gender divisions of labor today are significantly more blurred; family structures have become smaller in size; female labor in the workplace has increased; and ten-year long-term care plans and long-term care insurance have been successively implemented. These transformations will make labor outsourcing more and more popular and transform family care from a private problem to a pubic policy issue. In the future, family caregivers require consideration and support on a sustained basis. It is also important to improve and monitor the quality of care services. Nurses, the major professional members of long-term care teams, should be concerned over the issue of family care while providing nursing care. They should include family caregivers in the care plan so that they can make sure that patients receive comprehensive and constant care in order to enhance the overall quality of nursing care.

  8. Effects of Guided Care on Family Caregivers

    PubMed Central

    Wolff, Jennifer L.; Giovannetti, Erin R.; Boyd, Cynthia M.; Reider, Lisa; Palmer, Sara; Scharfstein, Daniel; Marsteller, Jill; Wegener, Stephen T.; Frey, Katherine; Leff, Bruce; Frick, Kevin D.; Boult, Chad

    2010-01-01

    Purpose: Guided Care (GC) is a model of health care for multimorbid older adults that is provided by a registered nurse who works with the patients’ primary care physician (PCP). The purpose of this study was to determine whether GC improves patients’ primary caregivers’ depressive symptoms, strain, productivity, and perceptions of the quality of care recipients’ chronic illness care. Design and Methods: A cluster-randomized controlled trial of GC was conducted within 14 PCP teams. The study sample included 196 primary caregivers who completed baseline and 18-month surveys and whose care recipients remained alive and enrolled in the GC study for 18 months. Caregiver outcomes included the following: depressive symptoms (Center for Epidemiological Studies-Depression scale), strain (Modified Caregiver Strain Index), the quality of care recipients’ chronic illness care [Patient Assessment of Chronic Illness Care (PACIC)], and personal productivity (Work Productivity and Activity Impairment questionnaire, adapted for caregiving). Results: In multivariate regression models, between-group differences in depression, strain, work productivity, and regular activity productivity were not statistically significant after 18 months, but GC caregivers reported the overall quality of their recipients’ chronic illness care to be significantly higher (adjusted beta = 0.40, 95% confidence interval : 0.14–0.67). Quality was significantly higher in 4 of 5 PACIC subscales, reflecting the dimensions of goal setting, coordination of care, decision support, and patient activation. Implications: GC improved the quality of chronic illness care received by multimorbid care recipients but did not improve caregivers’ depressive symptoms, affect, or productivity. PMID:19710354

  9. Family Caregiver Role and Burden Related to Gender and Family Relationships

    PubMed Central

    Friedemann, Marie-Luise; Buckwalter, Kathleen C.

    2015-01-01

    This study described and contrasted family caregivers and explored the effect of gender and family relationship on the caregiver’s role perception, workload, burden, and family help. Home care agencies and community organizations assisted with the recruitment of 533 multicultural, predominantly Latino caregivers who were interviewed at home. The Caregiver Identity Theory guided the study. Survey instruments were standardized tools or were constructed and pretested for this study. Descriptive statistics and t-test analyses assisted in describing the sample and multivariate analyses were used to contrast the caregiver groups. Findings suggested a gendered approach to self-appraisal and coping. Men in this predominantly Latino and Caribbean sample felt less burden and depression than women who believed caregiving is a female duty. Family nurses should pay attention to the most vulnerable groups: older spouses resistant to using family and community resources and hard-working female adult children, and assess each family situation individually. PMID:24777069

  10. Certified Nursing Assistants Balancing Family Caregiving Roles: Health Care Utilization Among Double- and Triple-Duty Caregivers.

    PubMed

    DePasquale, Nicole; Bangerter, Lauren R; Williams, Jessica; Almeida, David M

    2016-12-01

    This study examines how certified nursing assistants (CNAs) balancing family caregiving roles-child care (double-duty child caregivers), elder care (double-duty elder caregivers), and both child and elder care (triple-duty caregivers)-utilize health care services relative to nonfamily caregiving counterparts (formal-only caregivers). A sample of 884 CNAs from the Work, Family and Health Study was drawn on to assess the number of acute care (i.e., emergency room or urgent care facility) and other health care (i.e., outpatient treatment or counseling) visits made during the past 6 months. Double-duty elder and triple-duty caregivers had higher acute care utilization rates than formal-only caregivers. CNAs with and without family caregiving roles had similar rates of other health care visits. CNAs providing informal care for older adults have higher acute care visit rates. Given the increasing need for family caregivers and the vital importance of the health of the nursing workforce for the health of others, future research on how double- and triple-duty caregivers maintain their health amidst constant caregiving should be a priority. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. [Needs and expectations of Alzheimer's disease family caregivers].

    PubMed

    Amieva, H; Rullier, L; Bouisson, J; Dartigues, J-F; Dubois, O; Salamon, R

    2012-06-01

    Family members of people suffering from Alzheimer's disease play a major role in providing daily life care for their relatives. Compared to non-caregivers, they present increased risks of mortality as well as psychological and physical co-morbidity. Altered relationships between caregivers and medical staff and dissatisfaction with the quality of help provided tend to increase the risk of depression and anxiety disorders among caregivers. The present study aimed at exploring the needs and expectations of family caregivers of patients with Alzheimer's disease who request medical assistance for their relatives. The present analysis is an ancillary study of a large multicentric controlled randomized study designed to assess the efficacy of three non-pharmacological treatments in Alzheimer's disease, in which 645 mild-to-moderate Alzheimer patients were enrolled. Needs and expectations of the caregivers were assessed with a French scale of patient expectations for medical consultation, the échelle d'attentes en matière de consultations (EAC), completed by caregivers during the inclusion visit. This scale consists in a self-administered 28-item questionnaire concerning four main needs: learning skills to improve daily life management of their relatives; information regarding the disease; improving caregivers' self-confidence; support to improve communication with their relatives. The ten items for which more than 40% of caregivers reported high or very high expectations referred to two main needs: information regarding the disease (treatment, prognosis…) and learning skills in order to improve daily life management of their relative. The predominance of such needs was observed whatever the relationship between the caregiver and the cared relative but seemed to be more pronounced in female spouses and children of patients with Alzheimer's disease. Needs and expectations of Alzheimer's disease family caregivers involve two major aspects: first, information regarding

  12. Question asking by family caregivers in hospice interdisciplinary team meetings.

    PubMed

    Wittenberg-Lyles, Elaine; Oliver, Debra Parker; Demiris, George; Washington, Karla T; Regehr, Kelly; Wilder, Heidi M

    2010-04-01

    This article reports findings from a pilot study that enabled family caregivers to use videophone technology to participate in hospice interdisciplinary team meetings. The goal of the study was to ascertain which issues were important to caregivers and the hospice team. A qualitative content analysis of video-recorded team meetings between team members and caregivers was conducted. In a sample of 12 caregivers in 36 discussions, caregivers asked a total of 137 questions, with the majority being Yes/No questions (45.1%), primarily used to seek clarification (19.6%). Hospice staff asked 396 questions, with the majority consisting of Yes/No questions (66.5%), mainly used to ask about the overall condition of the patient (22.2%). Data from this study suggest that when given the opportunity to participate in hospice team meetings, caregivers will ask questions of hospice staff. In addition, in light of prior research, this study's findings suggest that caregivers may have questions that go unaddressed, specifically regarding pain and medication. Copyright 2010, SLACK Incorporated.

  13. Abuse of older persons with dementia by family caregivers: results of a 6-month prospective study in Hong Kong.

    PubMed

    Yan, Elsie

    2014-10-01

    To examine the association between care recipients' agitated behaviors, family caregivers' burnout, and abuse in community dwelling older Chinese with dementia in Hong Kong. This was a 6-month prospective study. One hundred forty-nine caregivers provided information on their demographic characteristics, care recipients' everyday functioning and agitated behaviors, and caregivers' burnout symptoms. Caregivers were re-interviewed 6 months later and provided information on changes in both care recipients' everyday functioning and agitated behaviors, and verbally and physically abusive behaviors directed at care recipients in the past month. The single most significant variable in predicting abuse at 6-month follow-up was abuse at baseline. In addition, verbal abuse was predicted by more co-residing days, a high level of agitated behavior, and a strong sense of caregiver depersonalization. Care recipients were more likely to be physically abused if they were male, had no chronic conditions other than dementia, and demonstrated a high level of agitated behaviors. Entering caregiver burnout into the model did not modify the association between care recipients' agitated behavior and abuse for either verbal or physical abuse. This study is the first to establish an association between care recipients' agitated behaviors, burnout, and abuse by family caregivers using prospective data. The present results confirmed that care recipients' agitated behaviors and caregivers' symptoms of burnout are associated with family caregivers' abusive behaviors. Caregiver burnout did not mediate the association between agitated behaviors and abuse. Proper management of care recipients' agitated behaviors and adequate support provided to family caregivers may help prevent the development of new cases of elder mistreatment. Copyright © 2014 John Wiley & Sons, Ltd.

  14. Wearable Technology to Garner the Perspective of Dementia Family Caregivers.

    PubMed

    Matthews, Judith T; Campbell, Grace B; Hunsaker, Amanda E; Klinger, Julie; Mecca, Laurel Person; Hu, Lu; Hostein, Sally; Lingler, Jennifer H

    2016-04-01

    Family caregivers of individuals with dementia typically have limited opportunity during brief clinical encounters to describe the dementia-related behaviors and interactions they find difficult to handle. Lack of objective data depicting the nature, intensity, and impact of these manifestations of the underlying disease further constrains the extent to which strategies recommended by nurses or other health care providers can be tailored to the situation. The current article describes a prototype wearable camera system used to gather image and voice data from the caregiver's perspective in a pilot feasibility intervention study conducted with 18 caregiving dyads. Several scenarios are presented that include salient events (i.e., behaviors or interactions deemed difficult by the caregiver or identified as concerning by the research team during screening) captured in the resulting video. The current authors anticipate future wearable camera systems and software will automate screening for salient events, providing new tools for assessment and intervention by nurses.

  15. Distance caregiving a family member with cancer: A review of the literature on distance caregiving and recommendations for future research.

    PubMed

    Douglas, Sara L; Mazanec, Polly; Lipson, Amy; Leuchtag, Mary

    2016-04-10

    Distance caregivers (DCGs) are a growing phenomenon in the United States Family members are struggling to provide care to loved ones with chronic illnesses such as cancer, from a distance. Unlike local caregiving research, distance caregiving research is limited and inconsistent definitions of distance make it difficult to compare studies. To date, DCGs have not been afforded the opportunities for educational and emotional support that local caregivers have received from the health care teams. Because they are not usually present at medical appointments, DCGs do not receive first-hand information from the health care team about the patient's condition, disease progression, and/or treatment options. These caregivers report feeling left out of important family discussions. They experience anxiety related to the uncertainty of the family members' well-being and guilt related to not being available to help local caregivers more. The challenges of distance caregiving are especially evident when the distance caregiver has a parent with advanced cancer. Family-centered care, attending to the needs of the whole family regardless of their geographic location is critical for quality cancer care. In this manuscript, the sparse literature on distance caregiving is reviewed. Recommendations for future research and for the development of creative technologically advanced interventions for this underserved caregiving population are suggested.

  16. Distance caregiving a family member with cancer: A review of the literature on distance caregiving and recommendations for future research

    PubMed Central

    Douglas, Sara L; Mazanec, Polly; Lipson, Amy; Leuchtag, Mary

    2016-01-01

    Distance caregivers (DCGs) are a growing phenomenon in the United States Family members are struggling to provide care to loved ones with chronic illnesses such as cancer, from a distance. Unlike local caregiving research, distance caregiving research is limited and inconsistent definitions of distance make it difficult to compare studies. To date, DCGs have not been afforded the opportunities for educational and emotional support that local caregivers have received from the health care teams. Because they are not usually present at medical appointments, DCGs do not receive first-hand information from the health care team about the patient’s condition, disease progression, and/or treatment options. These caregivers report feeling left out of important family discussions. They experience anxiety related to the uncertainty of the family members’ well-being and guilt related to not being available to help local caregivers more. The challenges of distance caregiving are especially evident when the distance caregiver has a parent with advanced cancer. Family-centered care, attending to the needs of the whole family regardless of their geographic location is critical for quality cancer care. In this manuscript, the sparse literature on distance caregiving is reviewed. Recommendations for future research and for the development of creative technologically advanced interventions for this underserved caregiving population are suggested. PMID:27081643

  17. The role of attitudes and culture in family caregiving for older adults.

    PubMed

    Anngela-Cole, Linda; Hilton, Jeanne M

    2009-01-01

    This study evaluated cultural differences in attitudes toward caregiving and the stress levels of family caregivers. Participants included 98 Japanese American and 86 Caucasian American family caregivers caring for frail elders. Analyses using MANOVA and multiple regression analyses revealed that the Caucasian caregivers had more positive attitudes and provided more hours of care than the Japanese caregivers but that both groups had elevated levels of caregiver stress. The stress that family caregivers currently experience could lead to a future generation of care recipients who enter old age in worse condition than their predecessors. Professionals need to work together to develop culturally appropriate, evidence-based interventions to address this issue.

  18. Resistiveness to Care as Experienced by Family Caregivers Providing Care for Someone With Dementia.

    PubMed

    Spigelmyer, Pamela C; Hupcey, Judith E; Smith, Carol A; Loeb, Susan J; Kitko, Lisa

    2017-09-15

    This research explored family caregivers' lived experiences of resistiveness to care when they provided care for people with dementia. The goal was to identify a general meaning of family caregivers' lived experiences to target potential areas for future nursing interventions to help family caregivers manage their caregiving role and provide a base for future research surrounding resistiveness to care. Descriptive phenomenology was used to provide descriptions of eight family caregivers who provided care for someone with dementia and experienced resistiveness to care. Family caregivers were recruited from Alzheimer's support groups from June to November 2014. Caregiver interviews were transcribed verbatim and analyzed using scientific phenomenology to identify essential constituents of the experience. The identified general meaning structure contained five essential constituents. These included self-questioning of abilities; signal for increased future caregiver responsibilities; changed perception of personal self; unexpected emotional responses; and seeing a changed person, not the disease. Study findings represent family caregivers' lived perceptions of resistiveness to care, which are different from current research findings regarding nurses' perceptions of resistiveness to care. The identified meaning structure indicates focus areas for future research and for nursing interventions to help family caregivers manage their distress when experiencing resistiveness to care. Identification of the meaning caregivers ascribe to their lived experience of resistiveness to care (five essential constituents) provides nurses with opportunities to help family caregivers (coproviders of care) holistically. Supporting caregivers in their caregiving role can decrease caregiver distress when resistiveness to care occurs. © 2017 Sigma Theta Tau International.

  19. New "horizontal" curriculum in family medicine residency.

    PubMed Central

    Tannenbaum, D. W.

    1998-01-01

    PROBLEM ADDRESSED: Opportunities for residents in a family medicine program to experience continuity of care with a group of patients and to be immersed in the role of a family physician were thought by faculty to be insufficient. OBJECTIVES OF THE PROGRAM: To enhance residents' experience of continuity of care with a group of patients; to create a model for training that better simulates clinical practice; and to position core family medicine experiences as the central and continuing focus of the residency program. MAIN COMPONENTS OF THE PROGRAM: The new curriculum replaces block rotations in family medicine with "horizontal" experiences comprising 3 half-days of patient care and 1 half-day seminar each week for all residents through both years of the program. The remaining time in first year is spent on the major disciplines--medicine, pediatrics, emergency, and obstetrics--for which a horizontal family medicine-centred experience has also been introduced. The second-year curriculum is flexible and largely self-directed. Initial evaluations indicate improved continuity of care of family practice patients and broadened clinical exposure for residents. The program has been fully accredited by the College. CONCLUSIONS: A horizontal curriculum in family medicine, designed to address perceived deficiencies in the traditional block rotational model of training, can be developed and implemented in an urban teaching hospital. PMID:9721423

  20. [Evaluation of gender differences of family caregivers with reference to the mode of caregiving at home and caregiver distress in Japan].

    PubMed

    Sugiura, Keiko; Ito, Mikiko; Mikami, Hiroshi

    2004-04-01

    Male caregivers are growing in number, as the frequency of spouse caregiving rapidly increases. This study aimed to examine gender differences in family caregivers with reference to the mode of caregiving and caregiver distress in Japan. It was designed to clarify the characteristics of both female and male caregivers. The subjects were 2,020 users of public Long-term Care Insurance, randomly stratified and sampled in Higashi-osaka city, Osaka prefecture. Data were collected through mailed, anonymous self-report questionnaires. 1,287 (63.7%) surveys were collected and data from 868 caregivers and care recipients were analyzed, after excluding incomplete cases from 947 participants who were family caregivers. We compared males and females for the level of nursing needs, cognitive disorders of their care recipients, the types and amounts of care provided, the levels of their burdens and the depression associated with providing care, the availability of informal support, the frequency of usage of Long-term care insurance services, and the types of stress coping strategies. Of the total, 27.1% of the caregivers were male. Their age was higher than that of females, but the age of care recipients of female caregivers was significantly higher than that of care recipients of males. There were no significant gender differences in the level of nursing needs of recipients. However, cognitive disorders of care recipients of female caregivers were more severe. Female caregivers spent more time providing care, and performed a greater number of care activities. In particular, female caregivers assisted their care recipients in taking medications, dressing, bathing, eating, meal preparation, shopping, laundry, and money management more often to a significant degree. Furthermore, the average scores for burden and depression were higher in female than in male caregivers. Concerning the usage of Long-term care insurance services, males used a Home-helper service more often. Female

  1. Cardiometabolic risk factors and health behaviors in family caregivers

    PubMed Central

    Shamburek, Robert; Wehrlen, Leslie; Klagholz, Stephen D.; Yang, Li; Stoops, Elyssa; Flynn, Sharon L.; Remaley, Alan T.; Pacak, Karel; Shelburne, Nonniekaye; Bevans, Margaret F.

    2017-01-01

    The purpose of this study was to compare components of cardiometabolic risk and health behaviors of 20 family caregivers of allogeneic hematopoietic stem cell transplant patients to those of age, gender, and race/ethnicity-matched controls. A prospective, repeated measures design was used to compare cardiometabolic risk and health behaviors in caregivers and controls at three time-points: pre-transplantation, discharge, and six weeks post-discharge. Measures included components of metabolic syndrome, Reynolds Risk Score, NMR serum lipoprotein particle analyses, and the Health-Promoting Lifestyle Profile II (HPLP-II). Mixed-model repeated measure analyses were used. There were no between or within group differences in LDL cholesterol, HDL cholesterol, and triglycerides. There was a significant interaction effect between time and role in large VLDL concentration (VLDL-P) (F (2, 76) = 4.36, p = .016), with the trajectory of large VLDL-P increasing over time in caregivers while remaining stable in controls. Within caregivers, VLDL particle size (VLDL-Z) was significantly larger at time-point three compared to time-points one (p = .015) and two (p = .048), and VLDL-Z was significantly larger in caregivers than in controls at time point three (p = .012). HPLP-II scores were lower in caregivers than controls at all time-points (p < .01). These findings suggest that caregiving may have a bigger impact on triglycerides than on other lipids, and it is through this pathway that caregivers may be at increased cardiometabolic risk. More sensitive measurement methods, such as NMR lipoprotein particle analyses, may be able to detect early changes in cardiometabolic risk. PMID:28472106

  2. The roles of unmet needs and formal support in the caregiving satisfaction and caregiving burden of family caregivers for persons with dementia.

    PubMed

    Park, Myonghwa; Choi, Sora; Lee, Song Ja; Kim, Seon Hwa; Kim, Jinha; Go, Younghye; Lee, Dong Young

    2017-09-28

    A growing number of studies are emphasizing the importance of positive and negative appraisals of caregiving and the utilization of social resources to buffer the negative effects of caring for persons with dementia. By assessing the roles of unmet needs and formal support, this study tested a hypothesized model for Korean family caregivers' satisfaction and burden in providing care for persons with dementia. The stress process model and a two-factor model were used as the conceptual framework for this study. Data for 320 family caregivers from a large cross-sectional survey, the Seoul Dementia Management study, were analyzed using structural equation modeling. In the hypothesized model, the exogenous variables were patient symptoms, including cognitive impairment, behavioral problems, and dependency on others to help with activities of daily living and with instrumental activities of daily living. The endogenous variables were the caregiver's perception of the unmet needs of the patient, formal support, caregiving satisfaction, and caregiving burden. The adjusted model explained the mediating effect of unmet needs on the relationship between patient symptoms or formal support and caregiving satisfaction. Formal support also had a mediating effect on the relationship between patient symptoms and unmet needs. Patient symptoms and caregiving satisfaction had a significant direct effect on caregiving burden. The level of unmet needs of persons with dementia and their family caregivers must be considered in the development of support programs focused on improving caregiving satisfaction.

  3. Positive appraisal of in-home family caregivers of dementia patients as an influence on the continuation of caregiving.

    PubMed

    Kajiwara, Kohei; Nakatani, Hisae; Ono, Mitsu; Miyakoshi, Yukiko

    2015-03-01

    We attempted to determine the factors that influence the continuation of in-home caregiving for patients with dementia. The participants were family caregivers of dementia patients who received home care services. Data were collected via a questionnaire completed by caregivers and then returned in the mail. Of the 705 caregivers who received the questionnaire, 405 completed and returned it (response rate: 57.4%). The average age of the caregivers was 63.9 ± 11.5 years, and they had been providing care for an average of 5.1 ± 4.1 years. The average age of the patients was 84.7 ± 7.4 years. We analyzed the path model. Caregivers' current feelings about continuing caregiving were directly affected by a positive appraisal of caregiving (β = 0.20, P < 0.001) and by the burden they experienced (β = -0.39, P < 0.001). The continuation of caregiving of patients with worsening symptoms was directly affected by a positive appraisal of caregiving (β = 0.15, P < 0.01) and by the burden experienced by the caregivers (β = -0.46, P < 0.001). The continuation of caregiving was indirectly affected by the patients' cognitive impairment and by the behavioral and psychological symptoms of dementia score. The continuation of in-home caregiving among caregivers of patients with dementia was affected by both positive appraisal and caregiver burden. In addition, the present study revealed that behavioral and psychological symptoms of dementia score indirectly affects the continuation of caregiving by directly affecting caregiver burden. © 2014 The Authors. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.

  4. [Subjective physical and mental health characteristics of male family caregivers].

    PubMed

    Nagai, Kuniyoshi; Hori, Yoko; Hoshino, Junko; Hamamoto, Rituko; Suzuki, Yoko; Sugiyama, Akiko; Niimi, Yukari; Kondo, Takaaki; Tamakoshi, Koji; Sakakibara, Hisataka

    2011-08-01

    Due to the increased population of elderly people requiring care and assisted living care, as well as changes in the social structure, the number of males playing a role in home care has therefore been increasing each year. The purpose of this study was to clarify characteristics related to subjective mental and physical health of male family caregivers based on a comparison with male non-caregivers. The subjects comprised 52 male family caregivers (caregiver group) who provide care for those requiring at-home care at level 3 or above, or who provided care for people with dementia in cases at a level below 3, with an average age and standard deviation of 69.3 +/- 10.9 years old. The comparison group comprised 52 people who underwent regular health checkups in K city, whose gender and ages, by 10-year age group, were matched to the subjects on a 1:1 basis, and whose average age and standard deviation were 69.2 +/- 11.1 years old. The research was conducted over ther period from December 2005 to April 2007. The survey was conducted with a self-answering format, and subjects were asked questions about such matters as lifestyle, QOL, psychosocial stress and coping with stress. The average age of people requiring care was 75.7 +/- 9.5 years old, and it became apparent that elderly caregivers generally provide care for other elderly people. In a health-related QOL (SF-8), care-giver group were significantly low in "General Health" and "Bodily Pain" in the physical health domain. In the mental health domain, "Mental Health" and mental health summary score of the care-giver group were significantly low. Regarding lifestyle, it was apparent that the care-giver group had significantly fewer sleeping hours than the control group and the PSQI score was also lower. Coping scores were significantly low for the caregiver group regarding 2 items, "Evasive Thinking" and "Recreation", and this indicated a tendency toward not adopting an evasive type of coping. It became clear that

  5. Group Intervention for Dementia Family Caregivers: A Longitudinal Perspective.

    ERIC Educational Resources Information Center

    Haley, William E.

    1989-01-01

    Conducted longitudinal follow-up to previously published experimental study of effectiveness of group intervention for dementia family caregivers. Found methodological and clinical issues relevant to future studies included issues of differential attrition from treatment, selection of participants,and need for measures appropriate to long-term…

  6. Group Intervention for Dementia Family Caregivers: A Longitudinal Perspective.

    ERIC Educational Resources Information Center

    Haley, William E.

    1989-01-01

    Conducted longitudinal follow-up to previously published experimental study of effectiveness of group intervention for dementia family caregivers. Found methodological and clinical issues relevant to future studies included issues of differential attrition from treatment, selection of participants,and need for measures appropriate to long-term…

  7. Emotions, Ideas and Experiences of Caregivers of Patients With Schizophrenia About "Family to Family Support Program".

    PubMed

    Bademli, Kerime; Duman, Zekiye Çetinkaya

    2016-06-01

    "Family to Family Support Program" is a significant intervention program to assist families by informing them about treatment procedures and coping strategies, increasing their functionality, helping them to overcome the challenges of the disease. This study was particularly designed to investigate the emotions, thoughts, and experiences of caregivers of schizophrenia patients who participated in "Family to Family Support Program." The study was conducted with one of the qualitative research methods, phenomenological method. The study sample included caregivers who care for schizophrenia patients and participated in the "Family to Family Support Program". Twenty caregivers were included in the sample. The study was carried out in İzmir Schizophrenia Support Association. The study data were collected with four open ended questions. The average age of the participants was 56,77 ± 72,89, 10 male caregivers and 10 female caregivers, 9 caregivers were fathers, 6 caregivers were mothers, and 5 of them were siblings. The thematic analysis indicated that the emotions, thoughts and experiences of caregivers can be categorized in four groups: "I learned to deal with my problems", "I am conscious in my interaction with the patient and I know and I am not alone", "I feel much better", and "Schizophrenia is not the end of the road, knowledge sorts things out." Caregivers who participated in "Family to Family Support Program" expressed their satisfaction that they were benefited from the program, their coping skills were improved, they experienced less challenges when providing care, they understood the disease better, and it felt comfortable. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Caregiver, child, family, and service system contributors to caregiver strain in two child mental health service systems.

    PubMed

    Brannan, Ana María; Heflinger, Craig Anne

    2006-10-01

    Children's mental health researchers are increasingly recognizing the importance of caregiver strain (i.e., the impact on families of caring for children with emotional and behavioral disorders). This study examined the caregiver, child, family, and service variables associated with caregiver strain with special attention to the role of barriers to care. These relationships were compared across enrollees in a managed care Medicaid and a traditional fee-for-service system. Findings indicated that severity of child problems was the most consistent predictor of caregiver strain. Although there was considerable similarity in the variables associated with caregiver strain across the two systems, important differences were also evident. Caregivers in the managed care setting were significantly more likely to report provider/payer-related barriers to care. Provider/payer barriers predicted strain in the managed care sample. In the fee-for-service system, barriers related to family perceptions and inconvenient location and appointment times were significant predictors.

  9. Enhancing the Social Well-Being of Family Caregivers

    PubMed Central

    Otis-Green, Shirley; Juarez, Gloria

    2013-01-01

    Objectives To provide an overview of key issues and resources useful for oncology professionals to support the social-well being of patients and their families. A caregiver narrative highlights examples of the importance of addressing the social impact of illness. Data Sources Review of the literature and websites related to social well-being of oncology patients and families. Conclusions Culture influences social well-being and impacts caregiving across the life span. Coping with cancer creates a myriad of social implications with potentially significant impacts upon communication; sexuality, intimacy and sexual expression; education, finances, work, and leisure. Implications for Nursing Practice Nurses spend the greatest amount of time with patients and their families and therefore have an especially important role in identifying and addressing social needs. An interdisciplinary approach to care that includes the assessment of those at high risk and family meetings increases opportunities to address the complex multidimensional social concerns associated with oncology care. PMID:23107182

  10. Collective Care: Multiple Caregivers and Multiple Care Recipients in Mexican American Families

    PubMed Central

    Evans, Bronwynne C.; Coon, David W.; Belyea, Michael J.; Ume, Ebere

    2016-01-01

    Purpose Specific stressors associated with caregiving in Mexican-American (MA) families are not well documented, yet caregiving issues are paramount because informal care for parents is central to their culture. Although MA families who band together to provide care for one member are not unique, the literature does not describe the phenomenon of collective caregiving, which may be widespread but unrecognized. Such families are both understudied and poorly served by contemporary health systems because their characteristics are unknown. Design Descriptive, multi-site, longitudinal mixed-methods study of MA caregiving families. Findings We identified three types of collective caregivers: those providing care for multiple family members simultaneously; those providing care successively to several family members, and/or those finding themselves obliged to accept care during their caregiving of others. Discussion and Conclusions Collective caregiving of MA elders warrants further investigation. Implications for Practice Exploration of collective caregiving may provide a foundation for tailored family interventions. PMID:27389911

  11. Accessible Support for Family Caregivers of Seniors with Chronic Conditions: From Isolation to Inclusion

    ERIC Educational Resources Information Center

    Stewart, Miriam; Barnfather, Alison; Neufeld, Anne; Warren, Sharon; Letourneau, Nicole; Liu, Lili

    2006-01-01

    Accessible support programs can improve health outcomes for family caregivers of older relatives with a chronic condition. Over the course of 6 months, 27 experienced family caregivers provided weekly support via the telephone to 66 individuals, either new family caregivers of seniors recently diagnosed with stroke or newly vulnerable family…

  12. Accessible Support for Family Caregivers of Seniors with Chronic Conditions: From Isolation to Inclusion

    ERIC Educational Resources Information Center

    Stewart, Miriam; Barnfather, Alison; Neufeld, Anne; Warren, Sharon; Letourneau, Nicole; Liu, Lili

    2006-01-01

    Accessible support programs can improve health outcomes for family caregivers of older relatives with a chronic condition. Over the course of 6 months, 27 experienced family caregivers provided weekly support via the telephone to 66 individuals, either new family caregivers of seniors recently diagnosed with stroke or newly vulnerable family…

  13. Needs and experiences of family caregivers during marrow transplantation.

    PubMed

    Stetz, K M; McDonald, J C; Compton, K

    1996-10-01

    To determine the information needs of family members of people undergoing marrow transplantation as well as their actions to meet those needs. Descriptive, cross-sectional, qualitative design. Marrow transplant units in the Pacific Northwestern United States. 19 adult family members of people who had undergone marrow transplants. Researchers conducted four focus group interviews. Three served as data generation interviews, and the fourth served as the validation interview. A transcriptionist recorded the subjects' responses, which then were analyzed using constant comparative techniques. Themes emerged from the data in five categories: (a) Preparing for Caregiving (seeking and acquiring health care, obtaining information and materials, and evaluating the validity of information), (b) Managing the Care (providing physical care, protecting, maintaining the patient's connection with life, and advocating), (c) Facing Challenges (personal and interpersonal stress, communication barriers with healthcare professionals, and healthcare system barriers), (d) Developing Supportive Strategies (community resources, personal and self-care resources, and healthcare system facilitators), and (e) Discovering Unanticipated Rewards and Benefits (personal growth and family cohesion). Family members, as well as patients undergoing marrow transplant, experience a unique set of information needs and demands as a result of this experience. However, these demands can be mitigated by actions that provide appropriate education strategies and foster a sense of caring and a nurturing way of interacting among the family, healthcare professionals, and the healthcare system. Healthcare professionals need to acknowledge the caregiving role and actively involve and support the family caregiver throughout the transplant experience.

  14. Economic and social changes among distressed family caregivers of lung cancer patients.

    PubMed

    Mosher, Catherine E; Champion, Victoria L; Azzoli, Christopher G; Hanna, Nasser; Jalal, Shadia I; Fakiris, Achilles J; Birdas, Thomas J; Okereke, Ikenna C; Kesler, Kenneth A; Einhorn, Lawrence H; Monahan, Patrick O; Ostroff, Jamie S

    2013-03-01

    Although costs of lung cancer care have been documented, economic and social changes among lung cancer patients' family caregivers have yet to be fully examined. In addition, research has not focused on caregivers with greater need for support services. This study examined various economic and social changes among distressed family caregivers of lung cancer patients during the initial months of cancer care in the USA. Lung cancer patients' primary family caregivers with significant anxiety or depressive symptoms were recruited from three medical centers within 12 weeks of the patient's new oncology visit. Caregivers (N = 83) reported demographic and medical information and caregiving burden at baseline. Seventy-four caregivers reported anxiety and depressive symptoms and economic and social changes 3 months later. Seventy-four percent of distressed caregivers experienced one or more adverse economic or social changes since the patient's illness. Common changes included caregivers' disengagement from most social and leisure activities (56%) and, among employed caregivers (n = 49), reduced hours of work (45%). In 18% of cases, a family member quit work or made another major lifestyle change due to caregiving. Additionally, 28% of caregivers reported losing the main source of family income, and 18% reported losing most or all of the family savings. Loss of the main source of family income and disengagement from most social and leisure activities predicted greater caregiver distress. Findings suggest that distressed caregivers of lung cancer patients experience high rates of adverse economic and social changes that warrant clinical and research attention.

  15. Wearable Technology to Garner the Perspective of Dementia Family Caregivers

    PubMed Central

    Matthews, Judith T.; Campbell, Grace B.; Hunsaker, Amanda E.; Klinger, Julie; Mecca, Laurel Person; Hu, Lu; Hostein, Sally; Lingler, Jennifer H.

    2015-01-01

    Family caregivers of persons with dementia typically have limited opportunity during brief clinical encounters to describe the dementia-related behaviors and interactions that they find difficult to handle. Lack of objective data depicting the nature, intensity, and impact of these manifestations of the underlying disease further constrains the extent to which strategies recommended by nurses or other health care providers can be tailored to the situation. We describe a prototype wearable camera system used to gather image and voice data from the caregiver’s perspective in a pilot feasibility intervention study conducted with 18 caregiving dyads. Several scenarios are presented that incorporate salient events (i.e., behaviors or interactions deemed difficult by the caregiver or identified as concerning by our team during screening) identified in the resulting video. We anticipate that future wearable camera systems and software will automate screening for salient events, providing new tools for assessment and intervention by nurses. PMID:26468655

  16. Differences in COPD Patient Care by Primary Family Caregivers: An Age-Based Study

    PubMed Central

    Hsiao, Peng-Ching; Chu, Chi-Ming; Sung, Pei-Yi; Perng, Wann-Cherng; Wang, Kwua-Yun

    2014-01-01

    Background Because Taiwan has the fastest aging rate among developed countries, care for the elderly is becoming more prominent in the country. Primary family caregivers play an important role in patient health and health promotion behavior. Chronic obstructive pulmonary disease (COPD), an age-related disease, is a major public health problem with high morbidity and mortality and can be a long-term burden for family members; however, little attention has been given to the differences in COPD care between elder caregivers and other caregivers. This study aimed to investigate the differences between elder family caregivers and non-elder family caregivers caring for COPD patients in Taiwan, including caring behavior, caregiver response, and caring knowledge. Methods This cross-sectional study was conducted between March 2007 and January 2008; 406 primary family caregivers of COPD patients from the thoracic outpatient departments of 6 hospitals in north-central Taiwan were recruited to answer questionnaires measuring COPD characteristics, care behavior, caregiver response, and COPD knowledge. All questionnaires, which addressed caregiver knowledge, care behaviors, and care reactions, were shown to have acceptable validity and reliability, and the data were analyzed using univariate and generalized linear model techniques. Results The elder caregivers group had 79 participants, and the non-elder caregivers comprised 327 participants. The COPD-related knowledge scale results were positively correlated with the family caregiver caring behavior scale, suggesting that better COPD-related knowledge among family caregivers may result in improved caring behavior. After adjusting for all possible confounding factors, the elder caregivers had significantly lower COPD-related knowledge than the non-elder caregivers (P<0.001). However, there were no significant differences in the family caregiver caring behavior scale or the caregiver reaction assessment scale between the two

  17. Universality of aging: family caregivers for elderly cancer patients

    PubMed Central

    Baider, Lea; Surbone, Antonella

    2014-01-01

    The world population is aging, with the proportion of older people (65+ years) expected to reach 21% in 2050 and to exceed the number of younger people (aged 15 or less) for the first time in history. Because cancer is particularly a chronic disease of older people, a large increase in the number of elderly patients with cancer is anticipated. The estimated number of new cancer cases worldwide among people over 65 is expected to grow from about 6 million in 2008 to more than 11 million during the coming decade. By 2030, individuals over 65 are expected to account for 70% of all cancer patients in the Western world. Along with the increase in oncology patients, the number of older people caring for their ill spouses or other relatives is also growing, with the ensuing toll on these caregivers causing major concern, especially in western countries. In different societies the characteristics of family caregiver stressors, cultural norms concerning caregiving, and the availability of support have a huge impact on those providing care. Any study of older caregivers of older cancer patients requires an integrative evaluation of aging that takes into account cultural, social, psychological, and behavioral variables. This review proposes a critical discussion of the multidimensionality of the caregiving and of the impact that age, culture, and gender have on it. PMID:25076927

  18. Spirituality and psychological well-being: testing a theory of family interdependence among family caregivers and their elders.

    PubMed

    Kim, Suk-Sun; Reed, Pamela G; Hayward, R David; Kang, Youngmi; Koenig, Harold G

    2011-04-01

    The family spirituality-psychological well-being model was developed and tested to explore how spirituality influences psychological well-being among elders and caregivers in the context of Korean family caregiving. The sample consisted of 157 Korean elder-family caregiver dyads in Seoul, Korea. The intraclass correlation coefficient and the actor-partner interdependence statistical model were used to analyze the data. There were significant correlations between elders' and caregivers' spirituality and between elders' and caregivers' psychological well-being. Elders' and caregivers' spirituality significantly influenced their own psychological well-being. The caregiver's spirituality significantly influenced the elder's psychological well-being, but the elder's spirituality did not significantly influence the caregiver's psychological well-being. Findings suggest that elders' and caregivers' spirituality should be assessed within the family to provide holistic nursing interventions.

  19. Influence of family dynamics on burden among family caregivers in aging Japan.

    PubMed

    Kusaba, Tesshu; Sato, Kotaro; Fukuma, Shingo; Yamada, Yukari; Matsui, Yoshinori; Matsuda, Satoshi; Ando, Takashi; Sakushima, Ken; Fukuhara, Shunichi

    2016-10-01

    Long-term care for the elderly is largely shouldered by their family, representing a serious burden in a hyper-aging society. However, although family dynamics are known to play an important role in such care, the influence of caring for the elderly on burden among caregiving family members is poorly understood. To examine the influence of family dynamics on burden experienced by family caregivers. We conducted a cross-sectional study at six primary care clinics, involving 199 caregivers of adult care receivers who need long-term care. Participants were divided into three groups based on tertile of Index of Family Dynamics for Long-term Care (IF-Long score), where higher scores imply poorer relationships between care receivers and caregiving family: best, <2; intermediate, 2 to <5; worst, ≥5. The mean differences in burden index of caregivers (BIC-11) between the three groups were estimated by linear regression model with adjustment for care receiver's activity of daily living and cognitive function. Mean age of caregivers was 63.2 years (with 40.7% aged ≥ 65 years). BIC-11 scores were higher in the worst IF-Long group (adjusted mean difference: 4.4, 95% confidence interval: 1.2 to 7.5) than in the best IF-Long group. We also detected a positive trend between IF-Long score and BIC-11 score (P-value for trend <0.01). Our findings indicate that family dynamics strongly influences burden experienced by caregiving family members, regardless of the care receiver's degree of cognitive impairment. These results underscore the importance of evaluating relationships between care receivers and their caregivers when discussing a care regimen for care receivers. © The Author 2016. Published by Oxford University Press.

  20. Influence of family dynamics on burden among family caregivers in aging Japan

    PubMed Central

    Kusaba, Tesshu; Sato, Kotaro; Fukuma, Shingo; Yamada, Yukari; Matsui, Yoshinori; Matsuda, Satoshi; Ando, Takashi; Sakushima, Ken; Fukuhara, Shunichi

    2016-01-01

    Background. Long-term care for the elderly is largely shouldered by their family, representing a serious burden in a hyper-aging society. However, although family dynamics are known to play an important role in such care, the influence of caring for the elderly on burden among caregiving family members is poorly understood. Objective. To examine the influence of family dynamics on burden experienced by family caregivers. Methods. We conducted a cross-sectional study at six primary care clinics, involving 199 caregivers of adult care receivers who need long-term care. Participants were divided into three groups based on tertile of Index of Family Dynamics for Long-term Care (IF-Long score), where higher scores imply poorer relationships between care receivers and caregiving family: best, <2; intermediate, 2 to <5; worst, ≥5. The mean differences in burden index of caregivers (BIC-11) between the three groups were estimated by linear regression model with adjustment for care receiver’s activity of daily living and cognitive function. Results. Mean age of caregivers was 63.2 years (with 40.7% aged ≥ 65 years). BIC-11 scores were higher in the worst IF-Long group (adjusted mean difference: 4.4, 95% confidence interval: 1.2 to 7.5) than in the best IF-Long group. We also detected a positive trend between IF-Long score and BIC-11 score (P-value for trend <0.01). Conclusion. Our findings indicate that family dynamics strongly influences burden experienced by caregiving family members, regardless of the care receiver’s degree of cognitive impairment. These results underscore the importance of evaluating relationships between care receivers and their caregivers when discussing a care regimen for care receivers. PMID:27450988

  1. (Handicapped) caregiver: the social representations of family members about the caregiving process.

    PubMed

    de Azevedo, Gisele Regina; Santos, Vera Lúcia Conceição de Gouveia

    2006-01-01

    This study aimed to analyze what looking after physically disabled persons with spinal cord injury by trauma means to their caregivers and family members. The analysis of the testimony of eight caregivers, obtained in open interviews, which was methodologically based on the Social Representations Theory (SR), pointed out two main routes: coping with the suffering process in care practice and the troubled waters that permeate this suffering process. These two routes, characterized as SR Central Core and Peripheral System, respectively, consisted of themes like the way of looking at impairment, affectivity, religiosity, social-economical changes and (lack of) technical and institutional support. The results show a handicapped caregiver dedicated to look after someone who is physically disabled, considered incapacitated, and who leads his or her chores with distress and privations, based on guilt and religiosity, supported by ambiguous affection and affected by deteriorating social-economical changes and (lack of) technical and institutional support to practice an activity that implies so many peculiarities. The transformation alternatives of these caregivers' daily life principally lead to a symbiosis of disability with the patient - to live for the physically disabled - or yet, for a few, a sketch to restart personal life projects - to live with the physically disabled.

  2. Mental health and morbidity of caregivers and co-residents of individuals with dementia: a quasi-experimental design.

    PubMed

    Maguire, Aideen; Rosato, Michael; O'Reilly, Dermot

    2017-10-01

    To determine if providing informal care to a co-resident with dementia symptoms places an additional risk on the likelihood of poor mental health or mortality compared with co-resident non-caregivers. A quasi-experimental design of caregiving and non-caregiving co-residents of individuals with dementia symptoms provides a natural comparator for the additive effects of caregiving on top of living with an individual with dementia symptoms. Census records, providing information on household structure, intensity of caregiving, presence of dementia symptoms and self-reported mental health were linked to mortality records over the following 33 months. Multi-level regression models were constructed to determine the risk of poor mental health and death in co-resident caregivers of individuals with dementia symptoms compared with co-resident non-caregivers, adjusting for the clustering of individuals within households. The cohort consisted of 10 982 co-residents (55.1% caregivers), with 12.1% of non-caregivers reporting poor mental health compared with 8.4% of intense caregivers (>20 h of care per week). During follow-up, the cohort experienced 560 deaths (245 to caregivers). Overall, caregiving co-residents were at no greater risk of poor mental health but had lower mortality risk than non-caregiving co-residents (adjusted odds ratio (ORadj) = 0.93, 95% confidence interval (CI) 0.79, 1.10 and ORadj = 0.67, 95% CI 0.56, 0.81, respectively); this lower mortality risk was also seen amongst the most intensive caregivers (ORadj = 0.65, 95% CI 0.53, 0.79). Caregiving poses no additional risk to mental health over and above the risk associated with merely living with someone with dementia and is associated with a lower mortality risk compared with non-caregiving co-residents. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  3. Executive Summary: Professional Partners Supporting Family Caregivers

    ERIC Educational Resources Information Center

    Kelly, Kathleen; Reinhard, Susan C.; Brooks-Danso, Ashley

    2008-01-01

    Today, more than three-quarters of adults who live in the community and need long-term care depend on family and friends as their only source of assistance with activities of daily living (such as bathing, dressing, and eating) or instrumental activities of daily living (such as transportation and managing finances). Research suggests that the…

  4. Handbook for Residents of Military Family Housing

    DTIC Science & Technology

    1989-02-01

    THE HOUSING ASSIGNMENT OFFICE FOR USE IN ASSISTING MILITARY PERSONNEL TO OBTAIN GOVERNMENT QUARTERS. EFFECTS OF NONDISCLOSURE - DISCLOSURE OF THIS...of regulations that govern child care in Military Family Housing . a. Occasional babysitting is allowed. Child care on a regular basis is also allowed...Commander Naval Base San Diego, CA. 92132-5100 DJS*MA-1pASEINST.11101.43 February 1989 I HANDBOOK FOR RESIDENTS OF MILITARY FAMILY HOUSING DTIC EECTE

  5. Taking Care of You: Self-Care for Family Caregivers

    MedlinePlus

    ... Network and Resource Center www.archrespite.org Recommended Reading The Caregiver Helpbook: Powerful Tools for Caregivers www. ... Tips Manual. The Caregiver Helpbook is highly recommended reading for caregivers. This fact sheet was prepared by ...

  6. Family functioning in the caregivers of patients with dementia: one-year follow-up.

    PubMed

    Heru, Alison M; Ryan, Christine E

    2006-01-01

    Caregivers for relatives with dementia can maintain their quality of life without specific intervention. It is unclear which variables are protective and which variables are aggravating for the caregiver. To assess the impact of family functioning on caregiver burden over time, the authors had caregivers of out patients with dementia complete self-report questionnaires at recruitment and at 1 year. At recruitment, 63% of caregivers were female, with a mean age of 62 years. Mean patient age was 73 years. The average number of caregiving years was 3.1. Caregivers were more likely to be spouses (61%). After 1-year, caregivers who stayed in the study reported no change in burden, reward, quality of life, or overall family functioning, although the patient's activities of daily living and level of disability were perceived to have significantly deteriorated. Caregivers who reported poor family functioning at initial assessment had higher ratings of strain and burden.

  7. Morning report in military family medicine residencies.

    PubMed

    Drifmeyer, Erin; Oh, Robert

    2008-08-01

    Morning report is a standard component of residency training; however, little is written about this conference in family medicine. We emailed a survey to all 17 military family medicine residency directors. Descriptive statistics were used to calculate means and SDs. Twelve of 17 programs responded. All conducted morning report and all agreed that the main purpose of morning report is education. Its educational value ranked highly (mean, 4.2; SD = 0.78; with 1 = minimal educational value and 5 = very important educational value). Programs reported morning report being held four to five times a week (66%) for 30 minutes (92%) and using preprepared cases (75%) half the time or more. Most (75%) reported having no written goals and objectives; 77% did not track educational outcomes. Although military residencies appear to regard morning report as an important educational venue, most do not have goals or objectives nor formally evaluate effectiveness.

  8. Otolaryngology Training for Family Practice Residents.

    ERIC Educational Resources Information Center

    And Others; Rood, Stewart R.

    1980-01-01

    The faculty of the Department of Otolaryngology, University of Pittsburgh School of Medicine, has designed a rotation in the otolaryngology service, that is a basic clinical orientation to ear, nose and throat medicine, to fit the one-month block committed by the local family practice residency training program. The program is described and its…

  9. Otolaryngology Training for Family Practice Residents.

    ERIC Educational Resources Information Center

    And Others; Rood, Stewart R.

    1980-01-01

    The faculty of the Department of Otolaryngology, University of Pittsburgh School of Medicine, has designed a rotation in the otolaryngology service, that is a basic clinical orientation to ear, nose and throat medicine, to fit the one-month block committed by the local family practice residency training program. The program is described and its…

  10. The Families Who Care Project: Meeting the Educational Needs of African American and Rural Family Caregivers Dealing with Dementia.

    ERIC Educational Resources Information Center

    Coogle, Constance L.

    2002-01-01

    Advisors from universities, human services agencies, and Alzheimer's Association identified the educational needs of family caregivers; results were used to prepare training materials. Family caregivers who were trained, mostly African American and rural (n=106), increased knowledge of the disease and caregiving. Economic barriers to participation…

  11. Family Caregiver Uplift and Burden: Associations with Aggressive Behavior in Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    Unwin, Gemma; Deb, Shoumitro

    2011-01-01

    The purpose of this study was to investigate the experience of family caregivers caring for adults with intellectual disabilities (ID) who display aggressive behavior in terms of associations with caregiver burden and uplift. The family caregivers of 44 people with ID and aggressive behavior were interviewed using a suite of questionnaires and…

  12. Health-Related Quality of Life in the Family Caregivers of Stroke Survivors

    ERIC Educational Resources Information Center

    Chen, Yangkun

    2010-01-01

    The objective of this cross-sectional study was to identify the factors associated with health-related quality of life (HRQOL) of family caregivers of Chinese stroke patients. One hundred and twenty-three stroke patients consecutively admitted to a stroke clinic and their 123 family caregivers were recruited. The caregivers' HRQOLs were assessed…

  13. Telephone interventions for family caregivers of patients with dementia: what are best nursing practices?

    PubMed

    Mason, Bernadette J; Harrison, Barbara E

    2008-01-01

    Family caregivers of patients with dementia experience caregiver burden and need holistic nursing interventions, such as telephone support. This article reviews the literature on telephone support interventions for family caregivers of patients with dementia and describes evidence-based holistic nursing practices within Watson's theory of human caring, which focuses on transpersonal caring relationships.

  14. Family Caregiver Uplift and Burden: Associations with Aggressive Behavior in Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    Unwin, Gemma; Deb, Shoumitro

    2011-01-01

    The purpose of this study was to investigate the experience of family caregivers caring for adults with intellectual disabilities (ID) who display aggressive behavior in terms of associations with caregiver burden and uplift. The family caregivers of 44 people with ID and aggressive behavior were interviewed using a suite of questionnaires and…

  15. Health-Related Quality of Life in the Family Caregivers of Stroke Survivors

    ERIC Educational Resources Information Center

    Chen, Yangkun

    2010-01-01

    The objective of this cross-sectional study was to identify the factors associated with health-related quality of life (HRQOL) of family caregivers of Chinese stroke patients. One hundred and twenty-three stroke patients consecutively admitted to a stroke clinic and their 123 family caregivers were recruited. The caregivers' HRQOLs were assessed…

  16. Experiences of caregiving, satisfaction of life, and social repercussions among family caregivers, two years post-stroke.

    PubMed

    Lurbe-Puerto, Kàtia; Leandro, Maria-Engracia; Baumann, Michèle

    2012-01-01

    Cerebrovascular diseases are a public health and social policy priority in Europe due to their high prevalence and the long-term disability they may result in (as the principal cause of handicap). Increasingly, family caregivers take over the care at home of these patients. Two years post-stroke, our study analyzed the feelings of family caregivers from Luxembourg and northeastern Portugal toward their experience of caregiving and its repercussions on social and couple relationships, life satisfaction, and socioeconomic characteristics. Participating hospitals identified survivors and consent was sought by letter. Patients (n = 62) and their main caregivers (n = 46 pairs) were interviewed at home. The mean life satisfaction of caregivers was similar, but the experience of providing care differed in terms of family support, and disruptions of the caregivers' family responsibilities. More Portuguese respondents gave activities up, found little time for relaxation, and estimated that their health had deteriorated; more Luxembourgers felt strong enough to cope. More Portuguese spouses reported an impact on their sex lives. Family caregivers represent a "population at risk." Social workers can help them by providing domestic assistance, undertaking coaching activities, fostering favorable attitudes, and offering reassurance. Home-based rehabilitation in Europe involving family care must take account of cultural lifestyle issues.

  17. Problems and benefits reported by stroke family caregivers: results from a prospective epidemiological study.

    PubMed

    Haley, William E; Allen, Jessica Y; Grant, Joan S; Clay, Olivio J; Perkins, Martinique; Roth, David L

    2009-06-01

    Stroke symptoms can be very stressful for family caregivers, but most knowledge about the prevalence and stressfulness of stroke-related patient problems is derived from convenience samples. In addition, little is known about perceived benefits of the stroke caregiving experience. The purpose of this study was to determine the prevalence and stressfulness of stroke-related problems, and perceived benefits of caregiving, as reported by an epidemiologically derived sample of caregivers of stroke survivors. Stroke survivors (N=75) from a prospective epidemiological study of stroke, the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, and their family caregivers were followed. Caregivers were given a comprehensive telephone interview 8 to 12 months after the stroke, using measures of stroke patient problems, caregiver appraisals of the stressfulness of these problems, and perceived benefits of caregiving. Caregivers rated patient problems with mood (depression, loneliness and anxiety), memory, and physical care (bowel control), as the most stressful, but reported prevalence of these problems was lower than those reported previously in studies using clinical samples. Caregivers also reported many benefits from caregiving, with over 90% reporting that caregiving enabled them to appreciate life more. Epidemiologically based studies of stroke caregiving provide a unique picture of caregiver strains and benefits compared with clinical studies, which tend to over-represent more impaired patients. Support for caregivers should include interventions to aid their coping with highly stressful mood, physical care, and cognitive problems of stroke patients, but should also attend to perceived benefits of caregiving.

  18. Quality of life in Chinese family caregivers for elderly people with chronic diseases.

    PubMed

    Xie, Hui; Cheng, Cheng; Tao, Yisheng; Zhang, Jie; Robert, Delprino; Jia, Jihui; Su, Yonggang

    2016-07-06

    Inadequate studies have been conducted in China to examine quality of life in family caregivers. Quality of life in family caregivers for elderly people with chronic diseases was evaluated, and the demographic and characteristic factors of both elderly people and their caregivers were explored. The 36-Item Short Form Health Survey (SF-36) was used to assess health-related quality of life in 407 family caregivers caring for elderly people with chronic diseases in six communities on the Mainland China. The explanatory variables included family caregivers' demographic and other caregiving variables related to eldercare. Descriptive statistics and multiple linear regression analysis were used in the data analysis, performed via SPSS 17.0. Mean SF-36 and physical and mental component scores were 66.14 ± 17.50, 70.06 ± 16.49, and 62.22 ± 18.51, respectively. The scores of caregivers' physical function and bodily pain were significantly higher, while the scores of caregivers' role limitations due to physical problems, general health, vitality, social function, mental health and role limitations due to emotional problems were significantly lower. Caregivers' ages, comorbidity, the perceived effects of caregiving on caregivers' social lives and elderly individuals' ages, marital status and Activities of Daily Living scores were significantly associated with the physical component score. In addition, caregivers' age, the affordability of the elderly person's healthcare expenses, the perceived effects of caregiving on caregivers' social lives, and elderly people's marital status and ADL scores were significantly associated with the mental component score. Family caregivers for elderly people with chronic diseases showed poorer mental and better physical well-being. Factors of both elderly people and their caregivers impact the caregivers' quality of life. These findings highlight the importance of addressing mental health of family caregivers, and of providing

  19. Physical health, mental health, and life changes among family caregivers of patients with lung cancer.

    PubMed

    Mosher, Catherine E; Bakas, Tamilyn; Champion, Victoria L

    2013-01-01

    To describe physical health, mental health, and life changes among family caregivers of patients with lung cancer. Cross-sectional quantitative study. A university outpatient oncology center, two Veterans Affairs outpatient clinics, and a private outpatient oncology practice in Indianapolis, IN. 91 family caregivers of patients with lung cancer. Data were collected using standardized instruments and analyzed using descriptive statistics and hierarchical multiple regression. Demographic and medical factors, physical health, mental health, and life changes from caregiving. Caregivers' physical health and mental health were below population norms, whereas social functioning did not differ from norms. More than 50% of caregivers reported negative emotional effects of caregiving, and more than 33% reported negative physical health effects of caregiving. About 40% of caregivers, however, reported positive changes in their relationships with the patients with lung cancer and other family members as a result of caregiving. Caregivers' mental health was more strongly associated with life changes than physical health. Findings suggest that many family caregivers of patients with lung cancer experience negative physical and mental health effects of caregiving, whereas relations with family members improve for a substantial minority of caregivers. These positive and negative consequences of caregiving should be jointly considered when developing self-report measures and interventions for this population. Nurses can conduct brief screening assessments to identify caregivers with probable distress and can provide practical and psychosocial support, as well as referrals to support services. Findings suggest that interventions are needed to address the negative physical and emotional health consequences of caring for family members with lung cancer. Such interventions could build on the relational benefits of caregiving to improve the patient-caregiver relationship and expand

  20. The association between family caregivers' involvement in managing older adults' medications and caregivers' information-seeking behavior.

    PubMed

    Noureldin, Marwa; Murawski, Matthew M; Mason, Holly L; Hyner, Gerald C; Plake, Kimberly S

    1) To explore the association between family caregivers' involvement in managing care recipients' medications and their information-seeking behavior related to caregiving; and 2) to examine the sources used by caregivers when seeking information. A retrospective analysis of cross-sectional data from 2 national studies, the 2011 National Health and Aging Trends Study (NHATS) and its supplement, the National Study of Caregiving (NSOC), was conducted. A nationally representative sample of community-dwelling adults (≥65 years of age) completed NHATS interviews, and a sample of their family caregivers participated in NSOC. Caregiver involvement in medication management was assessed with the use of 2 items asking caregivers if they helped keep track of care recipients' medications or helped with injecting medications. Information seeking was assessed with the use of an item asking caregivers if they ever looked for caregiving-related information. Out of 1367 caregivers interviewed, 54% reported helping to keep track of care recipients' medications and 8.7% assisting with injecting medications. Approximately 10.2% (n = 149) of caregivers reported seeking information to help them care for their care recipients. Caregivers sought information primarily on their own either through online resources or asking friends or relatives (73.3%). Sixty-four percent also sought information from medical providers or social workers. Adult children of caregivers were more likely to seek information for their older adult parents, based on bivariate analysis (P <0.01). In multivariable-adjusted models, caregivers who helped to keep track of medications had 2.30 (95% confidence interval [CI] 1.18 to 4.51) times higher odds of seeking information to help them to provide care for their care recipients. Caregivers helping with injecting medications were less likely to seek information (odds ratio 0.32, 95% CI 0.14 to 0.76). Specific caregiver responsibilities, such as assisting with

  1. 3 CFR 8900 - Proclamation 8900 of November 1, 2012. National Family Caregivers Month, 2012

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... caregivers to the ones they love even as they navigate their own health challenges. Mothers and fathers... stability to those they love. Family caregivers have an immeasurable impact on the lives of those they...

  2. Education Intervention "Caregivers Like Me" for Latino Family Caregivers Improved Attitudes Toward Professional Assistance at End-of-life Care.

    PubMed

    Cruz-Oliver, Dulce M; Malmstrom, Theodore K; Fernández, Natalia; Parikh, Manas; García, Jessica; Sanchez-Reilly, Sandra

    2016-07-01

    This study explores the ability of a culturally sensitive and case-based education intervention, Caregivers Like Me, to improve knowledge and attitudes regarding end-of-life (EOL) resources among Latino caregivers. A multicentered, cross-sectional study of Latino communities from different geographical regions and cultural backgrounds. An educational intervention was administered to family caregivers of Latino elders using a case-based video "telenovela" and pretest-posttest questionnaires. Participants (N = 145) were mostly females (79%) with mean age of 56 ± 15 years. They reported active learning from intervention (91%) and high satisfaction (92%) with educational experience. Both caregiver stress self-awareness and willingness to accept professional help improved significantly from pretest to posttest. A culturally sensitive educational intervention increased Latino caregivers' self-awareness about caregiver stress and the need to consider professional assistance for EOL care. © The Author(s) 2015.

  3. Randomized Trial of the Family Intervention: Telephone Tracking-Caregiver for Dementia Caregivers: Use of Community and Healthcare Resources.

    PubMed

    Tremont, Geoffrey; Davis, Jennifer D; Ott, Brian R; Galioto, Rachel; Crook, Cara; Papandonatos, George D; Fortinsky, Richard H; Gozalo, Pedro; Bishop, Duane S

    2017-05-01

    To examine the effects of a telephone-delivered intervention, Family Intervention: Telephone Tracking-Caregiver (FITT-C), on community support and healthcare use by dementia caregivers. Randomized, controlled trial. Academic medical center. Dyads (n = 250) of distressed informal dementia caregivers and care recipients. Caregivers were randomly assigned to receive the FITT-C (n = 133) or telephone support (TS; n = 117). Both groups received 16 telephone contacts from a master's-level therapist over 6 months. The FITT-C intervention provided psychoeducation, problem solving, and other directive approaches based on assessment of critical areas (e.g., mood, behavior, family functioning, social support). TS provided supportive therapeutic strategies. Outcome variables were caregiver report of community support service use, number of visits to the emergency department (ED) for caregivers and care recipients, and hospital stays for caregivers during the interventions. Intervention groups did not differ in demographic characteristics, use of support services, or use of healthcare resources at baseline. Caregivers who received the FITT-C used community support services at end of treatment significantly more than those receiving TS (P = .02). FITT-C caregivers had a significantly lower rate of ED visits (rate difference 9.5%, P = .048) and hospital stays (rate difference 11.4%, P = .01) over the 6-month course of the intervention than TS caregivers. Care recipient use of community or medical resources did not differ according to group. An entirely telephone-delivered intervention was effective in increasing caregiver engagement in community resources and reducing caregiver use of hospital-based healthcare resources. Results highlight the potential effect of FITT-C on healthcare use. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  4. Randomized Trial of the Family Intervention: Telephone Tracking—Caregiver for Dementia Caregivers: Use of Community and Healthcare Resources

    PubMed Central

    Tremont, Geoffrey; Davis, Jennifer D.; Ott, Brian R.; Galioto, Rachel; Crook, Cara; Papandonatos, George D.; Fortinsky, Richard H.; Gozalo, Pedro; Bishop, Duane S.

    2017-01-01

    OBJECTIVES To examine the effects of a telephone-delivered intervention, Family Intervention: Telephone Tracking—Caregiver (FITT-C), on community support and healthcare use by dementia caregivers. DESIGN Randomized, controlled trial. SETTING Academic medical center. PARTICIPANTS Dyads (n = 250) of distressed informal dementia caregivers and care recipients. INTERVENTION Caregivers were randomly assigned to receive the FITT-C (n = 133) or telephone support (TS; n = 117). Both groups received 16 telephone contacts from a master’s-level therapist over 6 months. The FITT-C intervention provided psychoeducation, problem solving, and other directive approaches based on assessment of critical areas (e.g., mood, behavior, family functioning, social support). TS provided supportive therapeutic strategies. MEASUREMENTS Outcome variables were caregiver report of community support service use, number of visits to the emergency department (ED) for caregivers and care recipients, and hospital stays for caregivers during the interventions. RESULTS Intervention groups did not differ in demographic characteristics, use of support services, or use of healthcare resources at baseline. Caregivers who received the FITT-C used community support services at end of treatment significantly more than those receiving TS (P = .02). FITT-C caregivers had a significantly lower rate of ED visits (rate difference 9.5%, P = .048) and hospital stays (rate difference 11.4%, P = .01) over the 6-month course of the intervention than TS caregivers. Care recipient use of community or medical resources did not differ according to group. CONCLUSION An entirely telephone-delivered intervention was effective in increasing caregiver engagement in community resources and reducing caregiver use of hospital-based healthcare resources. Results highlight the potential effect of FITT-C on healthcare use. PMID:28008609

  5. "I Get Along with Most of Them": Direct Care Workers' Relationships with Residents' Families in Assisted Living

    ERIC Educational Resources Information Center

    Kemp, Candace L.; Ball, Mary M.; Perkins, Molly M.; Hollingsworth, Carole; Lepore, Michael J.

    2009-01-01

    Purpose: The purpose of this article was to explore staff-family relationships in assisted living facilities (ALFs) as they are experienced by care staff and perceived by administrators. We identify factors that influence relationships and explore how interactions with residents' families affect care staff's caregiving experiences. Design and…

  6. Linking family dynamics and the mental health of Colombian dementia caregivers.

    PubMed

    Sutter, Megan; Perrin, Paul B; Chang, Yu-Ping; Hoyos, Guillermo Ramirez; Buraye, Jaqueline Arabia; Arango-Lasprilla, Juan Carlos

    2014-02-01

    This cross-sectional, quantitative, self-report study examined the relationship between family dynamics (cohesion, flexibility, pathology/ functioning, communication, family satisfaction, and empathy) and mental health (depression, burden, stress, and satisfaction with life [SWL]) in 90 dementia caregivers from Colombia. Hierarchical multiple regressions controlling for caregiver demographics found that family dynamics were significantly associated with caregiver depression, stress, and SWL and marginally associated with burden. Within these regressions, empathy was uniquely associated with stress; flexibility with depression and marginally with SWL; and family communication marginally with burden and stress. Nearly all family dynamic variables were bivariately associated with caregiver mental health variables, such that caregivers had stronger mental health when their family dynamics were healthy. Family-systems interventions in global regions with high levels of familism like that in the current study may improve family empathy, flexibility, and communication, thereby producing better caregiver mental health and better informal care for people with dementia.

  7. Mexican American Adolescents’ Family Caregiving: Selection Effects and Longitudinal Associations With Adjustment

    PubMed Central

    East, Patricia L.; Weisner, Thomas S.

    2013-01-01

    One hundred ten Mexican American adolescents (12 – 17 years) who provide infant care for their older sisters were studied to determine the effects of family caregiving responsibilities on adolescents’ adjustment. Controlling for prior adjustment and family context factors, providing many hours of caregiving predicted an increase in youths’ school absences and disciplinary problems. Frequent conflict surrounding caregiving was associated with increased stress and depression and lower school grades. Older girls appear to select into caregiving and experience the most problematic outcomes. Strong family obligations were not protective against caregiving stress but, rather, further compromised youths’ well-being for those who were highly involved in their family’s care. PMID:24000269

  8. Attachment and caregiving relationships in families affected by parental incarceration.

    PubMed

    Shlafer, Rebecca J; Poehlmann, Julie

    2010-07-01

    This longitudinal, mixed method study focused on 57 families of children who participated in a mentoring program for children of incarcerated parents. Children ranged in age from 4 to 15 years. Monthly interviews were conducted with children, caregivers, and mentors during the first six months of program participation, and questionnaires were administered at intake and six months to assess caregiver-child and incarcerated parent-child relationships, contact with incarcerated parents, and children's behavior problems. Although some children viewed their incarcerated parents as positive attachment figures, other children reported negative feelings toward or no relationship with incarcerated parents. In addition, our assessments of children nine years old and older revealed that having no contact with the incarcerated parent was associated with children reporting more feelings of alienation toward that parent compared to children who had contact. Children's behavior problems were a primary concern, often occurring in a relational context or in reaction to social stigma associated with parental imprisonment.

  9. Teaching resident physicians chronic disease management: simulating a 10-year longitudinal clinical experience with a standardized dementia patient and caregiver.

    PubMed

    Schlaudecker, Jeffrey D; Lewis, Timothy J; Moore, Irene; Pallerla, Harini; Stecher, Anna M; Wiebracht, Nathan D; Warshaw, Gregg A

    2013-09-01

    Education for all physicians should include specialty-specific geriatrics-related and chronic disease-related topics. We describe the development, implementation, and evaluation of a chronic disease/geriatric medicine curriculum designed to teach Accreditation Council for Graduate Medical Education core competencies and geriatric medicine competencies to residents by using longitudinal encounters with a standardized dementia patient and her caregiver daughter. Over 3 half-day sessions, the unfolding standardized patient (SP) case portrays the progressive course of dementia and simulates a 10-year longitudinal clinical experience between residents and a patient with dementia and her daughter. A total of 134 residents participated in the University of Cincinnati-based curriculum during 2007-2010, 72% of whom were from internal medicine (79) or family medicine (17) residency programs. Seventy-five percent of participants (100) said they intended to provide primary care to older adults in future practice, yet 54% (73) had little or no experience providing medical care to older adults with dementia. Significant improvements in resident proficiency were observed for all self-reported skill items. SPs' evaluations revealed that residents' use of patient-centered language and professionalism significantly improved over the 3 weekly visits. Nearly all participants agreed that the experience enhanced clinical competency in the care of older adults and rated the program as "excellent" or "above average" compared to other learning activities. Residents found this SP-based curriculum using a longitudinal dementia case realistic and valuable. Residents improved in both self-perceived knowledge of dementia and the use of patient-centered language and professionalism.

  10. Usage and Design Evaluation by Family Caregivers of aStroke Intervention Website

    PubMed Central

    Pierce, Linda L.; Steiner, Victoria

    2013-01-01

    Background Four out of 5 families are affected by stroke. Many caregivers access the Internet and gather healthcare information from web-based sources. Design The purpose of this descriptive evaluation was to assess the usage and design of the Caring~Web© site, which provides education/support for family caregivers of persons with stroke residing in home settings. Sample and Setting Thirty-six caregivers from two Midwest states accessed this intervention in a 1-year study. The average participant was fifty-four years of age, white, female, and the spouse of the care recipient. Methods In a telephone interview, four website questions were asked twice-/bi-monthly and a 33-item Survey at the conclusion of the study evaluated the website usage and design of its components. Descriptive analysis methods were used and statistics were collected on the number of visits to the website. Results On average, participants logged on to the website one to two hours per week, although usage declined after several months for some participants. Participants positively rated the website’s appearance and usability that included finding the training to be adequate. Conclusion Website designers can replicate this intervention for other health conditions. PMID:24025464

  11. Usage and design evaluation by family caregivers of a stroke intervention web site.

    PubMed

    Pierce, Linda L; Steiner, Victoria

    2013-10-01

    Four of five families are affected by stroke. Many caregivers access the Internet and gather healthcare information from Web-based sources. The purpose of this descriptive evaluation was to assess the usage and design of the Caring∼Web site, which provides education/support for family caregivers of persons with stroke residing in home settings. Thirty-six caregivers from two Midwest states accessed this intervention in a 1-year study. The average participant was 54 years old, White, woman, and the spouse of the care recipient. In a telephone interview, four Web site questions were asked twice a month/bimonthly, and a 33-item survey at the conclusion of the study evaluated the Web site usage and design of its components. Descriptive analysis methods were used, and statistics were collected on the number of visits to the Web site. On average, participants logged on to the Web site 1-2 hours per week, although usage declined after several months for some participants. Participants positively rated the Web site's appearance and usability that included finding the training to be adequate. Web site designers can replicate this intervention for other health conditions.

  12. Conflict between nursing home staff and residents' families: does it increase burnout?

    PubMed

    Abrahamson, Kathleen; Jill Suitor, J; Pillemer, Karl

    2009-09-01

    In this study, the authors examine the influence of conflict between nursing home staff and family members of residents on staff burnout. Data were collected from interviews with a representative sample of 655 nursing home nurses and nursing assistants. Hypotheses were tested using structural equation modeling. Results indicate that conflict with family members increases staff burnout and decreases staff satisfaction. Staff and family conflict increases when staff members feel they do not have enough time to complete required tasks. Level of conflict decreases when staff perceive that family members have care expectations that are similar to their own. Interestingly, staff who have personal experience as family caregivers are more likely to report conflict with family members of residents, a result that necessitates further study. Staff burnout and dissatisfaction affects both individuals and organizations. Policy that addresses staff and family interaction can have an important place in the design and delivery of long-term care.

  13. Caregiver Person-Centeredness and Behavioral Symptoms in Nursing Home Residents With Dementia: A Timed-Event Sequential Analysis

    PubMed Central

    Gilmore-Bykovskyi, Andrea L.; Roberts, Tonya J.; Bowers, Barbara J.; Brown, Roger L.

    2015-01-01

    Purpose: Evidence suggests that person-centered caregiving approaches may reduce dementia-related behavioral symptoms; however, little is known about the sequential and temporal associations between specific caregiver actions and behavioral symptoms. The aim of this study was to identify sequential associations between caregiver person-centered actions, task-centered actions, and resident behavioral symptoms and the temporal variation within these associations. Design and Methods: Videorecorded observations of naturally occurring interactions (N = 33; 724min) between 12 nursing home (NH) residents with dementia and eight certified nursing assistants were coded for caregiver person-centered actions, task-centered actions, and resident behavioral symptoms and analyzed using timed-event sequential analysis. Results: Although caregiver actions were predominantly person-centered, we found that resident behavioral symptoms were significantly more likely to occur following task-centered caregiver actions than person-centered actions. Implications: Findings suggest that the person-centeredness of caregivers is sequentially and temporally related to behavioral symptoms in individuals with dementia. Additional research examining the temporal structure of these relationships may offer valuable insights into the utility of caregiver person-centeredness as a low-cost strategy for improving behavioral symptom management in the NH setting. PMID:26055782

  14. Does Problem-Solving Training for Family Caregivers Benefit Their Care Recipients With Severe Disabilities? A Latent Growth Model of the Project CLUES Randomized Clinical Trial

    PubMed Central

    Berry, Jack W.; Elliott, Timothy R.; Grant, Joan S.; Edwards, Gary; Fine, Philip R.

    2012-01-01

    Objective To examine whether an individualized problem-solving intervention provided to family caregivers of persons with severe disabilities provides benefits to both caregivers and their care recipients. Design Family caregivers were randomly assigned to an education-only control group or a problem-solving training (PST) intervention group. Participants received monthly contacts for 1 year. Participants Family caregivers (129 women, 18 men) and their care recipients (81 women, 66 men) consented to participate. Main Outcome Measures Caregivers completed the Social Problem-Solving Inventory–Revised, the Center for Epidemiological Studies-Depression scale, the Satisfaction with Life scale, and a measure of health complaints at baseline and in 3 additional assessments throughout the year. Care recipient depression was assessed with a short form of the Hamilton Depression Scale. Results Latent growth modeling was used to analyze data from the dyads. Caregivers who received PST reported a significant decrease in depression over time, and they also displayed gains in constructive problem-solving abilities and decreases in dysfunctional problem-solving abilities. Care recipients displayed significant decreases in depression over time, and these decreases were significantly associated with decreases in caregiver depression in response to training. Conclusions PST significantly improved the problem-solving skills of community-residing caregivers and also lessened their depressive symptoms. Care recipients in the PST group also had reductions in depression over time, and it appears that decreases in caregiver depression may account for this effect. PMID:22686549

  15. As Families Grow Older: Information for Family Caregivers. Final Report.

    ERIC Educational Resources Information Center

    Halls, Dolores M.; And Others

    This document presents the final report of the "As Families Grow Older" project, a continuing education program for aging network service providers and family members in 23 counties throughout New Mexico which was designed to promote family well-being. It describes how the project, which was in operation from April 1986 through January 1987,…

  16. Vigilance. Evolution and definition for caregivers of family members with Alzheimer's disease.

    PubMed

    Mahoney, Diane Feeney

    2003-08-01

    The language of caregiving relies heavily on terms that are frequently negative such as caregiver stress and burden, but these are not universally accepted phenomenon. The purpose of this article is to report on the development of caregiver vigilance and to suggest it offers both neutral terminology and a means to include caregivers' perceptions of their supervisory role. The concept of vigilance emerged from a qualitative study of caregivers of family members with Alzheimer's disease. Vigilance is defined as the caregivers' continual oversight of their care recipients' activities. The five key components of vigilance were watchful supervision, protective intervening, anticipating, always on duty, and being there. Vigilant caregivers saw themselves as "on duty" even when they were not "doing things." The findings of this study support caregivers' perceptions of 24-hour-a-day responsibility. Nurses need to realize that caregiver vigilance is not necessarily diminished when professional caregivers intervene or institutionalization occurs. Debriefing caregivers about their unique family caregiving knowledge and incorporating it into caregiving is a key strategy for nurses to use to build caregiver trust and reduce their vigilance time.

  17. Pediatric SCI/D caregiver mental health and family dynamics in Colombia, South America.

    PubMed

    Doyle, Sarah T; Perrin, Paul B; Nicholls, Elizabeth; Olivera, Silvia Leonor; Quintero, Lorena Medina; Otálvaro, Nadezda Yulieth Méndez; Arango-Lasprilla, Juan Carlos

    2016-01-01

    This study examined the connections between family dynamics and the mental health of caregivers of youth with spinal cord injuries/disorders (SCI/D) caregivers from Colombia, South America. It was hypothesized that lower family functioning would be associated with poorer caregiver mental health. A cross-sectional study of self-report data collected from caregivers through the Hospital Universatario Hernando Moncaleano Perdomo in Neiva, Colombia. Thirty caregivers of children with SCI/D from Nevia, Colombia who were a primary caregiver for ≥3 months, providing care for an individual who was ≥6 months post-injury/diagnosis, familiar with the patient's history, and without neurological or psychiatric conditions. Caregivers' average age was 41.30 years (SD = 10.98), and 90% were female. Caregivers completed Spanish versions of instruments assessing their own mental health and family dynamics. Family dynamics explained 43.2% of the variance in caregiver burden and 50.1% of the variance in satisfaction with life, although family dynamics were not significantly associated with caregiver depression in the overall analysis. Family satisfaction was the only family dynamics variable to yield a significant unique association with any index of caregiver mental health (satisfaction with life). If similar findings emerge in future intervention research, interventions for pediatric SCI/D caregivers in Colombia and other similar global regions could benefit from including techniques to improve family dynamics, especially family satisfaction, given the strong potentially reciprocal connection between these dynamics and caregiver mental health. The degree of disability resulting from SCI/D can vary greatly depending on the severity and level of the lesion, though permanent impairment is often present that profoundly impacts both physical and psychological functioning. Very little is known about the impact of pediatric SCI/D in developing countries, despite the high rates of

  18. Accessible support for family caregivers of seniors with chronic conditions: from isolation to inclusion.

    PubMed

    Stewart, Miriam; Barnfather, Alison; Neufeld, Anne; Warren, Sharon; Letourneau, Nicole; Liu, Lili

    2006-01-01

    Accessible support programs can improve health outcomes for family caregivers of older relatives with a chronic condition. Over the course of 6 months, 27 experienced family caregivers provided weekly support via the telephone to 66 individuals, either new family caregivers of seniors recently diagnosed with stroke or newly vulnerable family caregivers (i.e., facing increasing demands from the deterioration of their senior relative's condition) of seniors with Alzheimer's disease. Qualitative data documented the perceived impact of the intervention, including increased satisfaction with support, coping skills, caregiving competence and confidence, and decreased caregiver burden and loneliness. Caregivers identified varied support processes that overcame support deficits in their social networks. These processes can facilitate replication in future research and inform practice, programs, and policies.

  19. Family Caregivers' Experiences of Caring for a Relative With Younger Onset Dementia: A Qualitative Systematic Review.

    PubMed

    Cabote, Christy Joy; Bramble, Marguerite; McCann, Damhnat

    2015-08-01

    Family caregiving for people with younger onset dementia affects everyone in the family unit. This article presents findings of a qualitative systematic review exploring the experiences of family caregivers of persons with younger onset dementia. A systematic search resulted in the inclusion of five relevant articles, and two groups within the family unit were identified-child caregivers and adult and spousal caregivers. Using the thematic synthesis approach, five themes emerged: dementia damage, grief for loss of relationship, changes in family roles, positive and negative impacts of family caregiving, and transition to formal care. The review findings support increasing evidence that despite the stress of caring for a person with dementia damage, family members have the capacity to cope, adapt, and grow through their experiences. Nurses can assist families to identify their unique strengths and enhance family resiliency so they can navigate the "lonely road" of younger onset dementia. © The Author(s) 2015.

  20. 1. VIEW OF THE SOUTHEAST CORNER OF THE FAMILY RESIDENCE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. VIEW OF THE SOUTHEAST CORNER OF THE FAMILY RESIDENCE (FEATURE B-10), FACING NORTH. - Nevada Lucky Tiger Mill & Mine, Family Residence, East slope of Buckskin Mountain, Paradise Valley, Humboldt County, NV

  1. The effectiveness of telehealth care on caregiver burden, mastery of stress, and family function among family caregivers of heart failure patients: a quasi-experimental study.

    PubMed

    Chiang, Li-Chi; Chen, Wan-Chou; Dai, Yu-Tzu; Ho, Yi-Lwun

    2012-10-01

    Telehealth care was developed to provide home-based monitoring and support for patients with chronic disease. The positive effects on physical outcome have been reported; however, more evidence is required concerning the effects on family caregivers and family function for heart failure patients transitioning from the hospital to home. To evaluate the effectiveness of nursing-led transitional care combining discharge plans and telehealth care on family caregiver burden, stress mastery and family function in family caregivers of heart failure patients compared to those receiving traditional discharge planning only. This is a quasi-experimental study design. Sixty-three patients with heart failure were assessed for eligibility and invited to participate in either telehealth care or standard care in a medical centre from May to October 2010. Three families refused to participate in data collection. Thirty families who chose telehealth care after discharge from the hospital to home comprised the experimental group; the others families receiving discharge planning only comprised the comparison group. Telenursing specialist provided the necessary family nursing interventions by 24-h remote monitoring of patients' health condition and counselling by telephone, helping the family caregivers successfully transition from hospital to home. Data on caregiver burden, stress mastery and family function were collected before discharge from the hospital and one month later at home. Effects of group, time, and group×time interaction were analysed using Mixed Model in SPSS (17.0). Family caregivers in both groups had significantly lower burden, higher stress mastery, and better family function at one-month follow-up compared to before discharge. The total score of caregiver burden, stress mastery and family function was significantly improved for the family caregivers in the experimental group compared to the comparison group at posttest. Two subscales of family function

  2. Caregiving experiences of family members of persons with dementia in south India.

    PubMed

    Narayan, Suzanne M; Varghese, Mathew; Hepburn, Kenneth; Lewis, Marsha; Paul, Isabel; Bhimani, Rozina

    2015-08-01

    This study reports on the first phase of an investigation aimed at adapting The Savvy Caregiver program, a successful family caregiving curriculum developed in the United States, for application in South India. Thirty family members caring for a person with dementia were interviewed regarding their experiences as caregivers (CGs). Qualitative interviews were conducted with the family member at a geriatric clinic, while other diagnostic procedures were being carried out with the person with dementia. Findings from the study revealed that although family members understood the term CG, none could identify a word for CG in his or her language. There was little understanding of dementia as an illness. Family CGs reported feeling distressed, overwhelmed, and frustrated with caregiving. Caregivers were interested in an educational program, but many had unrealistic expectations for what they wanted to learn. The findings provide directions for adapting The Savvy Caregiver curriculum for Indian family CGs. © The Author(s) 2015.

  3. Remediation plans in family medicine residency

    PubMed Central

    Audétat, Marie-Claude; Voirol, Christian; Béland, Normand; Fernandez, Nicolas; Sanche, Gilbert

    2015-01-01

    Abstract Objective To assess use of the remediation instrument that has been implemented in training sites at the University of Montreal in Quebec to support faculty in diagnosing and remediating resident academic difficulties, to examine whether and how this particular remediation instrument improves the remediation process, and to determine its effects on the residents’ subsequent rotation assessments. Design A multimethods approach in which data were collected from different sources: remediation plans developed by faculty, program statistics for the corresponding academic years, and students’ academic records and rotation assessment results. Setting Family medicine residency program at the University of Montreal. Participants Family medicine residents in academic difficulty. Main outcome measures Assessment of the content, process, and quality of remediation plans, and students’ academic and rotation assessment results (successful, below expectations, or failure) both before and after the remediation period. Results The framework that was developed for assessing remediation plans was used to analyze 23 plans produced by 10 teaching sites for 21 residents. All plans documented cognitive problems and implemented numerous remediation measures. Although only 48% of the plans were of good quality, implementation of a remediation plan was positively associated with the resident’s success in rotations following the remediation period. Conclusion The use of remediation plans is well embedded in training sites at the University of Montreal. The residents’ difficulties were mainly cognitive in nature, but this generally related to deficits in clinical reasoning rather than knowledge gaps. The reflection and analysis required to produce a remediation plan helps to correct many academic difficulties and normalize the academic career of most residents in difficulty. Further effort is still needed to improve the quality of plans and to support teachers.

  4. Socialization of Coping with Community Violence: Influences of Caregiver Coaching, Modeling, and Family Context

    ERIC Educational Resources Information Center

    Kliewer, Wendy; Parrish, Katie Adams; Taylor, Kelli W.; Jackson, Kate; Walker, Jean M.; Shivy, Victoria A.

    2006-01-01

    A socialization model of coping with community violence was tested in 101 African American adolescents (55% male, ages 9-13) and their maternal caregivers living in high-violence areas of a mid-sized, southeastern city. Participants completed interviews assessing caregiver coping, family context, and child adjustment. Caregiver-child dyads also…

  5. The Effect of a Family Therapy and Technology-Based Intervention on Caregiver Depression

    ERIC Educational Resources Information Center

    Eisdorfer, Carl; Czaja, Sara J.; Loewenstein, David A.; Rubert, Mark P.; Arguelles, Soledad; Mitrani, Victoria B.; Szapocznik, Jose

    2003-01-01

    Purpose: The majority of persons with Alzheimer's disease (AD) are cared for at home by a family member such as a spouse or daughter. Caregiving places enormous demands on these caregivers, and the negative consequences associated with caregiving are well documented. This paper reports results from the Miami site of the REACH (Resources for…

  6. Effects of Social Support and Coping of Family Caregivers of Older Adults with Dementia in Taiwan

    ERIC Educational Resources Information Center

    Huang, Chiung-Yu; Musil, Carol M.; Zauszniewski, Jaclene A.; Wykle, May L.

    2006-01-01

    The purpose of this study was to explore the relationship of demographic characteristics, contextual factors, social support, and coping on health outcomes of family caregivers of older adults with dementia in Taiwan. This study also examined caregiving stress and whether support moderated the effects of caregiver stress on health. Lazarus and…

  7. Older and Younger Family Caregivers of Adults with Intellectual Disability: Factors Associated with Future Plans

    ERIC Educational Resources Information Center

    Chou, Yueh-Ching; Lee, Yue-Chune; Lin, Li-Chan; Kroger, Teppo; Chang, Ai-Ning

    2009-01-01

    A structured interview survey was conducted in a major city in Taiwan to explore and compare older and younger family primary caregivers' well being and their future caregiving plans for these adults with intellectual disability. The sample size was 315 caregivers who were 55 years or older and who cared for adults with intellectual disability and…

  8. The Effect of a Family Therapy and Technology-Based Intervention on Caregiver Depression

    ERIC Educational Resources Information Center

    Eisdorfer, Carl; Czaja, Sara J.; Loewenstein, David A.; Rubert, Mark P.; Arguelles, Soledad; Mitrani, Victoria B.; Szapocznik, Jose

    2003-01-01

    Purpose: The majority of persons with Alzheimer's disease (AD) are cared for at home by a family member such as a spouse or daughter. Caregiving places enormous demands on these caregivers, and the negative consequences associated with caregiving are well documented. This paper reports results from the Miami site of the REACH (Resources for…

  9. Usability of a Wearable Camera System for Dementia Family Caregivers

    PubMed Central

    Matthews, Judith T.; Lingler, Jennifer H.; Campbell, Grace B.; Hunsaker, Amanda E.; Hu, Lu; Pires, Bernardo R.; Hebert, Martial; Schulz, Richard

    2015-01-01

    Health care providers typically rely on family caregivers (CG) of persons with dementia (PWD) to describe difficult behaviors manifested by their underlying disease. Although invaluable, such reports may be selective or biased during brief medical encounters. Our team explored the usability of a wearable camera system with 9 caregiving dyads (CGs: 3 males, 6 females, 67.00 ± 14.95 years; PWDs: 2 males, 7 females, 80.00 ± 3.81 years, MMSE 17.33 ± 8.86) who recorded 79 salient events over a combined total of 140 hours of data capture, from 3 to 7 days of wear per CG. Prior to using the system, CGs assessed its benefits to be worth the invasion of privacy; post-wear privacy concerns did not differ significantly. CGs rated the system easy to learn to use, although cumbersome and obtrusive. Few negative reactions by PWDs were reported or evident in resulting video. Our findings suggest that CGs can and will wear a camera system to reveal their daily caregiving challenges to health care providers. PMID:26288888

  10. [Family Caregivers as a Target Group for Health Promotion and Prevention].

    PubMed

    Budnick, A; Dräger, D; Blüher, S; Kummer, K

    2015-09-01

    Family caregivers are a target group for health promotion, due to the various burdens. Against this background an assessment (ARR) was developed, implemented, and validated in the project "Health Promotion for Elderly Family Caregiver". On the basis of the ARR, family caregivers received an individual, need-oriented, and specific offer for health promotion. In order to reach the target group optimally, a national health insurance company was used.

  11. Family-Oriented Patient Care through the Residency Training Cycle

    ERIC Educational Resources Information Center

    Berman, Ellen M.; Heru, Alison; Grunebaum, Henry; Rolland, John; Sargent, John; Wamboldt, Marianne; McDaniel, Susan

    2008-01-01

    Objective: Because family oriented patient care improves patient outcome and reduces family burden, clinical family skills of communication, assessment, alliance, and support are part of core competencies required of all residents. Teaching residents to "think family" as part of core competencies and to reach out to families requires change in the…

  12. Satisfaction with civilian family medicine residency training

    PubMed Central

    Wolfrom, Brent; Hodgetts, Geoff; Kotecha, Jyoti; Pollock, Emily; Martin, Mary; Han, Han; Morissette, Pierre

    2016-01-01

    Abstract Objective To evaluate satisfaction with civilian residency training programs among serving general duty medical officers within the Canadian Armed Forces. Design A 23-item, cross-sectional survey face-validated by the office of the Surgeon General of the Canadian Armed Forces. Setting Canada. Participants General duty medical officers serving in the Canadian Armed Forces as of February 2014 identified through the Directorate of Health Services Personnel of the Canadian Forces Health Services Group Headquarters. Main outcome measures Satisfaction with and time spent in 7 domains of training: trauma, critical care, emergency medicine, psychiatry, occupational health, sports medicine, and base clinic training. Overall preparedness for leading a health care team, caring for a military population, working in isolated and challenging environments, and being deployed were evaluated on a 5-point Likert scale. Results Among the survey respondents (n = 135, response rate 54%), 77% agreed or strongly agreed that their family medicine residency training was relevant to their role as a general duty medical officer. Most respondents were either satisfied or very satisfied with their emergency medicine training (77%) and psychiatry training (63%), while fewer were satisfied or very satisfied with their sports medicine (47%), base clinic (41%), and critical care (43%) training. Even fewer respondents were satisfied or very satisfied with their trauma (26%) and occupational health (12%) training. Regarding overall preparedness, 57% believed that they were adequately prepared to care for a military patient population, and 52% of respondents believed they were prepared for their first posting. Fewer respondents (38%) believed they were prepared to work in isolated, austere, or challenging environments, and even fewer (32%) believed that residency training prepared them to lead a health care team. Conclusion General duty medical officers were satisfied with many aspects of

  13. Cancer family caregiver depression: are religion-related variables important?

    PubMed

    Williams, Anna-Leila; Dixon, Jane; Feinn, Richard; McCorkle, Ruth

    2015-07-01

    Prevalence estimates for clinical depression among cancer family caregivers (CFC) range upwards to 39%. Research inconsistently reports risk for CFC depressive symptoms when evaluating age, gender, ethnicity, or length of time as caregiver. The discrepant findings, coupled with emerging literature indicating religiosity may mitigate depression in some populations, led us to investigate religion-related variables to help predict CFC depressive symptoms. We conducted a cross-sectional study of 150 CFC. Explanatory variables included age, gender, spousal status, length of time as caregiver, attendance at religious services, and prayer. The outcome variable was the Center for Epidemiological Studies Depression Scale score. Compared with large national and state datasets, our sample has lower representation of individuals with no religious affiliation (10.7% vs. 16.1% national, p = 0.07 and 23.0% state, p = 0.001), higher rate of attendance at religious services (81.3% vs. 67.2% national, p < 0.001 and 30.0% state, p < 0.001), and higher rate of prayer (65.3% vs. 42.9% national, p < 0.001; no state data available). In unadjusted and adjusted models, prayer is not significantly associated with caregiver depressive symptoms or clinically significant depressive symptomology. Attendance at religious services is associated with depressive symptoms (p = 0.004) with an inversely linear trend (p = 0.002). The significant inverse association between attendance at religious services and depressive symptoms, despite no association between prayer and depressive symptoms, indicates that social or other factors may accompany attendance at religious services and contribute to the association. Clinicians can consider supporting a CFC's attendance at religious services as a potential preventive measure for depressive symptoms. Copyright © 2014 John Wiley & Sons, Ltd.

  14. 24 CFR 1710.10 - Single-family residence exemption.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Single-family residence exemption... Requirements § 1710.10 Single-family residence exemption. (a) General. The sale of a lot which meets the... zoned for single-family residences or, in the absence of a zoning ordinance, limited exclusively...

  15. 24 CFR 1710.10 - Single-family residence exemption.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 5 2011-04-01 2011-04-01 false Single-family residence exemption... Requirements § 1710.10 Single-family residence exemption. (a) General. The sale of a lot which meets the... zoned for single-family residences or, in the absence of a zoning ordinance, limited exclusively by...

  16. Understanding caregiving patterns, motivations, and resource needs of subsidized family, friend, and neighbor child care providers.

    PubMed

    Liu, Meirong; Anderson, Steven G

    2010-01-01

    Family, friend, and neighbor (FFN) caregivers play important roles in delivering subsidized noncustodial child care. Yet, little is known about these noncustodial caregivers. This article profiles the caregiving experiences, motivations, and resource needs of these providers, based on a survey of 301 randomly selected FFN providers in one state. Kecommendations are offered for strengthening public supports to enhance the quality of this form of caregiving.

  17. The influence of Chinese culture on family caregivers of stroke survivors: A qualitative study.

    PubMed

    Qiu, Xichenhui; Sit, Janet W H; Koo, Fung Kuen

    2017-07-05

    To explore and describe the caregiving experiences of Chinese stroke caregivers. Previous research has indicated that culture can have a significant impact on the stroke caregiving experience. Moreover, scant research exists on stroke caregivers' experience within the Chinese culture. A qualitative descriptive design was used. In-depth, semistructured interviews were conducted with 25 family caregivers of stroke survivors. The interviews were audiotaped, transcribed and analysed. Content analysis was also performed. Twenty-five family caregivers of stroke survivors were recruited for the study. On average, respondents were 66 years old (range 45-82 years). Of 25 interviewees, 76% were female, 64% were spouse-caregivers and 36% were children-caregivers. Three themes reflecting the influence of Chinese culture on stroke caregiving emerged from the interviews. (i) Caregiving role perception. Informants accepted caregiving for the sick family member as an expected part of life, a culturally prescribed obligation and an expression of reciprocal love. (ii) Coping strategies. Connecting with family resources and connecting with inner strength were frequently reported coping strategies. (iii) Self-sacrifice. Informants identified self-reliance and feeling of restraint in their utilisation or access of formal caregiving service. Chinese caregivers sacrifice themselves for the care recipients regardless of the hardships and the neglect of their own health. Our findings provide a comprehensive and culturally sensitive perspective in understanding the experience of stroke caregivers in Chinese communities. Cultural and religious backgrounds were found to influence Chinese stroke caregivers' experience, coping strategies and self-sacrifice behaviour in idiosyncratic ways. Research on the practice of culture can serve as a basis for the formulation of specific policies and effective interventions for supporting stroke caregivers of different cultural backgrounds. © 2017 The

  18. Traumatic brain injury: unmet support needs of caregivers and families in Florida.

    PubMed

    Dillahunt-Aspillaga, Christina; Jorgensen-Smith, Tammy; Ehlke, Sarah; Sosinski, Melanie; Monroe, Douglas; Thor, Jennifer

    2013-01-01

    Sustaining a Traumatic Brain Injury results in familial strain due to the significant impact the injury has upon the role and function of individuals and their families at home and in the community. Using the Stress Process Model of Caregiving, a caregiver needs assessment survey was developed and conducted to better understand the needs of individuals with a Traumatic Brain Injury and their caregivers. Survey results indicate that caregivers experience many challenges including unmet needs in areas of relational supports such as maintaining relationships, long-term emotional and financial support for themselves and the survivor, and the need for a patient or caregiver advocate. Implications for future practice are presented.

  19. For love, legacy, or pay: legal and pecuniary aspects of family caregiving.

    PubMed

    Kapp, Marshall B

    2013-01-01

    Most caregiving and companionship provided by family members and friends to older individuals in home environments occurs because of the caregiver's feelings of ethical and emotional obligation and attachment. From a legal perspective, though, it might be ill-advised for an informal caregiver to admit such a motivation. Building on a recently published study of relevant litigation, this essay discusses changing cultural and legal aspects of family caregiving when there is some expectation of pay, property, or fuiture financial legacy in return for the caregiver's present work and sacrifices.

  20. Role of the Lebanese family caregivers in cardiac self-care: a collective approach

    PubMed Central

    Dumit, Nuhad Y; Abboud, Sarah; Massouh, Angela; Magilvy, Joan K

    2015-01-01

    Aims and objectives The purpose of this study was to explore perceptions of cardiac self-care among Lebanese family caregivers of cardiac patients. The specific aims were to describe the cultural context of cardiac care-giving in Lebanon and to explore the roles of family caregivers in enhancing self-care practices in patients with cardiac diseases. Background The role of family caregivers in Lebanon, a country in the Middle East, is assumed to extend beyond care-giving to making decisions on behalf of the patient and assuming responsibility for patient care. To date, there has been no study done to empirically validate this impression. Design The design of the study is qualitative descriptive that used semi-structured individual interviews with family caregivers of Lebanese cardiac patients. Method Thirteen family caregivers of cardiac patients were recruited from a referral medical centre in Lebanon. The participants were designated by their patients and interviewed in a place of their choice. Results One overarching and three themes emerged from data analysis describing roles of family care givers in cardiac self-care. The overarching theme was: Family caregivers of Lebanese cardiac patients were unfamiliar with the term, concept and meaning of Self-Care. The moral and emotional duty to care for the family member stemmed from obligation and responsibility towards patients (theme I). Interdependent care (theme II) between cardiac patients and their families emerged as a significant cultural role. Family members play multiple supportive roles in care-giving namely emotional, informational and instrumental role (theme III). Conclusion In this study, family caregiver role is shown to be based in the sense of obligation and duty towards the sick family member who collectively provide different types of supportive care. Relevance to clinical practice Nurses have to give significant importance to the family caregiver role as an integral part of any culturally sensitive

  1. Patients' and Family Caregivers' Goals for Care During Transitions Out of the Hospital.

    PubMed

    Coleman, Eric A; Min, Sung-Joon

    2015-01-01

    The aims of this study were to (a) describe the nature of patients' goals upon discharge from hospital, family caregivers' goals for their loved ones, and family caregivers' goals for themselves; (b) determine the degree of concordance with respect to the three elicited goals; (c) ascertain goal attainment across the three elicited goals; and (d) examine factors predictive of goal attainment. Our findings support the position that eliciting patient and family caregiver goals and promoting goal attainment may represent an important step toward promoting greater patient and family caregiver engagement in their care.

  2. Communication between nurses and family caregivers of hospitalised older persons: a literature review.

    PubMed

    Bélanger, Louise; Bourbonnais, Anne; Bernier, Roxanne; Benoit, Monique

    2017-03-01

    To review the literature concerning the feelings, thoughts and behaviours of nurses and family caregivers of hospitalised older persons when they communicate with one another. Communication between nurses and family caregivers of hospitalised older persons is not always optimal. Improving the frequency and quality of this communication might be a way to make the most of available human capital in order to better care for hospitalised older people. A literature review was carried out of qualitative, quantitative and mixed-design studies relating to communication between nurses and family caregivers. Findings were analysed thematically. Family caregiver thoughts, feelings and behaviours relative to nurse control and authority, nurse recognition of their contribution, information received from and shared with nurses and care satisfaction could influence communication with nurses. Nurse thoughts regarding usefulness of family caregivers as care partners and their lack of availability to meet family caregiver demands could influence communication with family caregivers. The thoughts, feelings and behaviours of family caregivers and nurses that might create positive or negative circular patterns of communication are evidenced. Further research is required to gain a more comprehensive understanding of the phenomenon. Nurses must be trained in how to communicate with family caregivers in order to form a partnership geared to preventing complications in hospitalised older persons. Results could be used to inform policy regarding the care of hospitalised older persons. © 2016 John Wiley & Sons Ltd.

  3. Development and psychometric testing of the Suicide Caring Competence Scale (SCCS) for family caregivers in Taiwan.

    PubMed

    Sun, Fan-Ko; Chiang, Chun-Ying; Chen, Wei-Jen; Wang, Ruey-Hsia; Huang, Hui-Man; Lin, Hung-Yen

    2014-08-01

    Suicide caring competence is important for family caregivers to care their relatives with suicidal tendencies. The purpose of this study was to develop and test the psychometric properties of the Suicide Caring Competence Scale (SCCS) for family caregivers in Taiwan. A 20-item SCCS was tested on 165 family caregivers. Confirmatory factor analysis indicated that five subscales with 19 items best fit the data. The Cronbach's α and test-retest reliability of the SCCS was 0.90 and 0.81, respectively. The SCCS demonstrated acceptable construct validity and reliability. Nurses can use the SCCS to assess the suicide caring competence of family caregivers.

  4. Conflict Resolution and Distress in Dementia Caregiver Families: Comparison of Cubans and White Non-Hispanics

    PubMed Central

    Mitrani, Victoria B.; Vaughan, Ellen L.; McCabe, Brian E.; Feaster, Daniel J.

    2010-01-01

    This study investigated the role of family conflict resolution as a mediator of the relationship between ethnicity and psychological distress in dementia caregivers. The sample was composed of the families of 182 caregivers who participated in REACH (Resources for Enhancing Alzheimer’s Caregiver Health). The sample consisted of 84 Cuban American and 98 non-Hispanic White American families. Mediation analyses revealed that both income and conflict resolution partially mediated the relationship between ethnicity and caregiver psychological distress. Specifically, Cuban American families were less likely than non-Hispanic White families to reach a resolution to their disagreements, which may have rendered the caregiver at greater risk for psychological distress. These results suggest that Cuban American caregivers may benefit from interventions that improve the family’s ability to resolve conflicts. PMID:20448830

  5. Home-based music strategies with individuals who have dementia and their family caregivers.

    PubMed

    Hanser, Suzanne B; Butterfield-Whitcomb, Joan; Kawata, Mayu; Collins, Brett E

    2011-01-01

    The purpose of this exploratory study was to test a caregiver-administered music program with family members who have dementia. The music protocol was designed to reduce distress and enhance satisfaction with caregiving, while offering the person with dementia the potential to improve mood and psychological state. Fourteen elders with dementia and their family caregivers were recruited, and 8 completed the protocol. Both caregivers and care recipients improved self-reported relaxation, comfort, and happiness, when mean scores were compared between baseline and music conditions. Caregivers showed the most benefit. While drop-out was high (6 families dropped), and caregiving satisfaction failed to improve over time, caregivers expressed enjoyment in reminiscing and participating in musical activities with their loved ones. More direct intervention by a music therapist is recommended to improve impact.

  6. The Family Time Squeeze: Perceived Family Time Adequacy Buffers Work Strain in Certified Nursing Assistants With Multiple Caregiving Roles.

    PubMed

    DePasquale, Nicole; Mogle, Jacqueline; Zarit, Steven H; Okechukwu, Cassandra; Kossek, Ellen Ernst; Almeida, David M

    2017-01-10

    This study examined how certified nursing assistants (CNAs) with unpaid family caregiving roles for children ("double-duty-child caregivers"), older adults ("double-duty-elder caregivers"), and both children and older adults ("triple-duty caregivers") differed from their nonfamily caregiving counterparts ("workplace-only caregivers") on four work strain indicators (emotional exhaustion, job satisfaction, turnover intentions, and work climate for family sacrifices). The moderating effects of perceived family time adequacy were also evaluated. Regression analyses were conducted on survey data from 972 CNAs working in U.S.-based nursing homes. Compared with workplace-only caregivers, double-and-triple-duty caregivers reported more emotional exhaustion and pressure to make family sacrifices for the sake of work. Triple-duty caregivers also reported less job satisfaction. Perceived family time adequacy buffered double-duty-child and triple-duty caregivers' emotional exhaustion and turnover intentions, as well as reversed triple-duty caregivers' negative perceptions of the work climate. Perceived family time adequacy constitutes a salient psychological resource for double-duty-child and triple-duty caregivers' family time squeezes. Amid an unprecedented demand for long-term care and severe direct-care workforce shortages, future research on workplace factors that increase double-and-triple-duty caregiving CNAs' perceived family time adequacy is warranted to inform long-term care organizations' development of targeted recruitment, retention, and engagement strategies. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Support groups for dementia caregivers - Predictors for utilisation and expected quality from a family caregiver's point of view: A questionnaire survey PART I*

    PubMed Central

    2010-01-01

    Background Support groups have proved to be effective in reducing the burden on family caregivers of dementia patients. Nevertheless, little is known about the factors that influence utilisation or quality expectations of family caregivers. These questions are addressed in the following paper. Methods The cross-sectional study was carried out as an anonymous written survey of family caregivers of dementia patients in Germany. Qualitative and quantitative data from 404 caregivers were analysed using content analysis and binary logistic regression analysis. Results The only significant predictor for utilisation is assessing how helpful support groups are for the individual care situation. Family caregivers all agree that psycho-educative orientation is a priority requirement. Conclusions In order to increase the rate of utilisation, family caregivers must be convinced of the relevant advantages of using support groups. Support groups which offer an exchange of experiences, open discussion, information and advice meet the requirements of family caregivers. PMID:20667092

  8. A comprehensive assessment of family caregivers of stroke survivors during inpatient rehabilitation.

    PubMed

    Young, Mary Ellen; Lutz, Barbara J; Creasy, Kerry Rae; Cox, Kim J; Martz, Crystal

    2014-01-01

    Stroke caregivers have been identified as a group at high risk for poor outcomes as a result of the suddenness of stroke and a potentially high level of care needed due to significant functional limitations of the patient. However, there is little research on the assessment of family members who will assume the caregiving role prior to patient discharge from rehabilitation. The purpose of this article is to delineate critical assessment domains identified by a subset of spousal stroke caregivers. Semi-structured interviews were conducted pre- and post-discharge from rehabilitation as part of a larger study that focused on identifying caregiver and stroke survivor needs as they transitioned home from inpatient rehabilitation. For this study, two semi-structured interviews with 14 spousal caregivers were analyzed using grounded theory methods. Long-term stroke survivor outcomes were dependent upon the commitment, capacity and preparedness of the family caregiver. Twelve domains of assessment were identified and presented. A comprehensive, systematic caregiver assessment to understand the caregiver's concerns about stroke should be conducted during rehabilitation to help the team to develop a plan to address unmet needs and better prepare family caregivers to take on the caregiving role. Stroke is a sudden event that often leaves stroke survivors and their families in crisis. The needs of stroke family caregivers are not often systematically assessed as part of inpatient rehabilitation. Long-term stroke survivor outcomes are dependent upon the commitment, capacity and preparedness of the family caregiver. Stroke caregiver assessment should include the commitment, capacity and preparedness to provide care, and the overall impact of stroke in order to develop discharge plans that will adequately address the needs of the stroke survivor/caregiver dyad.

  9. Unmet Needs of Community-Residing Persons with Dementia and Their Informal Caregivers: Findings from the MIND at Home Study

    PubMed Central

    Black, Betty S.; Johnston, Deirdre; Rabins, Peter V.; Morrison, Ann; Lyketsos, Constantine; Samus, Quincy M.

    2014-01-01

    OBJECTIVES To determine the prevalence and correlates of unmet needs in a sample of community-residing persons with dementia (PWD) and their informal caregivers. DESIGN Analysis of cross-sectional, baseline participant characteristics prior to randomization in a care coordination intervention trial. SETTING Baltimore, MD. PARTICIPANTS Community-residing PWD (n=254) and their informal caregivers (n=246). MEASUREMENTS In-home assessments of dementia-related needs based on the Johns Hopkins Dementia Care Needs Assessment. Bivariate and multivariate regression analyses were conducted to identify demographic, socioeconomic, clinical, functional and quality of life correlates of unmet needs. RESULTS The mean number of unmet needs in PWD was 7.7 (SD=4.8) and 4.6 (SD=2.3) in caregivers, with almost all PWD (99%) and caregivers (97%) having one or more unmet needs. Unmet needs in PWD were significantly greater among those with higher cognitive function. Ninety percent of PWD had unmet safety needs, over half had unmet needs for meaningful activities, and almost one-third had not received a prior evaluation or diagnosis. Higher unmet needs in PWD were associated significantly with non-white race, lower incomes, less impairment in activities of daily living and more symptoms of depression. For caregivers, more than 85% had unmet needs for resource referrals and caregiver education. Higher unmet caregiver needs were associated significantly with non-white race, less education, and more symptoms of depression. CONCLUSION Many community-residing PWD and their caregivers have unmet dementia-related needs for care, services and support. Providers should be aware that unmet needs may be higher among minority and low-income community residents, caregivers with lower education, and individuals with early-stage dementia. Identifying and treating symptoms of depression in PWD and caregivers may enable them to address their other unmet needs. PMID:24479141

  10. Validation of the Italian Version of the Caregiver Abuse Screen among Family Caregivers of Older People with Alzheimer's Disease

    PubMed Central

    Di Rosa, Mirko; Barbabella, Francesco; Barbini, Norma; Chiatti, Carlos

    2017-01-01

    Introduction. Elder abuse is often a hidden phenomenon and, in many cases, screening practices are difficult to implement among older people with dementia. The Caregiver Abuse Screen (CASE) is a useful tool which is administered to family caregivers for detecting their potential abusive behavior. Objectives. To validate the Italian version of the CASE tool in the context of family caregiving of older people with Alzheimer's disease (AD) and to identify risk factors for elder abuse in Italy. Methods. The CASE test was administered to 438 caregivers, recruited in the Up-Tech study. Validity and reliability were evaluated using Spearman's correlation coefficients, principal-component analysis, and Cronbach's alphas. The association between the CASE and other variables potentially associated with elder abuse was also analyzed. Results. The factor analysis suggested the presence of a single factor, with a strong internal consistency (Cronbach's alpha = 0.86). CASE score was strongly correlated with well-known risk factors of abuse. At multivariate level, main factors associated with CASE total score were caregiver burden and AD-related behavioral disturbances. Conclusions. The Italian version of the CASE is a reliable and consistent screening tool for tackling the risk of being or becoming perpetrators of abuse by family caregivers of people with AD. PMID:28265571

  11. Effects of Green House nursing homes on residents' families.

    PubMed

    Lum, Terry Y; Kane, Rosalie A; Cutler, Lois J; Yu, Tzy-Chyi

    2008-01-01

    A longitudinal quasi-experimental study with two comparison groups was conducted to test the effects of a Green House (GH) nursing home program on residents' family members. The GHs are individual residences, each serving 10 elders, where certified nursing assistant (CNA)-level resident assistants form primary relationships with residents and family, family is encouraged to visits, and professionals adapted their roles to support the model. GH family were somewhat less involved in providing assistance to their residents although family contact did not differ among the settings at any time period. GH family were more satisfied with their resident's care and with their own experience as family members, and had no greater family burden. Issues in studying family outcomes are discussed as well as implications for roles of various personnel, including social service and activities staff in a GH model.

  12. The vulnerability of family caregivers in relation to vulnerability as understood by nurses.

    PubMed

    Sarvimäki, Anneli; Stenbock-Hult, Bettina; Sundell, Eija; Oesch-Börman, Christine

    2017-03-01

    In Finland, the care of older persons is shifting from institutional care to family care. Research shows that family caregivers experience their situation much in the same way as professional nurses. The nurses' experiences have been studied in terms of vulnerability, and the same perspective could deepen our understanding of family caregivers' experiences. The aim of this study was to gain knowledge of the vulnerability of older caregivers taking care of an ageing family member. The research questions were as follows: How do family caregivers experience vulnerability? How do their experiences relate to vulnerability as understood by nurses? The study was done as a secondary analysis of focus group interviews on the experiences and daily life of older family caregivers. Four caregivers had taken part in monthly interviews during a period of 10 months. The interviews were analysed by deductive and inductive content analysis. The results showed that the caregivers saw caregiving as part of being human. They experienced a variety of feelings and moral agony and were harmed physically, mentally and socially. They showed courage, protected themselves and recognised that being a caregiver also was a source of maturing and developing. These results corresponded with the nurses' understanding of vulnerability. Shame, the experience of duty as a burden, worry and loneliness were themes that were found only among the family caregivers. The use of a matrix may have restricted the analysis, but using it in an unconstrained way allowed for new themes to be created. The results indicate a common humanness and vulnerability in professional and family caregiving. They also show that family caregivers need more support both from society and professionals. © 2016 Nordic College of Caring Science.

  13. A DVD program on fall prevention skills training for cancer family caregivers.

    PubMed

    Potter, Patricia; Olsen, Sarah; Kuhrik, Marilee; Kuhrik, Nancy; Huntley, Lance R

    2012-03-01

    This feasibility study tested an instructional DVD program for improving cancer family caregivers' knowledge and preparedness in fall prevention and reducing fall occurrence among the patients they care for at home. DVD program features included training caregivers on safe mobility skills. Family caregivers of cancer patients were surveyed before and after viewing the DVD program on "Moving Safely" in the home. Cancer patients were followed 4 months postintervention to determine if fall occurrence was reduced. There was a decrease in the number of patients who fell postintervention compared with those who fell preintervention. Caregivers' perceptions of knowledge about fall prevention improved significantly after viewing the DVD. An instructional DVD program is an effective educational tool for preparing family caregivers with the knowledge and skills needed to reduce the incidence of falls in the home setting. Educators must develop programs for preparing family caregivers to perform nursing skills within the home.

  14. Implications of smart wear technology for family caregiving relationships: focus group perceptions.

    PubMed

    Hall, Scott S; Kandiah, Jayanthi; Saiki, Diana; Nam, Jinhee; Harden, Amy; Park, Soonjee

    2014-10-01

    Technological advances in monitoring vulnerable care-recipients are on the rise. Recent and future development of Smart Wear technology (devices integrated into clothing that monitor care-recipients) might assist family caregivers with tasks related to caring for young children, relatives with disabilities, and frail spouses or parents. However, the development and use of this technology in family caregiving contexts is in its infancy. Focus group interviews of family caregivers were conducted to explore perspectives regarding the potential integration of Smart Wear technology into their family caregiving. Responses were analyzed qualitatively for themes related to perceptions of how Smart Wear could impact relationships between caregivers and care-recipients. Three major themes emerged: quality and quantity of interaction, boundary issues, and implications for anxiety. Implications and recommendations are discussed regarding maximizing the potential benefits of Smart Wear technology in ways that promote and protect healthy relationships among caregivers and care-recipients.

  15. FACTORS ASSOCIATED WITH STROKE SURVIVOR BEHAVIORS AS IDENTIFIED BY FAMILY CAREGIVERS

    PubMed Central

    Gonzalez, Carmanny; Bakas, Tamilyn

    2013-01-01

    Stroke survivor behaviors that caregivers identify as bothersome can lead to family caregiver stress, which can result in premature institutionalization of the survivor. The purpose of this study was to explore demographic and theory-based factors associated with survivor bothersome behaviors as identified by family caregivers. A secondary analysis of a combined sample of 96 family caregivers of stroke survivors was conducted using baseline data from 2 existing studies. Bothersome behaviors were measured using the Revised Memory and Behavior Problems Checklist (RMBPC). Theory-based factors were measured using well-validated scales. Male stroke survivors exhibited more bothersome behaviors (t = 3.53, p < .01). After controlling for survivor gender, 35% of the variance in bothersome behaviors was explained by caregiver depressive symptoms, task difficulty, life changes, and threat appraisal [F(5,88) = 10.82, p < .001]. These results identify potential areas for nursing interventions designed to reduce bothersome behaviors as identified by family caregivers. PMID:23686515

  16. Critically examining diversity in end-of-life family caregiving: implications for equitable caregiver support and Canada's Compassionate Care Benefit.

    PubMed

    Giesbrecht, Melissa; Crooks, Valorie A; Williams, Allison; Hankivsky, Olena

    2012-11-01

    Family (i.e., unpaid) caregiving has long been thought of as a 'woman's issue', which ultimately results not only in gendered, but also financial and health inequities. Because of this, gender-based analyses have been prioritized in caregiving research. However, trends in current feminist scholarship demonstrate that gender intersects with other axes of difference, such as culture, socio-economic status, and geography to create diverse experiences. In this analysis we examine how formal front-line palliative care providers understand the role of such diversities in shaping Canadian family caregivers' experiences of end-of-life care. In doing so we consider the implications of these findings for a social benefit program aimed at supporting family caregivers, namely the Compassionate Care Benefit (CCB). This analysis contributes to a utilization-focused evaluation of Canada's CCB, a social program that provides job security and limited income assistance to Canadian family caregivers who take a temporary leave from employment to provide care for a dying family member at end-of-life. Fifty semi-structured phone interviews with front-line palliative care providers from across Canada were conducted and thematic diversity analysis of the transcripts ensued. Findings reveal that experiences of caregiving are not homogenous and access to services and supports are not universal across Canada. Five axes of difference were commonly raised by front-line palliative care providers when discussing important differences in family caregivers' experiences: culture, gender, geography, lifecourse stage, and material resources. Our findings reveal inequities with regard to accessing needed caregiver services and resources, including the CCB, based on these axes of difference. We contend that without considering diversity, patterns in vulnerability and inequity are overlooked, and thus continually reinforced in health policy. Based on our findings, we demonstrate that re

  17. Burden and associated pathologies in family caregivers of Alzheimer's disease patients in Spain.

    PubMed

    Cotelo, Natalia Vérez; Rodríguez, N Floro Andrés; Pérez, José A Fornos; Iglesias, J Carlos Andrés; Lago, Marcos Ríos

    2015-01-01

    To evaluate the profile of family caregivers of Alzheimer's disease patients, identify any signs of psychopathology, quantify the level of perceived burden on the caregiver, and determine the caregiver's relationship with their pharmacist. A cross-sectional study was conducted at a community pharmacy in Pontevedra, Spain. Demographic variables were collected, and the following questionnaires were administered: the Beck Depression Inventory-II, STAI-Anxiety Questionnaire, Zarit Burden Scale, family APGAR scale, and the Duke-UNC questionnaire. The typical caregiver profile consists of a 55-year old first degree relative (mostly daughters) with a primary education who belongs to a functional or mildly dysfunctional family. Nearly one quarter (24%) of caregivers had a high perception of burden, with anxiety in 20% of caregivers and symptoms of depression in 20%. Family caregivers usually went to the same pharmacy as the patients (96%), were treated with psychotropic drugs (68%), and interacted with the pharmacist (92%). This study confirmed that psychological distress and burden is present among family caregivers. Care for caregivers should be integrated into patient care as part of a national plan, including grants and subsidies, which will result in better care of Alzheimer's patients. Pharmacists are the most accessible health care professionals and can provide information about Alzheimer's disease management to caregivers to ease the burden of care.

  18. Predictors of family caregivers' burden and quality of life when providing care for a family member with schizophrenia in the People's Republic of China.

    PubMed

    Li, Jufang; Lambert, Clinton E; Lambert, Vickie A

    2007-09-01

    Limited research has been undertaken regarding family caregivers' burden and quality of life (QOL) when providing care for a family member with schizophrenia in the People's Republic of China. This study examined the following in Chinese families caring for a member with schizophrenia: (i) the level of family caregivers' burden and QOL; (ii) the relationships among the demographic characteristics of family caregivers, the demographic characteristics of family members with schizophrenia, and family caregivers' burden and QOL; and (iii) the best predictors of family caregivers' burden and QOL. The findings suggest that family caregivers suffer a high level of burden when caring for a family member with schizophrenia. Numerous significant correlations were found among the variables. The best predictor of family caregivers' burden was found to be their level of education, while the best predictors of family caregivers' QOL were physical health and household income.

  19. Family caregiving to those with dementia in rural Alabama: racial similarities and differences.

    PubMed

    Kosberg, Jordan I; Kaufman, Allan V; Burgio, Louis D; Leeper, James D; Sun, Fei

    2007-02-01

    This study explored differences and similarities in the experiences of African American and White family caregivers of dementia patients living in rural Alabama. This cross-sectional survey used a caregiving stress model to investigate the interrelationships between caregiving burden, mediators, and outcomes. Random-digit-dialing telephone interviews were used to obtain data on a probability sample of 74 non-Hispanic White and 67 African American caregivers. White caregivers were more likely to be married and older, used acceptance and humor as coping styles, and had fewer financial problems. African American caregivers gave more hours of care, used religion and denial as coping styles, and were less burdened. The authors have developed a methodology for obtaining a representative sample of African American and White rural caregivers. Further investigations are needed of the interactions between urban/rural location and ethnic/racial backgrounds of dementia caregivers for heuristic and applied reasons.

  20. Caregiving Styles: A Cognitive and Behavioral Typology Associated with Dementia Family Caregiving

    ERIC Educational Resources Information Center

    Corcoran, Mary A.

    2011-01-01

    Purpose: An increasing number of elderly individuals are diagnosed with Alzheimer's disease and related disorders (ADRD), many of whom receive daily caregiving from spouse or adult child. Caregiving is a "cultural activity," and as such it is strongly influenced by sociocultural beliefs about caregiving and how it should be enacted.…

  1. Caregiving Styles: A Cognitive and Behavioral Typology Associated with Dementia Family Caregiving

    ERIC Educational Resources Information Center

    Corcoran, Mary A.

    2011-01-01

    Purpose: An increasing number of elderly individuals are diagnosed with Alzheimer's disease and related disorders (ADRD), many of whom receive daily caregiving from spouse or adult child. Caregiving is a "cultural activity," and as such it is strongly influenced by sociocultural beliefs about caregiving and how it should be enacted.…

  2. Needs of family caregivers in home care for older adults.

    PubMed

    Bierhals, Carla Cristiane Becker Kottwitz; Santos, Naiana Oliveira Dos; Fengler, Fernanda Laís; Raubustt, Kamila Dellamora; Forbes, Dorothy Anne; Paskulin, Lisiane Manganelli Girardi

    2017-04-06

    to reveal the felt and normative needs of primary family caregivers when providing instrumental support to older adults enrolled in a Home Care Program in a Primary Health Service in the South of Brazil. using Bradshaw's taxonomy of needs to explore the caregiver's felt needs (stated needs) and normative needs (defined by professionals), a mixed exploratory study was conducted in three steps: Descriptive quantitative phase with 39 older adults and their caregiver, using a data sheet based on patient records; Qualitative exploratory phase that included 21 caregiver interviews, analyzed by content analysis; Systematic observation, using an observation guide with 16 caregivers, analyzed by descriptive statistics. the felt needs were related to information about instrumental support activities and subjective aspects of care. Caregivers presented more normative needs related to medications care. understanding caregivers' needs allows nurses to plan interventions based on their particularities. identificar as necessidades sentidas e normativas dos cuidadores familiares principais no apoio instrumental a idosos registrados em um Programa de Atenção Domiciliar em uma Unidade Básica de Saúde no Sul do Brasil. usando a Taxonomia de Necessidades de Bradshaw para explorar as necessidades sentidas (necessidades declaradas) e normativas (definidas por profissionais), desenvolveu-se um estudo exploratório misto em três etapas: Etapa descritiva quantitativa, envolvendo 39 idosos e seus cuidadores, com a ajuda de um folha de dados baseada no prontuário do paciente; Etapa exploratória qualitativa, baseada em entrevistas com 21 cuidadores, analisadas mediante a análise de conteúdo; Observação sistemática, aplicando um roteiro de observação a 16 cuidadores, com análise estatística descritiva. as necessidades sentidas estavam relacionadas a informações sobre atividades de apoio instrumental e aspectos subjetivos do cuidado. Os cuidadores apresentaram maior número de

  3. Family caregivers in public tertiary care hospitals in Bangladesh: risks and opportunities for infection control.

    PubMed

    Islam, M Saiful; Luby, Stephen P; Sultana, Rebeca; Rimi, Nadia Ali; Zaman, Rashid Uz; Uddin, Main; Nahar, Nazmun; Rahman, Mahmudur; Hossain, M Jahangir; Gurley, Emily S

    2014-03-01

    Family caregivers are integral to patient care in Bangladeshi public hospitals. This study explored family caregivers' activities and their perceptions and practices related to disease transmission and prevention in public hospitals. Trained qualitative researchers conducted a total of 48 hours of observation in 3 public tertiary care hospitals and 12 in-depth interviews with family caregivers. Family caregivers provided care 24 hours a day, including bedside nursing, cleaning care, and psychologic support. During observations, family members provided 2,065 episodes of care giving, 75% (1,544) of which involved close contact with patients. We observed family caregivers washing their hands with soap on only 4 occasions. The majority of respondents said diseases are transmitted through physical contact with surfaces and objects that have been contaminated with patient secretions and excretions, and avoiding contact with these contaminated objects would help prevent disease. Family caregivers are at risk for hospital-acquired infection from their repeated exposure to infectious agents combined with their inadequate hand hygiene and knowledge about disease transmission. Future research should explore potential strategies to improve family caregivers' knowledge about disease transmission and reduce family caregiver exposures, which may be accomplished by improving care provided by health care workers. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  4. Health Trajectories of Family Caregivers: Associations With Care Transitions and Adult Day Service Use

    PubMed Central

    Liu, Yin; Kim, Kyungmin; Zarit, Steven H.

    2017-01-01

    Objective The study examines family caregivers’ health changes over 1 year on four health dimensions and explores the association of differential health trajectories with adult day service (ADS) use and caregiving transitions. Method The participants were 153 primary caregivers of individuals with dementia (IWDs) who provided information on care situations and their own health at baseline, 6-month, and 12-month interviews. Results Caregivers showed increasing functional limitations and decreasing bodily pain over time, whereas role limitation and general health perception remained stable. Furthermore, caregivers’ trajectories of functional limitation were associated with their extent of ADS use at baseline and their relatives’ placement. Discussion Health is multidimensional; all dimensions of caregiver health do not change in a uniform manner. The findings underscore the importance of the association of caregiving transitions and caregiver health and the potential health benefits of ADS use for family caregivers. PMID:25348275

  5. Social Networking Family of Caregivers during Hospitalization of Children.

    PubMed

    Menezes, Marina; Moré, Carmen Leontina Ojeda Ocampo; Barros, Luísa

    2016-06-01

    To identify and analyze the significant networks of family, social and hospital support described by the family caregivers of hospitalized children 5-12 years during the hospital stay. Descriptive study, exploratory and qualitative study conducted with 20 caregivers of children hospitalized in a hospital in a city in southern Brazil, through semi-structured interviews and significant social networks maps, tailored to the hospital setting. Data analysis showed that the most active social network was comprised of families through emotional support, material aid and services. Relations with hospital health care team and the hospital context were cited as providing support to the caregivers of the hospitalized child. The identification of social networks in the child's hospitalization course enables equip professionals working in the institution aiming at better targeting of actions and care for the family and hospitalized children. Identificar e analisar as redes significativas de suporte familiar, social e hospitalar descritas pelos familiares acompanhantes de crianças hospitalizadas de 5 a 12 anos, durante o período de internação. Estudo descritivo, exploratório e de cunho qualitativo realizado com 20 acompanhantes de crianças hospitalizadas em uma unidade hospitalar em uma cidade do Sul do Brasil, por meio de entrevistas semiestruturadas e dos Mapas de Redes sociais significativas, adaptado para o contexto hospitalar. A análise dos dados demonstrou que a rede social mais atuante foi composta por familiares, através de apoio emocional, ajuda material e de serviços. As relações com a equipe de saúde do hospital e com o contexto hospitalar foram citadas como capazes de fornecer apoio ao acompanhante da criança internada. a identificação das redes sociais no curso da hospitalização da criança possibilita instrumentalizar os profissionais que atuam na instituição objetivando um melhor direcionamento de ações e cuidados destinados à família e a

  6. Anticipatory Grief in New Family Caregivers of Persons with Mild Cognitive Impairment and Dementia

    PubMed Central

    Garand, Linda; Lingler, Jennifer H.; Deardorf, Kaitlyn E.; DeKosky, Steven T.; Schulz, Richard; Reynolds, Charles F.; Dew, Mary Amanda

    2011-01-01

    Anticipatory grief is the process of experiencing normal phases of bereavement in advance of the loss of a significant person. To date, anticipatory grief has been examined in family caregivers to individuals who have had Alzheimer’s Disease (AD) an average of 3 to 6 years. Whether such grief is manifested early in the disease trajectory (at diagnosis) is unknown. Using a cross-sectional design, we examined differences in the nature and extent of anticipatory grief between family caregivers of persons with a new diagnosis of mild cognitive impairment (MCI, n=43) or AD (n=30). We also determined whether anticipatory grief levels were associated with caregiver demographics, caregiving burden, depressive symptoms and marital quality. Mean anticipatory grief levels were high in the total sample, with AD caregivers endorsing significantly more anticipatory grief than MCI caregivers. In general, AD caregivers endorsed difficulty functioning whereas MCI caregivers focused on themes of “missing the person” they once knew. Being a female caregiver, reporting higher levels of objective caregiving burden and higher depression levels each bore independent, statistically significant relationships with anticipatory grief. Given these findings, family caregivers of individuals with mild cognitive deficits or a new AD diagnosis may benefit from interventions specifically addressing anticipatory grief. PMID:21946013

  7. Understanding How to Support Family Caregivers of Seniors with Complex Needs.

    PubMed

    Charles, Lesley; Brémault-Phillips, Suzette; Parmar, Jasneet; Johnson, Melissa; Sacrey, Lori-Ann

    2017-06-01

    The purpose of this study was to describe the experiences and challenges of supporting family caregivers of seniors with complex needs and to outline support strategies and research priorities aimed at supporting them. A CIHR-funded, two-day conference entitled "Supporting Family Caregivers of Seniors: Improving Care and Caregiver Outcomes" was held. An integrated knowledge translation approach guided this planning conference. Day 1 included presentations of research evidence, followed by participant engagement Qualitative data was collected regarding facilitators, barriers/gaps, and recommendations for the provision of caregiver supports. Day 2 focused on determination of research priorities. Identified facilitators to the provision of caregiver support included accessibility of health-care and community-based resources, availability of well-intended health-care providers, and recognition of caregivers by the system. Barriers/gaps related to challenges with communication, access to information, knowledge of what is needed, system navigation, access to financial resources, and current policies. Recommendations regarding caregiver services and research revolved around assisting caregivers to self-identify and seek support, formalizing caregiver supports, centralizing resources, making system navigation available, and preparing the next generation for caregiving. A better understanding of the needs of family caregivers and ways to support them is critical to seniors' health services redesign.

  8. Understanding How to Support Family Caregivers of Seniors with Complex Needs

    PubMed Central

    Charles, Lesley; Brémault-Phillips, Suzette; Parmar, Jasneet; Johnson, Melissa; Sacrey, Lori-Ann

    2017-01-01

    Purpose of the Study The purpose of this study was to describe the experiences and challenges of supporting family caregivers of seniors with complex needs and to outline support strategies and research priorities aimed at supporting them. Design and Methods A CIHR-funded, two-day conference entitled “Supporting Family Caregivers of Seniors: Improving Care and Caregiver Outcomes” was held. An integrated knowledge translation approach guided this planning conference. Day 1 included presentations of research evidence, followed by participant engagement Qualitative data was collected regarding facilitators, barriers/gaps, and recommendations for the provision of caregiver supports. Day 2 focused on determination of research priorities. Results Identified facilitators to the provision of caregiver support included accessibility of health-care and community-based resources, availability of well-intended health-care providers, and recognition of caregivers by the system. Barriers/gaps related to challenges with communication, access to information, knowledge of what is needed, system navigation, access to financial resources, and current policies. Recommendations regarding caregiver services and research revolved around assisting caregivers to self-identify and seek support, formalizing caregiver supports, centralizing resources, making system navigation available, and preparing the next generation for caregiving. Implication A better understanding of the needs of family caregivers and ways to support them is critical to seniors’ health services redesign. PMID:28690707

  9. Caregiving to persons living with HIV/AIDS: experiences of Vietnamese family members.

    PubMed

    Lundberg, Pranee C; Doan, Thoa Thi Kim; Dinh, Thu Thi Xuan; Oach, Nhung Kim; Le, Phong Hoang

    2016-03-01

    To examine the experiences of caregiving among Vietnamese family members of persons living with HIV/AIDS. As the number of persons living with HIV/AIDS increases, the need of family caregivers who can take responsibility for the home care of these persons increases. Vietnam has one of the fastest growing HIV epidemics in Asia. A descriptive cross-sectional study with quantitative and qualitative methods was used. A purposive sample of 104 family caregivers, both male and female, participated voluntarily by answering a questionnaire of caregiver burden, and 20 of them participated in in-depth interview. Female caregivers were mainly mothers and wives while male caregivers were mainly husbands, fathers and siblings. The largest group of family caregivers reported moderate to severe burden. There was no difference between genders in total caregiver burden, but there were several differences between older and younger caregivers in some items of caregiver burden. Five categories of experiences emerged: Different types of caregiving to persons living with HIV/AIDS, cultural and religious issues associated with caregiving, keeping secret to avoid stigma and discrimination, lack of knowledge about disease and provision of care, and fear, anxiety and frustration. Stigma and discrimination should be decreased by providing knowledge to the general public about HIV/AIDS, in particular about ways of transmission and protection. Special knowledge should be given to family caregivers to enable them to give care to persons living with HIV/AIDS at home. This could be done through culturally appropriate training/intervention programmes in which coping methods should be included. Support group interventions should also be carried through. The results obtained can be used as baseline information. Health care providers should consider gender, age and culture of family members of persons living with HIV/AIDS. Knowledge about HIV/AIDS, provision of care at home and in hospital, and

  10. Family caregiver preferences for patient decisional control among Hispanics in the United States and Latin America

    PubMed Central

    Yennurajalingam, Sriram; Noguera, Antonio; Parsons, Henrique Afonseca; Torres-Vigil, Isabel; Duarte, Eva Rosina; Palma, Alejandra; Bunge, Sofia; Palmer, J. Lynn; Delgado-Guay, Marvin Omar; Bruera, Eduardo

    2013-01-01

    Background Understanding family caregivers’ decisional role preferences is important for communication, quality of care, and patient and family satisfaction. The family caregiver has an important role in a patient’s decisional role preferences. There are limited studies on family caregivers’ preferences of the patient’s decisional control at the end of life among Hispanics. Aims To identify Hispanic caregivers’ preferences of the decision control of patients with advanced cancer and to compare the preferences of caregivers in Latin America (HLA) and Hispanic American (HUSA) caregivers. Design We surveyed patients and their family caregivers referred to outpatient palliative care clinics in the United States, Chile, Argentina, and Guatemala. Caregiver preferences of patient’s decisional control were evaluated using the Control Preference Scale. Caregivers’ and patients’ socio-demographic variables, patient performance status, and HUSA patient acculturation level was also collected. Participants A total of 387 caregivers were surveyed: 100 (26%) in Chile, 99 (26%) in Argentina, 97 (25%) in Guatemala, and 91 (24%) in the United States. The median age was 56 years, and 59% were female. Results Caregiver preference of patients decisions control was passive, shared, and active by 10 (11%), 45 (52%) and 32 (37%) HUSA caregivers and 54 (19%), 178 (62%) and 55 (19%) HLA caregivers (p=0.0023). Caregiver acculturation level did not affect the preferences of the HUSA sample (p=0.60). Conclusions Most Hispanic family caregivers preferred the patient to make shared decisions. HLA caregivers preferred more frequently patients to assume a passive decisional role. Acculturation did not influence the preferences of HUSA caregivers. PMID:23670718

  11. Evaluating life in foster homes for persons with serious mental illness: Resident and caregiver perspectives.

    PubMed

    Piat, Myra; Ricard, Nicole; Lesage, Alain

    2009-08-26

    In Montreal Canada, the majority of persons with serious mental illness discharged from psychiatric hospitals were placed into foster homes. Very little updated information exists on life in foster homes, and the level of autonomy allowed in this residential setting. The purpose of the study was to elicit the foster home residents' opinions about their lives in this setting and their caregiver's perception of the level of autonomy allowed. Two questionnaires were administered to 102 foster home residents and their caregivers: (1) Patient Attitude Questionnaire and (2) Hospital and Hostel Practices Profile Survey. Consumers are satisfied living in this type of milieu and do not desire to change their housing. The foster home provides residents with a sense of security and well being. Foster homes rank second in terms of autonomy when compared to hospitals and hostels. Only supported apartments rank higher. These findings shed a new light on this type of residential milieu. Over time the structure of foster homes has evolved. This study points to the need to value the opinions of consumers and not force people to move onto other types of housing.

  12. Problems and Benefits Reported by Stroke Family Caregivers: Results from a Prospective Epidemiological Study

    PubMed Central

    Haley, William E.; Allen, Jessica Y.; Grant, Joan S.; Clay, Olivio J.; Perkins, Martinique; Roth, David L.

    2009-01-01

    Background and Purpose Stroke symptoms can be very stressful for family caregivers, but most knowledge about the prevalence and stressfulness of stroke-related patient problems is derived from convenience samples. In addition, little is known about perceived benefits of the stroke caregiving experience. The purpose of this study was to determine the prevalence and stressfulness of stroke-related problems, and perceived benefits of caregiving, as reported by an epidemiologically-derived sample of caregivers of stroke survivors. Methods Stroke survivors (N=75) from a prospective epidemiological study of stroke, the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, and their family caregivers were followed. Caregivers were given a comprehensive telephone interview 8 to 12 months after the stroke, using measures of stroke patient problems, caregiver appraisals of the stressfulness of these problems, and perceived benefits of caregiving. Results Caregivers rated patient problems with mood (depression, loneliness and anxiety), memory, and physical care (bowel control), as the most stressful, but reported prevalence of these problems was lower than those reported previously in studies using clinical samples. Caregivers also reported many benefits from caregiving, with over 90% reporting that caregiving enabled them to appreciate life more. Conclusions Epidemiologically based studies of stroke caregiving provide a unique picture of caregiver strains and benefits compared with clinical studies, which tend to over-represent more impaired patients. Support for caregivers should include interventions to aid their coping with highly stressful mood, physical care, and cognitive problems of stroke patients, but should also attend to perceived benefits of caregiving. PMID:19407230

  13. Exploring family stigma among caregivers of persons with Alzheimer's disease: The experiences of Israeli-Arab caregivers.

    PubMed

    Abojabel, Hanan; Werner, Perla

    2016-11-24

    Providing care to persons with Alzheimer's disease poses challenges for spouses and adult children, including experiencing stigmatic beliefs towards themselves-i.e., family stigma. Drawing on the frameworks of ethnicity and stigma and ethnicity and dementia, the current study explored stigmatic experiences among Israeli Arab family caregivers of a person with Alzheimer's disease. Three focus groups with 20 caregivers (adult children and spouses) of persons with Alzheimer's disease were conducted. Data were analyzed using theory-led thematic analysis. Caregivers reported experiencing family stigma in two dimensions: public and affiliate stigma, in both the existence of an attribution process in which cognitive stereotypes elicit negative and positive emotions which in turn provoke behavioral attributions, was evident. Family stigma was found to be a discernible feature of everyday reality among Israeli Arab caregivers of persons with Alzheimer's disease and stress the importance of developing management strategies that are tailored to the socio-cultural characteristics of the caregivers. © The Author(s) 2016.

  14. Family and Other Unpaid Caregivers and Older Adults with and without Dementia and Disability.

    PubMed

    Riffin, Catherine; Van Ness, Peter H; Wolff, Jennifer L; Fried, Terri

    2017-08-01

    To estimate the number of caregivers providing assistance to community-dwelling older persons with and without dementia and with or without substantial disability; to describe the characteristics of caregivers and care recipients in these groups; to characterize the health-related tasks that caregivers provide; and to estimate associations between the numbers of tasks and caregiver burden. Nationally representative surveys of caregivers and older adults in the United States. 2011 National Health and Aging Trends Study and National Study of Caregiving. Community-dwelling older adults and their family caregivers, who were selected on the basis of having assisted with mobility, self-care, household activities, transportation, or medical tasks. Caregiver burden (emotional, physical, financial difficulties) and restrictions on social participation. Although much larger proportions of older adults with dementia and disability (98.4%, n = 1.0 million) and dementia but not disability (95.5%, n = 1.3 million) received caregiving assistance, the largest absolute number of individuals receiving assistance were older adults without dementia or disability (4.0 million). Within each caregiver group, caregivers provided assistance with at least one task across domains of activity of daily living and instrumental activity of daily living-related assistance (>98%), health systems logistics (>70%), and health management (>50%). There was a significant linear association between number of tasks provided and risk of burden in virtually all caregiver groups and domains of assistance. Caregivers of care recipients without dementia or disability accounted for the largest absolute number of helpers. These caregivers, similar to caregivers of care recipients with dementia or disability, delivered a broad spectrum of health-related tasks and experienced caregiver burden and restrictions on social participation. Findings support the need for interventions that address the needs of caregivers

  15. Support Service Use and Interest in Support Services among Distressed Family Caregivers of Lung Cancer Patients

    PubMed Central

    Mosher, Catherine E.; Champion, Victoria L.; Hanna, Nasser; Jalal, Shadia I.; Fakiris, Achilles J.; Birdas, Thomas J.; Okereke, Ikenna C.; Kesler, Kenneth A.; Einhorn, Lawrence H.; Given, Barbara A.; Monahan, Patrick O.; Ostroff, Jamie S.

    2012-01-01

    Objective This study examined support service use and interest in support services among distressed family caregivers of patients recently entering a comprehensive cancer care facility. Methods Primary family caregivers of lung cancer patients (N = 83) were recruited from three medical centers within 12 weeks of the patient’s new visit to the oncology clinic. All family caregivers were screened for psychological distress and those reporting significant anxiety or depressive symptoms were eligible for this study. Caregivers completed a baseline assessment of support service use (i.e., use of mental health services and complementary and alternative medicine [CAM]) and interest in support services. Support service use was also assessed three months later. Results Although all caregivers reported clinically meaningful distress, only 26% used mental health and 39% used CAM services during the 3-month study period. Patients’ receipt of chemotherapy was positively associated with caregivers’ mental health service use, whereas greater education and receiving assistance with caregiving tasks were associated with CAM use. Forty percent of caregivers who did not use CAM at baseline were interested in CAM. In addition, 29% of caregivers who did not receive mental health services at baseline were interested in professional psychosocial support, and 29% of caregivers who did not receive staff assistance with practical needs at baseline were interested in this service. Conclusions Findings suggest that distressed family caregivers of lung cancer patients underuse mental health services and that a sizable minority are interested in professional help with psychosocial and practical needs. PMID:22941782

  16. Experience with a Family-Practice-Resident-Directed Obstetrical Clinic.

    ERIC Educational Resources Information Center

    Hunter, Jerry L.; Snyder, Frank

    1980-01-01

    At Toledo Hospital, family practice residents have assumed responsibility for the normal obstetrics clinic. Specialty consultations are provided by the hospital's obstetrics residency program. A medical audit of the clinic indicates that the family practice residents obtained consultations and made referrals at the appropriate times. (JMD)

  17. Family Caregiver Participation in Palliative Care Research: Challenging the Myth.

    PubMed

    Aoun, Samar; Slatyer, Susan; Deas, Kathleen; Nekolaichuk, Cheryl

    2017-05-01

    Despite international guidelines emphasizing consumer-directed care and autonomous decisions in research participation, there is a common myth that research can be an additional and unwanted burden on patients and their family members. To examine the experiences and impact of research involvement on family caregivers (FCs) of terminally ill people, focusing within home-based palliative care. Three hundred sixteen of 322 participants (98.1%), who completed an FC support intervention through a stepped-wedge cluster trial (Australia, 2012-2015), participated in a postintervention telephone interview on their study experiences, which included quantitative and qualitative questions. Ninety-seven percent of both the control (n = 89) and intervention (n = 227) groups perceived positive aspects, whereas almost all did not report any negative aspects of being involved in this research; the majority rated their involvement as very/extremely beneficial (control 77%; intervention 83%). The qualitative analysis generated three major themes: "intrapersonal-inward directed"; "connection with others-outward directed"; and "interpersonal-participant-researcher relationship." This study provided quantitative and qualitative evidence challenging the myth. In contrast to health professional concerns, FCs appreciated the opportunity to participate and benefited from their involvement in research. Research protocols need to be specifically tailored to the needs of family caregivers and include debriefing opportunities for all participants at the end of intervention studies, regardless of which group they have been assigned. Strategies that facilitate health professionals' understanding of the research and risk benefits may help reduce gatekeeping and improve the validity of research findings. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  18. Understanding Discrepancy in Perceptions of Values: Individuals with Mild to Moderate Dementia and Their Family Caregivers

    ERIC Educational Resources Information Center

    Reamy, Allison M.; Kim, Kyungmin; Zarit, Steven H.; Whitlatch, Carol J.

    2011-01-01

    Purpose of the Study: We explore discrepancies in perceptions of values and care preferences between individuals with dementia (IWDs) and their family caregivers. Design and Methods: We interviewed 266 dyads consisting of an individual with mild to moderate dementia and his or her family caregiver to determine IWDs' beliefs for 5 values related to…

  19. Respite Utilization and Responses to Loss among Family Caregivers: Relationship Matters

    ERIC Educational Resources Information Center

    DeCaporale, Lauren; Mensie, Lauren; Steffen, Ann

    2013-01-01

    Family caregivers of physically and cognitively impaired older adults face multiple challenges when providing care, including responses to tangible and anticipated losses. However, little is known about the grief experiences of family caregivers and how these might differentially influence the care-related behaviors of spouses and adult children.…

  20. Respite Utilization and Responses to Loss among Family Caregivers: Relationship Matters

    ERIC Educational Resources Information Center

    DeCaporale, Lauren; Mensie, Lauren; Steffen, Ann

    2013-01-01

    Family caregivers of physically and cognitively impaired older adults face multiple challenges when providing care, including responses to tangible and anticipated losses. However, little is known about the grief experiences of family caregivers and how these might differentially influence the care-related behaviors of spouses and adult children.…

  1. Understanding Discrepancy in Perceptions of Values: Individuals with Mild to Moderate Dementia and Their Family Caregivers

    ERIC Educational Resources Information Center

    Reamy, Allison M.; Kim, Kyungmin; Zarit, Steven H.; Whitlatch, Carol J.

    2011-01-01

    Purpose of the Study: We explore discrepancies in perceptions of values and care preferences between individuals with dementia (IWDs) and their family caregivers. Design and Methods: We interviewed 266 dyads consisting of an individual with mild to moderate dementia and his or her family caregiver to determine IWDs' beliefs for 5 values related to…

  2. Starting A Healthy Family: Choosing Parenthood. Starting A Healthy Family Series/Family and Community Health Through Caregiving.

    ERIC Educational Resources Information Center

    Education Development Center, Inc., Newton, MA.

    This student manual, part of the Family and Community Health Through Caregiving program, explores the impact a baby has on its family. Case studies and activities help high school students in: (1) understanding the responsibilities of parenthood; (2) becoming aware of increasing numbers of adolescent pregnancies; and (3) picturing themselves as…

  3. How Does Culture Shape Roles and Relationships in Taiwanese Family Caregiving for an Adolescent With Cancer?

    PubMed

    Yeh, Li-Chyun; Kellet, Ursula; Henderson, Saras; Chen, Kang-Hua

    2015-01-01

    Chinese culture plays a significant part in how Taiwanese families view life events. Caregivers envisage themselves as guardians of their children in all facets of family life, including wellness and strive to maintain harmonious relationships within the family. However, it remains unclear what impact caring for an adolescent with cancer has on family roles and relationships in Taiwanese families, nor are the processes for managing change in family roles and relationships associated with caregiving well understood. This study explores the impact of caregiving for an adolescent with cancer on the roles and relationships within Taiwanese families. Seven families were recruited from a medical hospital in Taiwan. Data were collected through qualitative interviews and analyzed following Strauss and Corbin's grounded theory. The core category, underpinned by Chinese culture, proved to be experiencing the broken chain of family life. This was the central issue brought about by 4 consequences for the broken chain of family life. The expression "the broken chain of family life" encapsulates how important Chinese cultural values are in defining caregiver task performance. The findings have implications for Taiwanese families in perceiving, adjusting to, and fulfilling the altered roles and relationships associated with caring for an adolescent with cancer at home. The delivery of exceptional care and services depends on gaining insight into how caregiving influences family roles and relationships. How families failed to manage the process of caregiving provides valuable insight for informing and providing recommendations for services and support.

  4. Resolving to go forward: the experience of Latino/Hispanic family caregivers.

    PubMed

    Lucke, Kathleen T; Martinez, Hernando; Mendez, Thomas B; Arévalo-Flechas, Lyda C

    2013-02-01

    Little is known about the experiences and needs of family caregivers of Latino/Hispanic individuals with spinal cord injury (SCI) during the early years of recovery. The purpose of this grounded theory study was to describe the experiences and identify the informational, decisional, interpersonal, and resource support needs of family caregivers of newly injured Latino/Hispanic individuals with SCI during the first 2 years after undergoing rehabilitation. "Resolving to go forward" was the core category that emerged from two simultaneous processes of "learning to care for" and "getting through" during the initial years as the primary informal caregiver. Most caregivers felt alone and abandoned after the injured person returned home, and experienced barriers to services and resources primarily because of language issues and economic status. We recommend that researchers develop and evaluate culturally appropriate, informal caregiving models to improve outcomes for both Latino individuals with SCI and their family caregivers.

  5. Primary Caregivers' Support for Female Family Members With Breast or Gynecologic Cancer.

    PubMed

    Han, Jung-Hee; Han, Song-Hee; Lee, Myo-Suk; Kwon, Hye-Jin; Choe, Kwisoon

    2016-01-01

    Female patients with cancer depend on loved ones; thus, family support is pivotal to assist patients in successfully adjusting to life with treatment routines. Our study explored the experiences of primary caregivers who provide care and support for female family members with cancer. This study used a qualitative phenomenological research approach. Interviews and journaling about the caregiving experience were conducted with the family members of female cancer patients-6 spouses, 11 daughters, 1 son, and 1 younger sister. Data analysis involved Giorgi's 3-step phenomenological analysis method. The central theme of the primary caregivers' supportive care for their female family member with cancer was "being with" her. This was composed of the following themes: "being there for her via efforts," "living through feelings of guilt and anxiety," and "lessons learned from cancer in the family." This study reveals an integrated picture of family caregivers' supportive caring experiences. By providing both positive and negative aspects of the caregiving experience, the findings in this study will provide a theoretical foundation to develop more successful support programs for family caregivers of female patients with cancer. Family-oriented education programs need to be developed to include both the family and the patient in the long journey of cancer. The family caregivers' feelings of guilt regarding the cause of the illness and feelings of anxiety about the uncertainty of the illness should be assessed and managed during the course of the patients' treatment and care.

  6. Burden and associated pathologies in family caregivers of Alzheimer’s disease patients in Spain

    PubMed Central

    Cotelo, Natalia Vérez; Rodríguez, N. Floro Andrés; PÉREZ, José A. Fornos; Iglesias, J. Carlos Andrés; Lago, Marcos Ríos

    2014-01-01

    Objectives: To evaluate the profile of family caregivers of Alzheimer’s disease patients, identify any signs of psychopathology, quantify the level of perceived burden on the caregiver, and determine the caregiver’s relationship with their pharmacist. Methods: A cross-sectional study was conducted at a community pharmacy in Pontevedra, Spain. Demographic variables were collected, and the following questionnaires were administered: the Beck Depression Inventory-II, STAI-Anxiety Questionnaire, Zarit Burden Scale, family APGAR scale, and the Duke-UNC questionnaire. Results: The typical caregiver profile consists of a 55-year old first degree relative (mostly daughters) with a primary education who belongs to a functional or mildly dysfunctional family. Nearly one quarter (24%) of caregivers had a high perception of burden, with anxiety in 20% of caregivers and symptoms of depression in 20%. Family caregivers usually went to the same pharmacy as the patients (96%), were treated with psychotropic drugs (68%), and interacted with the pharmacist (92%). Conclusion: This study confirmed that psychological distress and burden is present among family caregivers. Care for caregivers should be integrated into patient care as part of a national plan, including grants and subsidies, which will result in better care of Alzheimer’s patients. Pharmacists are the most accessible health care professionals and can provide information about Alzheimer’s disease management to caregivers to ease the burden of care. PMID:26131040

  7. Effectiveness of online cognitive behavioral therapy on family caregivers of people with dementia.

    PubMed

    Kwok, Timothy; Au, Alma; Wong, Bel; Ip, Isaac; Mak, Vivian; Ho, Florence

    2014-01-01

    Family caregivers of persons with dementia (PWD) may receive caregiver training because of logistical constraints and privacy concerns. This study evaluated the effectiveness of an online intervention for family caregivers of PWD in improving their self-efficacy in managing behavioral and psychological symptoms of dementia (BPSD), and their emotion well-being. A total of 36 family caregivers of people with dementia participated in a 9-week online intervention based on the cognitive behavioral therapy model. Outcomes of the intervention were measured by the Chinese version of the Neuropsychiatric Inventory Questionnaire and two domains of the Revised Scale for Caregiving Self-Efficacy. Wilcoxon signed rank tests were used to compare the change in outcome variables. The severity of BPSD of PWD and BPSD-related distress in family caregivers showed a statistically significant reduction after the intervention. Subgroup analysis showed self-efficacy in controlling upsetting thoughts significantly improved in caregivers of PWD at moderate to severe stages. Online cognitive behavioral therapy for family caregivers reduced BPSD of PWD and the related distress in their caregivers.

  8. Faith, Work, and Reciprocity: Listening to Mexican Men Caregivers of Elderly Family Members.

    PubMed

    Nance, Douglas C; Rivero May, Maria Isabel; Flores Padilla, Luis; Moreno Nava, Mario; Deyta Pantoja, Alma Laura

    2016-06-28

    The purpose of this qualitative study was to examine the role of Mexican men caregivers of older adults. Studies investigating male caregiving practice in Mexico are lacking. Listening events for older adults and family caregivers were held in six cities, obtaining an ethnically and socioeconomically diverse sample of 121 participants-81 older adults and 57 primary caregivers (including 17 older adults). Focus groups discussed end-of-life issues and challenges of care. Discussions were audio recorded and field notes were made. Framework Analysis was used to analyze data. Nationally, 37% of the caregivers were men. In the metropolitan area of Mexico City, 57% of caregivers were men. The men caregivers discussed their roles and experiences. The results were categorized into three themes: (a) reciprocity in family caregiving, (b) a practical work-oriented attitude toward caregiving, and (c) strong religious faith. Caregiving formed an important part of their masculine role. Stereotypes related to gender and care should be reexamined. Further research is needed to explore gender variations in caregiving, evolving gender roles, and needs for support and services.

  9. Reflections on methodological approaches and conceptual contributions in a program of caregiving research: development and testing of Wuest's theory of family caregiving.

    PubMed

    Wuest, Judith; Hodgins, Marilyn J

    2011-02-01

    Caregiving by family members, particularly women, is a societal expectation that is intensifying in the context of an aging population and health care restructuring. Our program of caregiving research spans two decades, moving from inductive theory development using grounded theory methods to deductive theory testing. In this article, we reflect on the serendipitous development of this program of research methodologically and conceptually. We summarize the key conceptual contributions that the program has made to caregiving knowledge, particularly with respect to the past relationship between care recipient and caregiver, obligation to care, caregiver agency, and relationships between caregivers and the health care system.

  10. Cancer caregivers advocate a patient- and family-centered approach to advance care planning.

    PubMed

    Michael, Natasha; O'Callaghan, Clare; Baird, Angela; Hiscock, Nathaniel; Clayton, Josephine

    2014-06-01

    Cancer caregivers have important roles in delivering practical, emotional, and end-of-life support to patients; however, they express multiple unmet needs, particularly information on future care planning. Early regular communication and decision making may improve access to timely information, alleviate anxiety, reduce uncertainty, and improve coping strategies. This study examines how cancer caregivers view advance care planning (ACP) to inform an ACP program in an Australian cancer center. This study used a qualitative descriptive design with grounded theory overtones. Eighteen caregivers of patients from lung and gastrointestinal tumor streams participated in focus groups or semistructured interviews, which incorporated the vignette technique. Caregivers believe that, although confronting, ACP discussions can be helpful. Conversations are sometimes patient initiated, although caregivers may intend to sensitively broach conversations over time. Findings highlight the impact of caregiver hierarchies, adaptive family decision-making styles, and complex cultural influences on decision making. Some caregivers may develop subsidiary care intentions, based on "knowing" or overriding patients' desires. Hindrances on caregivers supporting patients' ACPs include limited information access, patient or caregiver resistance to engage in conversations, and ACPs association in oncology with losing hope. Many caregivers wanted professional support and further opportunities to obtain information, develop subsidiary plans, and help patients engage in ACP discussions. Findings highlight the influence of cancer caregivers and family dynamics over ACP decisions and actualization of future care plans. A patient- and family-centered care approach to ACP, promoting shared decision making and caregiver support, is recommended. Given that caregivers may override and, plausibly, misinterpret patients' desires, caregivers' subsidiary planning warrants further investigation. Copyright

  11. Using a complex adaptive system lens to understand family caregiving experiences navigating the stroke rehabilitation system.

    PubMed

    Ghazzawi, Andrea; Kuziemsky, Craig; O'Sullivan, Tracey

    2016-10-01

    Family caregivers provide the stroke survivor with social support and continuity during the transition home from a rehabilitation facility. In this exploratory study we examined family caregivers' perceptions and experiences navigating the stroke rehabilitation system. The theories of continuity of care and complex adaptive systems were integrated to examine the transition from a stroke rehabilitation facility to the patient's home. This study provides an understanding of the interacting complexities at the macro and micro levels. A convenient sample of family caregivers (n = 14) who provide care for a stroke survivor were recruited 4-12 weeks following the patient's discharge from a stroke rehabilitation facility in Ontario, Canada. Interviews were conducted with family caregivers to examine their perceptions and experiences navigating the stroke rehabilitation system. Directed and inductive content analysis and the theory of Complex Adaptive Systems were used to interpret the perceptions of family caregivers. Health system policies and procedures at the macro-level determined the types and timing of information being provided to caregivers, and impacted continuity of care and access to supports and services at the micro-level. Supports and services in the community, such as outpatient physiotherapy services, were limited or did not meet the specific needs of the stroke survivors or family caregivers. Relationships with health providers, informational support, and continuity in case management all influence the family caregiving experience and ultimately the quality of care for the stroke survivor, during the transition home from a rehabilitation facility.

  12. Age Effects on Cognitive and Physiological Parameters in Familial Caregivers of Alzheimer's Disease Patients

    PubMed Central

    Corrêa, Márcio Silveira; Giacobbo, Bruno Lima; Vedovelli, Kelem; de Lima, Daiane Borba; Ferrari, Pamela; Argimon, Irani Iracema de Lima; Walz, Julio Cesar

    2016-01-01

    Objectives Older familial caregivers of Alzheimer’s disease patients are subjected to stress-related cognitive and psychophysiological dysfunctions that may affect their quality of life and ability to provide care. Younger caregivers have never been properly evaluated. We hypothesized that they would show qualitatively similar cognitive and psychophysiological alterations to those of older caregivers. Method The cognitive measures of 17 young (31–58 years) and 18 old (63–84 years) caregivers and of 17 young (37–57 years) and 18 old (62–84 years) non-caregiver controls were evaluated together with their salivary cortisol and dehydroepiandrosterone (DHEA) levels, as measured by radioimmunoassays and ELISA assays of brain-derived neurotrophic factor (BDNF) in serum. Results Although younger caregivers had milder impairments in memory and executive functions than older caregivers, their performances fell to the same or lower levels as those of the healthy older controls. Decreases in DHEA and BDNF levels were correlated with the cognitive dysfunctions observed in the older and younger caregivers, respectively. Cortisol at 10PM increased in both caregiver groups. Discussion Younger caregivers were prone to cognitive impairments similar to older caregivers, although the degree and the neuropsychological correlates of the cognitive dysfunctions were somewhat different between the two groups. This work has implications for caregiver and care-recipient health and for research on the neurobiology of stress-related cognitive dysfunctions. PMID:27706235

  13. Age Effects on Cognitive and Physiological Parameters in Familial Caregivers of Alzheimer's Disease Patients.

    PubMed

    Corrêa, Márcio Silveira; Giacobbo, Bruno Lima; Vedovelli, Kelem; Lima, Daiane Borba de; Ferrari, Pamela; Argimon, Irani Iracema de Lima; Walz, Julio Cesar; Bromberg, Elke

    2016-01-01

    Older familial caregivers of Alzheimer's disease patients are subjected to stress-related cognitive and psychophysiological dysfunctions that may affect their quality of life and ability to provide care. Younger caregivers have never been properly evaluated. We hypothesized that they would show qualitatively similar cognitive and psychophysiological alterations to those of older caregivers. The cognitive measures of 17 young (31-58 years) and 18 old (63-84 years) caregivers and of 17 young (37-57 years) and 18 old (62-84 years) non-caregiver controls were evaluated together with their salivary cortisol and dehydroepiandrosterone (DHEA) levels, as measured by radioimmunoassays and ELISA assays of brain-derived neurotrophic factor (BDNF) in serum. Although younger caregivers had milder impairments in memory and executive functions than older caregivers, their performances fell to the same or lower levels as those of the healthy older controls. Decreases in DHEA and BDNF levels were correlated with the cognitive dysfunctions observed in the older and younger caregivers, respectively. Cortisol at 10PM increased in both caregiver groups. Younger caregivers were prone to cognitive impairments similar to older caregivers, although the degree and the neuropsychological correlates of the cognitive dysfunctions were somewhat different between the two groups. This work has implications for caregiver and care-recipient health and for research on the neurobiology of stress-related cognitive dysfunctions.

  14. Constructing the meaning of quality of life for residents in care homes in the Lebanon: perspectives of residents, staff and family.

    PubMed

    Adra, Marina Gharibian; Hopton, John; Keady, John

    2015-12-01

    Located in two care homes in Lebanon, the study explores the perspectives of quality of life for a sample of older residents, care staff and family caregivers. Quality of life for older people living in care homes is traditionally reported in the literature as a Westernised construct and so far little is known about its meanings from an Arabic cultural perspective and context. There is also a knowledge gap about the conditions of older people living in care homes in Lebanon. The study was a qualitative exploration of perspectives of quality of life of older residents, care staff and family caregivers. Two care homes for older people situated in Beirut took part in the study. Between 2010 and 2011 semi-structured interviews were undertaken with a sample of 20 residents, eight family caregivers and 11 care staff. Data were analysed using the constant comparative method. Four categories emerged from this analytical process: (i) maintaining family connectedness; (ii) engaging in worthwhile activities; (iii) maintaining and developing significant relationships; and (iv) holding and practicing spiritual beliefs. The emergence of these categories confirmed the complex, interrelated and multidimensional nature of quality of life for residents and other stakeholders. The findings supplement an emerging body of knowledge about the composition of quality of life for older residents in Lebanon. Improving the quality of life of older residents will require action in respect of all of the domains identified in study. Moving nursing practice from task-based care to relationship-centred approaches was seen as pivotal in helping to develop quality of life for residents living in the participating care homes. The findings have implications for education, nursing practice and research in Lebanon and help start an evidence base for care. © 2015 John Wiley & Sons Ltd.

  15. Caring for the Caregiver: Supporting Families of Youth With Special Health Care Needs.

    PubMed

    Pilapil, Mariecel; Coletti, Daniel J; Rabey, Cindy; DeLaet, David

    2017-08-01

    Caregivers of youth with special health care needs (YSHCN) are a critical part of the health care team. It is important for pediatric providers to be cognizant of the burden and strain caregiving can create. This article will discuss the health, psychological, social, and financial effects of caregiving, as well as strategies to screen for caregiver strain among families of YSHCN. Caregivers of YSHCN, for example, are more likely to report poor health status and demonstrate higher rates of depression and anxiety. Numerous validated screens for caregiver strain have been developed to address the multi-faceted effects of caregiving. Finally, we will discuss strategies to alleviate caregiver strain among this vulnerable population. We will describe services pediatric providers can encourage caregivers to utilize, including financial support through Supplemental Security Income (SSI), benefits available through the Family Medical Leave Act (FMLA), and options for respite care. Addressing caregiver strain is an important aspect of maintaining a family centered approach to the care of YSHCN. Copyright © 2017. Published by Elsevier Inc.

  16. Predictors of the depressive symptomatology of the family caregivers of Chinese stroke patients in Hong Kong.

    PubMed

    Lau, C G; Tang, W K; Wong, K S; Mok, V; Ungvari, G S

    2012-05-01

    The aim of this cross-sectional study was to determine the socio-demographic and clinical factors associated with depressive symptoms in the family caregivers of Hong Kong Chinese stroke patients. One hundred and twenty-three patients at a stroke clinic and their family caregivers formed the study sample. The depressive symptoms of both the patients and their family caregivers were rated with the Chinese version of the 15-item Geriatric Depression Scale (GDS). Participants' socio-demographic data and clinical characteristics served as the independent variables in relation to the caregivers' GDS scores. Patients' and caregivers' somatic and psychological conditions were measured with 10 scales. In univariate analysis, caregivers' GDS scores were significantly correlated with certain of their characteristics [Modified Life Event Scale (MLES), Cumulative Illness Rating Scale (CIRS) and Lubben Social Network Scale (LSNS) scores, sex and being a housewife] and those of the patients (GDS score and being a housewife). Multiple regression analysis showed caregivers' MLES and CIRS scores and patients' GDS scores to be independent correlates of caregivers' GDS scores. Adverse events encountered by caregivers in the past 6 months, their current health problems and patients' depressive symptoms were found to be the principal factors associated with caregivers' depressive symptoms. © 2011 Blackwell Publishing.

  17. Neuro-oncology family caregivers are at risk for systemic inflammation.

    PubMed

    Sherwood, Paula R; Price, Thomas J; Weimer, Jason; Ren, Dianxu; Donovan, Heidi S; Given, Charles W; Given, Barbara A; Schulz, Richard; Prince, Jennifer; Bender, Catherine; Boele, Florien W; Marsland, Anna L

    2016-05-01

    Prolonged periods of family caregiving can induce stress levels that may negatively influence caregiver health. However, the physiologic effect of psychological distress in oncology family caregivers has received little attention. Therefore we aimed to determine longitudinal profiles of inflammatory cytokines (IL-6 and IL-1ra) in neuro-oncology caregivers and identify associations between psychological distress and cytokine levels. Depressive symptoms, anxiety, caregiver burden and blood were collected from 108 adult caregivers at adult patients' diagnosis, 4-, 8-, and 12-months. Trajectory analyses of log transformed cytokine levels were performed. Multiple logistic regression analyses evaluated the impact of psychological distress on cytokine levels. For both cytokines, two distinct populations were identified, neither of which changed over time. High IL-1ra was associated with male caregivers with anxiety (OR = 1.7; 95 %CI 1.06-2.83) and obese caregivers (BMI = 40) who felt burdened due to disrupted schedules (OR = 1.3; 95 %CI 1.02-1.77). Conversely, caregivers with a healthy weight (BMI = 25) who felt burdened due to disrupted schedules were less likely to have high IL-1ra (OR = 0.71; 95 %CI 0.54-0.92). Caregivers ≤30 years old with lower self-esteem from caregiving were 1.16 times (95 %CI 1.04-1.30) more likely to have high IL-6. Analysis demonstrated groups of family caregivers with high and low levels of systemic inflammation and these levels did not change longitudinally over the care trajectory. Poor physical health in family caregivers may have a negative impact on the burden placed on the healthcare system in general and on the well-being of neuro-oncology patients in particular.

  18. Caregiver criticism, help-giving, and the burden of schizophrenia among Mexican American families.

    PubMed

    Villalobos, Bianca T; Ullman, Jodie; Krick, Tracy Wang; Alcántara, Darcy; Kopelowicz, Alex; López, Steven R

    2017-09-01

    This study tested an attribution model of help-giving in family caregivers of persons with schizophrenia as it relates to caregivers' reported burden. We hypothesized (a) that caregivers' attributions of their ill relatives' responsibility for their symptoms would be associated with more negative and less positive affective reactions, (b) that affective reactions would be related to perceptions of administered support, and (c) that support would in turn predict greater burden. We examined 60 family caregivers of Mexican origin living in Southern California. Mexican Americans were chosen because of their high degree of contact with their ill relative, thereby facilitating the examination of help-giving and burden. Contrary to past studies, caregivers' attributions and affective stance were assessed independently, the former based on self-report and the latter based on codes drawn from the Camberwell Family Interview. Caregiver burden was assessed at baseline and one year later. Path analyses showed partial support for the attribution model of help-giving. Specifically, attributions of responsibility negatively predicted caregiver's warmth, which in turn predicted more administered support. Contrary to hypotheses, attributions were not associated with caregiver criticism, and criticism was positively related to administered support. In addition, caregiver support was not related to burden at either baseline or a year later. Criticism was a significant predictor of burden at follow-up through burden at baseline. The emotional stance of caregivers predicts burden independent of the help they provide. Caregiver criticism not only predicts negative patient outcomes but can predict negative caregiver outcomes as well. Positive clinical implications In family treatment, it is important to address caregiver criticism not only because of its relationship to poor clinical outcomes of ill relatives but also because of its relationship to greater caregiver burden. Integrating a

  19. Experiences of stigma and discrimination faced by family caregivers of people with schizophrenia in India.

    PubMed

    Koschorke, Mirja; Padmavati, R; Kumar, Shuba; Cohen, Alex; Weiss, Helen A; Chatterjee, Sudipto; Pereira, Jesina; Naik, Smita; John, Sujit; Dabholkar, Hamid; Balaji, Madhumitha; Chavan, Animish; Varghese, Mathew; Thara, R; Patel, Vikram; Thornicroft, Graham

    2017-04-01

    Stigma associated with schizophrenia significantly affects family caregivers, yet few studies have examined the nature and determinants of family stigma and its relationship to their knowledge about the condition. This paper describes the experiences and determinants of stigma reported by the primary caregivers of people living with schizophrenia (PLS) in India. The study used mixed methods and was nested in a randomised controlled trial of community care for people with schizophrenia. Between November 2009 and October 2010, data on caregiver stigma and functional outcomes were collected from a sample of 282 PLS-caregiver dyads. In addition, 36 in-depth-interviews were conducted with caregivers. Quantitative findings indicate that 'high caregiver stigma' was reported by a significant minority of caregivers (21%) and that many felt uncomfortable to disclose their family member's condition (45%). Caregiver stigma was independently associated with higher levels of positive symptoms of schizophrenia, higher levels of disability, younger PLS age, household education at secondary school level and research site. Knowledge about schizophrenia was not associated with caregiver stigma. Qualitative data illustrate the various ways in which stigma affected the lives of family caregivers and reveal relevant links between caregiver-stigma related themes ('others finding out', 'negative reactions' and 'negative feelings and views about the self') and other themes in the data. Findings highlight the need for interventions that address both the needs of PLS and their family caregivers. Qualitative data also illustrate the complexities surrounding the relationship between knowledge and stigma and suggest that providing 'knowledge about schizophrenia' may influence the process of stigmatisation in both positive and negative ways. We posit that educational interventions need to consider context-specific factors when choosing anti-stigma-messages to be conveyed. Our findings suggest

  20. Creating patient and family education web sites: design and content of the home parenteral nutrition family caregivers web site.

    PubMed

    Fitzgerald, Sharon A; Macan Yadrich, Donna; Werkowitch, Marilyn; Piamjariyakul, Ubolrat; Smith, Carol E

    2011-11-01

    When managing chronic illnesses, caregivers repeatedly seek online information about providing complex, long-term care but often neglect to find information about how to care for themselves. Poor health among caregivers is not only detrimental to their own well-being but may also result in harm to those for whom they care. For this reason, caregivers need access to information and activities about caring for themselves in addition to the information about managing home care they are already likely to seek. The HPN Family Caregivers Web site was developed to guide caregivers through the process of caring for themselves by establishing a caregiving routine, self-monitoring their mental and physical health, and practicing good sleep hygiene, while also managing the complexities of home care. While Web site information, activities, and algorithms for managing chronic illnesses need to be specific to each population, the content guiding caregivers to care for their own health is universal.

  1. Empowerment of family caregivers of adults and elderly persons: A concept analysis.

    PubMed

    Sakanashi, Sayori; Fujita, Kimie

    2017-07-09

    This concept analysis defined and described the components of empowerment of family caregivers who care for adults and the elderly. Rodgers evolutionary method of concept analysis was used. Data sources included Pub Med, CINAHL, Scopus, and Igaku Chuo Zasshi. Thirty articles published between 1995 and 2015 focusing on the empowerment of family caregivers providing care to adults and the elderly were selected. The analysis reveals 6 attributes, 5 antecedents, and 5 consequences. In addition, the results reveal structured aspects of family caregivers, care receivers, and other people surrounding them, and their relationships. Empowerment of adults' and elders' family caregivers may be defined as "positive control of one's mind and body, cultivating a positive attitude, proactively attempting to understand one's role as a caregiver to improve caregiving capabilities, focusing on others as well as oneself, supporting the independence of the care receiver, and creating constructive relationships with other people surrounding them." The components of empowerment clarified in this research can be used for the measurement of and interventions aimed at improving empowerment among family caregivers. Furthermore, clarifying the definition of empowerment among family caregivers enables researchers to better distinguish empowerment from similar concepts in the future. © 2017 John Wiley & Sons Australia, Ltd.

  2. Evaluation of a quality improvement curriculum for family medicine residents.

    PubMed

    Tudiver, Fred; Click, Ivy A; Ward, Patricia; Basden, Jeri Ann

    2013-01-01

    East Tennessee State University's (ETSU) Department of Family Medicine initiated Quality Improvement (QI) training in its three residency programs in 2008. The purpose of the project was to develop, implement, and assess a formal curriculum and experiential learning process to train family medicine residents in QI knowledge and skills. Family medicine faculty members received training in QI theory and design. Rising second-year residents received a day-long workshop on the basics of QI principles. Residents worked in teams to develop and implement QI projects. Self-assessed QI proficiency was measured prior to and immediately following the workshop. QI knowledge was assessed with the Quality Improvement Knowledge Application Tool (QIKAT) at baseline and following project completion. Two groups of residents (n=37) received training and completed at least 1 year on their projects. Analyses revealed that residents' self-assessed QI proficiency improved after receiving a day-long training workshop and was consistent for both groups of resident training. Application of QI knowledge as assessed by the QIKAT did not improve following QI project participation in resident Group 1 but did improve in resident Group 2. A formal QI curriculum was successfully developed and implemented into three family medicine residency programs. Residents' QI knowledge and skills improved following training and experience conducting QI projects. Faculty and resident commitment to the program and competing time demands proved challenging to the introduction of QI training. Future studies should assess residents' sustained learning and translating QI residency experiences into practice.

  3. Liminality as a Conceptual Frame for Understanding the Family Caregiving Rite of Passage: An Integrative Review

    PubMed Central

    Gibbons, Susanne W.; Ross, Alyson; Bevans, Margaret

    2014-01-01

    Family caregiving is a significant rite of passage experienced by family caregivers of individuals with protracted illness or injury. In an integrative review of 26 studies, we characterized family caregiving from the sociocultural perspective of liminality and explored associated psychosocial implications. Analysis of published evidence on this dynamic and formative transition produced a range of themes. While role ambiguity resolved for most, for others, uncertainty and suffering continued. The process of becoming a caregiver was transformative and can be viewed as a rebirth that is largely socially and culturally driven. The transition to family caregiving model produced by this review provides a holistic perspective on this phenomenon and draws attention to aspects of the experience previously underappreciated. PMID:25176315

  4. Violence Towards Family Caregivers by Their Relative with Schizophrenia in Japan.

    PubMed

    Kageyama, Masako; Solomon, Phyllis; Yokoyama, Keiko; Nakamura, Yukako; Kobayashi, Sayaka; Fujii, Chiyo

    2017-10-02

    There have been several violence-related deaths in Japan due to family violence by persons with severe mental illness against their caregivers. However, it is not often acknowledged that these violent acts are mainly directed at family members. This study aimed to clarify what acts of violence family caregivers experienced from their relative with schizophrenia, and how frequently these violent incidents occurred in their lifetime. We also examined caregivers' thoughts of death about themselves and their relatives, as well as their consultation efforts and escape from the violence perpetrated by their relative. Of the 277 caregivers, 87.7% had experienced psychological violence and 75.8% had experienced physical violence perpetrated by their relative. Of 210 caregivers who had experienced physical violence, 26.7% had thought of murder-suicide and 31.0% had wished for their relative's death. Family violence by persons with schizophrenia is not rare but a common occurrence in Japan and may have fatal consequences.

  5. Liminality as a conceptual frame for understanding the family caregiving rite of passage: an integrative review.

    PubMed

    Gibbons, Susanne W; Ross, Alyson; Bevans, Margaret

    2014-10-01

    Family caregiving is a significant rite of passage experienced by family caregivers of individuals with protracted illness or injury. In an integrative review of 26 studies, we characterized family caregiving from the sociocultural perspective of liminality and explored associated psychosocial implications. Analysis of published evidence on this dynamic and formative transition produced a range of themes. While role ambiguity resolved for most, for others, uncertainty and suffering continued. The process of becoming a caregiver was transformative and can be viewed as a rebirth that is largely socially and culturally driven. The transition to family caregiving model produced by this review provides a holistic perspective on this phenomenon and draws attention to aspects of the experience previously underappreciated. Published 2014. This article is a U.S. Government work and is in the public domain in the USA. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

  6. [Differential efficacy of two psychoeducational interventions for dementia family caregivers].

    PubMed

    Losada Baltar, A; Izal Fernández de Trocóniz, M; Montorio Cerrato, I; Márquez González, M; Pérez Rojo, G

    The aim of this work is to compare the effectiveness of two psychoeducational interventions for dementia caregivers: a cognitive behavioral one (PCC), aimed at the modification of dysfunctional thoughts about caregiving, and another one consisting in problem solving skills training (PSP) for caregivers, with the aim of modifying the behavioral problems of their relative. Seventy five caregivers were asked to participate in an intervention program, of whom 31 finally completed the study. Both group interventions are compared with a control group (CG). The caregiver groups were randomly assigned to each experimental condition. Pre, post intervention, and follow up assessments of the following variables have been made: depression, perceived stress, frequency of behavioral problems, perceived stress associated with the behavioral problems and dysfunctional thoughts about caregiving. Following the intervention, caregivers in the PCC program show significantly less perceived stress than the other two groups. In the same direction, a trend exists to a significant reduction of the stress associated with the behavioral problems. In the follow up assessment, caregivers of the PCC program significantly report less relative's behavioral problems than the other two groups. Caregivers of the PCC program have less dysfunctional thoughts than the other two groups, differences almost reaching significance. Benefits of a psychoeducational intervention vary as a function of the contents it includes. The importance of intervening on the caregiver dysfunctional thoughts for an adequate coping with caregiving is highlighted.

  7. Seeking Medical Information Using Mobile Apps and the Internet: Are Family Caregivers Different from the General Public?

    PubMed

    Kim, Hyunmin; Paige Powell, M; Bhuyan, Soumitra S; Bhuyan, Soumitra Sudip

    2017-03-01

    Family caregivers play an important role to care cancer patients since they exchange medical information with health care providers. However, relatively little is known about how family caregivers seek medical information using mobile apps and the Internet. We examined factors associated with medical information seeking by using mobile apps and the Internet among family caregivers and the general public using data from the 2014 Health Information National Trends Survey 4 Cycle 1. The study sample consisted of 2425 family caregivers and 1252 non-family caregivers (the general public). Guided by Comprehensive Model of Information Seeking (CMIS), we examined related factors' impact on two outcome variables for medical information seeking: mobile apps use and Internet use with multivariate logistic regression analyses. We found that online medical information seeking is different between family caregivers and the general public. Overall, the use of the Internet for medical information seeking is more common among family caregivers, while the use of mobile apps is less common among family caregivers compared with the general public. Married family caregivers were less likely to use mobile apps, while family caregivers who would trust cancer information were more likely to use the Internet for medical information seeking as compared to the general public. Medical information seeking behavior among family caregivers can be an important predictor of both their health and the health of their cancer patients. Future research should explore the low usage of mobile health applications among family caregiver population.

  8. Compassion Fatigue: An Application of the Concept to Informal Caregivers of Family Members with Dementia

    PubMed Central

    Day, Jennifer R.; Anderson, Ruth A.

    2011-01-01

    Introduction. Compassion fatigue is a concept used with increasing frequency in the nursing literature. The objective of this paper is to identify common themes across the literature and to apply these themes, and an existing model of compassion fatigue, to informal caregivers for family members with dementia. Findings. Caregivers for family members with dementia may be at risk for developing compassion fatigue. The model of compassion fatigue provides an informative framework for understanding compassion fatigue in the informal caregiver population. Limitations of the model when applied to this population were identified as traumatic memories and the emotional relationship between parent and child, suggesting areas for future research. Conclusions. Research is needed to better understand the impact of compassion fatigue on informal caregivers through qualitative interviews, to identify informal caregivers at risk for compassion fatigue, and to provide an empirical basis for developing nursing interventions for caregivers experiencing compassion fatigue. PMID:22229086

  9. Family Caregiving for Immigrant Seniors Living With Heart Disease and Stroke: Chinese Canadian Perspective.

    PubMed

    Liu, Lichun Willa; McDaniel, Susan A

    2015-01-01

    Heart disease and stroke are two leading causes of death and disability among older Canadians. Family support and caregiving are crucial to the positive functional recovery and psychological well-being of heart disease and stroke survivors. Based on focus groups and individual interviews with Chinese family caregivers in the Canadian province of Ontario, we explored the caregiver's experience, including the challenges, needs, and service gaps in providing care for immigrant seniors with heart disease and stroke. We found that caregiving practices and the strategies used to cope with caregiving challenges varied by gender, ethnicity, age, and length of migration. We provide recommendations for narrowing the gaps in caregiving at the end of the article.

  10. Living with schizophrenia: Health-related quality of life among primary family caregivers.

    PubMed

    Hsiao, Chiu-Yueh; Lee, Chun-Te; Lu, Huei-Lan; Tsai, Yun-Fang

    2017-09-07

    To examine influencing factors of health-related quality of life in primary family caregivers of people with schizophrenia receiving inpatient psychiatric rehabilitation services. Families, particularly primary family caregivers, have become more important than ever in mental health care. Yet, research on health-related quality of life among primarily family caregivers is limited. A correlational study design was used. A convenience sample of 122 primary family caregivers participated in the study. Data were analysed with descriptive statistics, Pearson's product-moment correlation, t test, one-way analysis of variance and a hierarchical multiple regression analysis. Primary family caregivers who were parents, older, less educated, and had a lower monthly household income, increased affiliate stigma and decreased quality of family-centred care experienced poor health-related quality of life. Particularly, monthly household income, affiliate stigma and quality of family-centred care appeared to be the most critical determinants of health-related quality of life. Efforts to enhance satisfaction of life should focus on reducing affiliate stigma as well as increasing monthly household income and strengthening the quality of family-centred care. Findings may assist in the development of culturally integrated rehabilitation programmes to decrease affiliate stigma and increase family engagement as a means of promoting quality of life for primary family caregivers living with people who have schizophrenia. © 2017 John Wiley & Sons Ltd.

  11. Emotional vitality in family caregivers: content validation of a theoretical framework.

    PubMed

    Barbic, Skye P; Mayo, Nancy E; White, Carole L; Bartlett, Susan J

    2014-12-01

    Emotional vitality may play an important role in determining whether informal caregivers are able to successfully adopt and persist in their roles. This study describes a content validation of a conceptual model of emotional vitality in informal caregivers. A secondary content analysis was performed on transcripts of 30 caregivers who were interviewed about their quality of life in relation to assuming the role of informal caregiver for a family member who had experienced a recent stroke. Caregivers discussed changes in their own health, relationships, roles, finances, participation, and mood after assuming the caregiving role. Using a thematic inductive approach, two raters independently coded the presence and frequency of physical, emotional, and social impacts associated with the caregiving role in order to further develop and validate a conceptual model of caregiver emotional vitality. The interviews provided information that affirmed the relevance of four themes relevant to caregiver emotional vitality previously identified: physical health and well-being; mood regulation; sense of control/mastery of new skills; and participation in meaningful activity. An additional theme of support and recognition from others also emerged. Adopting the informal caregiving role results in major impacts to the caregiver's physical, emotional, and social health. Five core domains appear to meaningfully contribute to emotional vitality of caregivers and may influence their ability to persist in this role over time. Many of the factors that influence emotional vitality in caregivers are potentially modifiable. This new model offers new opportunities for rehabilitation specialists and allied health professionals to develop skill-building interventions that may help caregivers successfully adapt and thrive in the caregiving role.

  12. Training Experiences of Family Medicine Residents on Behavioral Health Rotations.

    PubMed

    Zubatsky, Max; Brieler, Jay; Jacobs, Christine

    2017-09-01

    Although accreditation guidelines for residency in family medicine include behavioral health curriculum, little is known about resident learning activities in real world training. Our study explored residents' perceptions about and exposure to specific activities during their behavioral health rotations. Family medicine residents (N=84) recruited via faculty list serves completed a survey about their experiences during behavioral health rotations. The survey included quantitative Likert scale questions, along with open-ended questions on which a qualitative content analysis was performed. Open-ended responses indicated that many residents receive constructive observation and collaboration opportunities during their training month. However, residents wanted more time to practice behavioral health skills beyond the rotation, more practice in psychotherapy skills, and additional education on medication management. Most residents (62%) received either limited or no training in couples or family therapy during their behavioral health rotation. Residents who reported more behavioral health knowledge gain during the rotation also reported higher self-perceived competency using Motivational Interviewing (M=3.82, P<.01). While family medicine as a discipline is based on the biopsychosocial model of care, residents reported deficits in education about family systems. Residents desire additional opportunities to learn psychotherapy techniques and practice counseling skills. Family medicine residency programs and faculty may consider supplementing their core behavioral curriculum to include these content areas.

  13. The Savvy Caregiver Program: Developing and Testing a Transportable Dementia Family Caregiver Training Program

    ERIC Educational Resources Information Center

    Hepburn, Kenneth W.; Lewis, Marsha; Sherman, Carey Wexler; Tornatore, Jane

    2003-01-01

    Purpose: This article reports on the development and field testing of the Savvy Caregiver Program, the transformation of a successful, academic-based caregiver psychoeducational program into a self-contained program that can be adopted in other locations. Design and Methods: Program development began with a prototype of a 12-hr course with the…

  14. Family caregivers: what do they need? An integrative review.

    PubMed

    Fernandes, Carla Sílvia; Angelo, Margareth

    2016-01-01

    Aimed to identify the main needs expressed by family caregivers in caring for adependent person. An integrative review of the literature in the period between 2010 and 2015 using specific search engine tools in the EBSCO and SCOPUSdatabases. 11 articles were selected, and the analysis of the scientific evidence obtained allowed for organizing the results into five thematic areas:transition into care, being responsible for everything, the importance of support, access to formal support, communication and informationprocesses. The results showed that caregivers have many needs in different areas, which should be addressed in nursing interventions. Este estudo teve como objetivo identificar quais as principais necessidades manifestadas pelo cuidador familiar no cuidado à pessoa dependente. Realizou-se uma revisão integrativa da literatura no período entre 2010 e 2015 com o recurso de instrumentos de busca específicos, nas bases de dados EBSCO e SCOPUS. Foram selecionados 11 artigos A análise da evidência científica obtida permitiu organizar os resultados em cinco áreas temáticas: a transição para o cuidar, o ser responsável por tudo, a importância do suporte, o acesso aos apoios formais, a comunicação e a informação na tomada de decisão. Os resultados demonstram que o cuidador apresenta inúmeras necessidades em áreas distintas,as quais devem ser abordadasnas intervenções de enfermagem.

  15. Effect of acculturation and mutuality on family loyalty among Mexican American caregivers of elders.

    PubMed

    Kao, Hsueh-Fen S; An, Kyungeh

    2012-06-01

    Informal family care for elders is conventional in Mexican American communities despite increasing intergenerational gaps in filial values. In our study, we explored whether acculturation and dyadic mutuality, as perceived by Mexican American family caregivers, explain the caregivers' expectations of family loyalty toward elderly relatives. A nonexperimental, correlational design with convenience sampling was used in El Paso, Texas, from October 2007 to January 2008. Three bilingual promotoras collected data from 193 Mexican American adult caregivers of community-dwelling elders using three scales designed for Mexican Americans: the Acculturation Rating Scale for Mexican Americans II-Short Form, the Mutuality Scale, and the Expectations of Family Loyalty of Children Toward Elderly Relatives Scale. Confirmatory factor analysis was used to analyze the data. Acculturation had a marginal effect (r = .21, p < .05), but mutuality presented a strong correlation (r = .45, p < .001) with the expectations of family loyalty toward elderly relatives. There was no significant correlation between acculturation and mutuality (r = .05). Although Mexican American caregivers with strong Mexican orientation may have high expectations of family loyalty toward elderly relatives, mutuality exhibits more significant effects on expectations. Among Mexican Americans, mutuality between the caregiving dyad, as perceived by caregivers, may be a better predictor of filial values than caregivers' acculturation alone. It may be useful to incorporate the dual paradigm of acculturation and mutuality into immigrant family care for elderly relatives. © 2012 Sigma Theta Tau International.

  16. Web-based health interventions for family caregivers of elderly individuals: A Scoping Review.

    PubMed

    Wasilewski, Marina B; Stinson, Jennifer N; Cameron, Jill I

    2017-07-01

    For the growing proportion of elders globally, aging-related illnesses are primary causes of morbidity causing reliance on family members for support in the community. Family caregivers experience poorer physical and mental health than their non-caregiving counterparts. Web-based interventions can provide accessible support to family caregivers to offset declines in their health and well-being. Existing reviews focused on web-based interventions for caregivers have been limited to single illness populations and have mostly focused on the efficacy of the interventions. We therefore have limited insight into how web-based interventions for family caregiver have been developed, implemented and evaluated across aging-related illness. To describe: a) theoretical underpinnings of the literature; b) development, content and delivery of web-based interventions; c) caregiver usage of web-based interventions; d) caregiver experience with web-based interventions and e) impact of web-based interventions on caregivers' health outcomes. We followed Arksey and O'Malley's methodological framework for conducting scoping reviews which entails setting research questions, selecting relevant studies, charting the data and synthesizing the results in a report. Fifty-three publications representing 32 unique web-based interventions were included. Over half of the interventions were targeted at dementia caregivers, with the rest targeting caregivers to the stroke, cancer, diabetes and general frailty populations. Studies used theory across the intervention trajectory. Interventions aimed to improve a range of health outcomes for caregivers through static and interactive delivery methods Caregivers were satisfied with the usability and accessibility of the websites but usage was generally low and declined over time. Depression and caregiver burden were the most common outcomes evaluated. The interventions ranged in their impact on health and social outcomes but reductions in perception of

  17. Family caregivers' perspectives on dementia-related dressing difficulties at home: The preservation of self model.

    PubMed

    Mahoney, Diane F; LaRose, Sharon; Mahoney, Edward L

    2015-07-01

    Alzheimer's caregiving literature acknowledges dressing as a major daily stressor but research on this topic is negligible. A qualitative grounded theory approach was used to explore Alzheimer's family caregivers' perspectives about issues that arise when their family members lose the ability to dress independently. Three focus groups and seven individual interviews were conducted and audio recorded with 25 information rich caregivers. Constant comparative analyses and coding of the transcripts identified six major themes leading to a 'Preservation of Self Model: Care Recipient to Care Giver' that portrays the caregiving trajectory. Initially, caregivers tried to protect the self dignity of the family member by maintaining usual routines and absorbing blame for difficulties. Dressing 'battles' occurred and caregivers learned management through trial and error. Crossing adult-child-gender role boundaries escalated discomfort. When facing unrelenting demands, concern shifted to preservation of the caregivers' health and self. Results suggest that caregivers would benefit from more pro-active dressing counseling to shorten the trial and error periods, dressing aids more relevant to dementia and more knowledgeable helpers. The preservation model can facilitate understanding of the caregiving trajectory and guide intervention support.

  18. Long-term impact of stroke on family caregiver well-being

    PubMed Central

    Roth, David L.; Hovater, Martha; Clay, Olivio J.

    2015-01-01

    Objective: Three-year changes in well-being were studied among family caregivers of an epidemiologically derived sample of stroke survivors from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study and compared to matched noncaregivers. Methods: Family caregivers of REGARDS participants who experienced a stroke event completed telephone interviews assessing depressive symptoms, mental and physical health quality of life (QOL), life satisfaction, and leisure satisfaction at approximately 9, 18, 27, and 36 months after the stroke (n = 235). For each stroke caregiver, a family member of a stroke-free REGARDS participant was enrolled as a matched noncaregiving control (n = 235) and completed similar interviews. Results: Multilevel longitudinal models found that caregivers showed poorer well-being at 9 months poststroke than controls on all measures except physical health QOL. Significant differences were sustained for 22 months after the stroke event for depressive symptoms, 31 months for mental health QOL, and 15 months for life satisfaction. For leisure satisfaction, differences were still significant at 36 months poststroke. Caregiving effects were similar across race and sex. Conclusions: Stroke caregiving is associated with persistent psychological distress, but life satisfaction, depression, and mental health QOL became comparable to noncaregivers by 3 years after stroke. Caregiver leisure satisfaction was chronically lower than in noncaregivers. Intervention for stroke caregivers should recognize both the strains faced by caregivers and their capacity for successful coping over time. PMID:25740862

  19. [Factors affecting subjective satisfaction with verbal communication among the disabled elderly and their family caregivers].

    PubMed

    Miura, Hiroko; Arai, Yumiko; Yamasaki, Kiyoko

    2005-05-01

    The aims of the present study were to investigate satisfaction with verbal communication among the disabled elderly and their family caregivers; and to find the significantly influential factors of satisfaction with verbal communication. The subjects were 85 disabled elderly and 85 family caregivers. For the disabled elderly, satisfaction with verbal communication, demographic, and physical factors were examined using an interview survey. For the caregivers, satisfaction with verbal communication, demographic factors, and some factors related caregiving were examined using a self-administered questionnaire. In the disabled elderly, 82.4% were satisfied with their verbal communication while 55.3% of family caregivers were satisfied. Satisfaction with verbal communication between the disabled elderly and their caregivers showed low agreement (kappa = 0.17). Bivariate analysis revealed that satisfaction with verbal communication of the disabled elderly was significantly related to ADL (p < 0.01), dysphagia risk (p < 0.05), and ability of comprehension (p < 0.05) while satisfaction with verbal communication of caregivers was significantly related to the gender of the disabled elderly and caregivers' burden. Furthermore, multiple regression analysis showed that the factor most related to satisfaction with verbal communication for the disabled elderly was ability of comprehension (p value = 0.032, odds ratio = 2.960), and the most related factor for their caregivers was the burden evaluated by J-ZBI_8 (p value = 0.004, odds ratio = 0.842). These results suggest that satisfaction with verbal communication of the disabled elderly disagrees with that of the family caregivers, and that some related factors for the disabled elderly are different from those in their family caregivers.

  20. Multiple Family Groups for Child Behavior Difficulties Retention Among Child Welfare-Involved Caregivers.

    PubMed

    Gopalan, Geetha; Fuss, Ashley; Wisdom, Jennifer P

    2015-09-01

    Among children who remain at home with their permanent caregivers following a child welfare investigation, few who manifest emotional and behavioral difficulties actually engage in mental health treatment. The Multiple Family Group service delivery model to reduce childhood disruptive behavior disorders (MFG) has shown promise in engaging child welfare-involved families. This qualitative study examines caregiver perceptions of factors that influence retention in MFGs among child welfare-involved families.

  1. Clinical Evaluation in a Family Medicine Residency.

    ERIC Educational Resources Information Center

    Herman, James M.; And Others

    1985-01-01

    A study assessed (1) the validity of the Bowman Gray School of Medicine evaluation instrument regarding the occurrence of halo effects and (2) possible relationships between the faculty's evaluations of the residents and the residents' cognitive knowledge and productivity. (MLW)

  2. Clinical Evaluation in a Family Medicine Residency.

    ERIC Educational Resources Information Center

    Herman, James M.; And Others

    1985-01-01

    A study assessed (1) the validity of the Bowman Gray School of Medicine evaluation instrument regarding the occurrence of halo effects and (2) possible relationships between the faculty's evaluations of the residents and the residents' cognitive knowledge and productivity. (MLW)

  3. Enhancing Mutual Respect among Nursing Assistants, Residents, and Residents' Families.

    ERIC Educational Resources Information Center

    Heiselman, Terry; Noelker, Linda S.

    1991-01-01

    Interviewed nursing assistants (n=40) and nursing facility residents (n=37) regarding ways they experienced respect, disrespect, attachment, and distancing in their relationships with each other. As a result of finding evidence of disrespect, an inservice session on gaining respect as a nursing assistant was presented. (ABL)

  4. Caregiver Positive and Negative Appraisals: Effects of the National Alliance on Mental Illness Family-to-Family Intervention.

    PubMed

    Toohey, Michael J; Muralidharan, Anjana; Medoff, Deborah; Lucksted, Alicia; Dixon, Lisa

    2016-02-01

    The 3-month-long Family-to-Family intervention (FTF) has been shown to increase empowerment, knowledge, and coping and to reduce distress among caregivers of people with serious mental illness. We sought to determine the influence of FTF on caregivers' appraisal of their caregiving experience. Family members of individuals with mental illness who sought enrollment in FTF (n = 318) were randomly assigned to FTF or a waitlist condition. Positive and negative appraisals were measured using the Experiences of Caregiving Inventory at baseline and 3 months later; 259 participants completed both assessments. Regression analyses found significant increases in positive appraisal but no significant decreases in negative appraisals for those in the FTF condition. In the context of overall benefits from taking FTF, these relationships reflect the FTF curriculum's emphasis on positive coping (e.g., strength and empowerment) and the potential value of strategies that help caregivers increase positive appraisal.

  5. Potential and Active Family Caregivers: Changing Networks and the ‘Sandwich Generation’

    PubMed Central

    Spillman, Brenda C.; Pezzin, Liliana E.

    2000-01-01

    Informal family care giving has been a traditional mainstay of care for the frail elderly. As the Baby Boomers approach retirement and old age, it is not clear that society can continue to rely on informal arrangements. The 1984 and 1994 National Long Term Care Surveys were used as sources for examining changes over a decade in the population of chronically disabled elderly, their sources of care, and the characteristics of family caregivers. The results showed that although the total number of active family caregivers declined, a constant number of primary caregivers was looking after recipients who were more severely disabled. Members of the ‘sandwich generation’ and full-time workers maintained or even increased their participation as primary caregivers. The competing demands confronting these caregivers and the higher disability levels among care recipients probably contributed to the growing pattern of reliance on formal care, a situation that is likely to continue. PMID:11028188

  6. Health-related quality of life in the family caregivers of stroke survivors.

    PubMed

    Chen, Yangkun; Lu, Jinyan; Wong, Ka Sing; Mok, Vincent C T; Ungvari, Gabor S; Tang, Wai Kwong

    2010-09-01

    The objective of this cross-sectional study was to identify the factors associated with health-related quality of life (HRQOL) of family caregivers of Chinese stroke patients. One hundred and twenty-three stroke patients consecutively admitted to a stroke clinic and their 123 family caregivers were recruited. The caregivers' HRQOLs were assessed with the Short Form 36 (SF-36). Two subscores of the SF-36, the Physical Component Summary and the Mental Component Summary Scores served as the dependent variables. Independent variables comprised patients and caregivers' demographic data and physical and psychological conditions in relation to caregivers' HRQOL. The severity of coexisting illnesses of both the patients and their caregivers was assessed using the Cumulative Illness Rating Scale. The Geriatric Depression Scale (GDS) was administered to rate both the patients and their caregivers' depressive symptoms. The extent of the patients' functional disability was assessed using the Barthel Index and the Instrumental Activities of Daily Living. Global cognition of the patients was measured using the Mini Mental State Examination. The level of social support and recent life events of the caregivers were rated using Lubben Social Network Scale and the Modified Life Event Scale, respectively. The multiple linear regression revealed caregivers' Cumulative Illness Rating Scale and GDS score were associated with Physical Component Summary Score of SF-36. The patients and caregivers' GDS score were associated with Mental Component Summary Score of SF-36. Severity of depressive symptoms in Chinese stroke patients and their caregivers is an important factor associated with the caregivers' HRQOL. Further studies evaluating interventions on caregivers' HRQOL should include the assessment and management of mood disorders.

  7. What makes family caregivers happy during the first 2 years post stroke?

    PubMed

    Cameron, Jill I; Stewart, Donna E; Streiner, David L; Coyte, Peter C; Cheung, Angela M

    2014-04-01

    This study aimed to identify aspects of the caregiving situation contributing to family caregivers' psychological well-being. Longitudinal cohort study with structured quantitative interviews 1, 3, 6, and 12 months post stroke. A subset of participants also completed surveys 18 and 24 months post stroke. Participants included individuals hospitalized for their first stroke and their family caregivers. Psychological well-being was assessed by the Positive Affect Scale. A total of 399 stroke survivor, caregiver dyads completed the 1-year follow-up and 80 dyads completed the second year of follow-up. Using mixed effects modeling for longitudinal data, caregivers reported more psychological well-being when they provided more assistance to stroke survivors who had fewer symptoms of depression, better cognitive functioning, and who had more severe strokes. In addition, caregivers who maintained participation in valued activities had more mastery, gained personally providing care, were in better physical health, were older, and were from Quebec reported more psychological well-being. Caregivers followed for a second year post stroke reported better psychological well-being when caring for stroke survivors with fewer symptoms of depression and more severe strokes and when the caregivers had a greater sense of mastery and gained more personally providing care. Our findings contribute to the caregiver intervention development literature by identifying aspects of the caregiving situation that are associated with positive outcomes. Incorporating specific aspects, for example, strategies to enhance caregiver mastery into programs and services offered to caregivers may enhance their positive experiences with providing care and ultimately enhance the sustainability of the caregiving situation.

  8. Depressive symptoms in patients with heart failure negatively affect family caregiver outcomes and quality of life.

    PubMed

    Chung, Misook L; Lennie, Terry A; Mudd-Martin, Gia; Dunbar, Sandra B; Pressler, Susan J; Moser, Debra K

    2016-02-01

    Depressive symptoms in people with heart failure (HF) are highly prevalent. Caring for patients with both HF and depression may be more burdensome than caring for patients with HF alone. The purpose of this study was to examine differences in caregivers' outcomes (i.e. caregiving burden, difficulty and time spent on caregiving, perceptions of life change as a result of caregiving, and quality of life) between caregivers who take care of HF patients with depressive symptoms and without depressive symptoms. Patient-caregiver dyads at an outpatient clinic completed survey questionnaires. Patients' depression was assessed using the Beck Depression Inventory-II (BDI-II); primary caregivers completed caregiving outcome questionnaires. Differences in caregiving outcomes between patients with and without depressive symptoms (BDI-II≥14) were examined using t-tests, Chi-square, and Mann-Whitney U-test. Of 102 patients (64% male, mean age 61, 41% NYHA Class III-IV, mean ejection fraction 35.8±13.9), 26.5% had clinically significant depressive symptoms. Of the primary caregivers (78% female; mean age 56.7), 42% reported severe burden (the Zarit Burden Interview (ZBI)≥17). Caregivers of patients with depressive symptoms had a higher level of burden (25±13 vs 13.5±12 on the ZBI; p<0.001), spent more time caregiving (37±12 vs 30±11 on the Oberst Caregiving Burden Scale; p=0.004), and reported worse mental quality of life (46±10 vs 51±10 on the SF-12v2; p=0.026) than those of patients without depressive symptoms. Family members caring for HF patients with depressive symptoms had significantly higher levels of caregiving burden and worse quality of life compared to those caring for patients without depressive symptoms. © The European Society of Cardiology 2014.

  9. Preserving Personhood of Individuals with Advanced Dementia: Lessons from Family Caregivers

    PubMed Central

    Palmer, Janice L.

    2014-01-01

    This article reports on a phenomenological study of 15 family caregivers who admitted their spouse or parent with probable Alzheimer’s disease to long-term care. The caregivers were attuned to the needs, desires, moods and concerns of their family members with dementia; thus, they were attuned to personhood. Caregivers also reported observations of care by nurses and nursing staff. Observations were of individualized care and actions that promoted personhood and impoverished care delivered with minimal or no communication. These family caregivers’ perspectives can inform the care of individuals with advanced dementia by nurses and nursing staff. PMID:23583171

  10. Does Expressive Writing Reduce Stress and Improve Health for Family Caregivers of Older Adults?

    ERIC Educational Resources Information Center

    Mackenzie, Corey S.; Wiprzycka, Ursula J.; Hasher, Lynn; Goldstein, David

    2007-01-01

    Purpose: We examined whether written emotional disclosure reduces stress and improves health outcomes for family caregivers of physically frail and cognitively impaired older adults, as it has been shown to do for certain student and clinical populations. Design and Methods: Primary caregivers of older adults attending a day program were randomly…

  11. Family Caregiving: Impact of Patient Functioning and Underlying Causes of Dependency.

    ERIC Educational Resources Information Center

    Silliman, Rebecca A.; Sternberg, Josef

    1988-01-01

    Notes that diseases affect health and functional status of patients in different ways and have variable impacts on family caregivers. Using hip fracture, dementia, and stroke as examples, illustrates how physical, social, psychological, and cognitive disabilities place different demands on caregivers. (Author)

  12. Kinship Care and Nonrelative Family Foster Care: A Comparison of Caregiver Attributes and Attitudes.

    ERIC Educational Resources Information Center

    Gebel, Timothy J.

    1996-01-01

    Reports the findings of a survey that explored the attitudes and attributes of nonrelative family foster caregivers and kinship caregivers for children adjudicated dependent and placed by a state public welfare agency. Found significant differences on several demographic variables, in the frequency of caseworker contacts and in perceptions and…

  13. Families Who Care: Assisting African American and Rural Caregivers Dealing with Dementia. A Training Manual.

    ERIC Educational Resources Information Center

    Coogle, Constance L., Ed.; Finley, Ruth B., Ed.

    Although this training manual was developed as a tool for trainers of African American and rural family caregivers of elders with dementia, it can easily be adapted for trainers of caregivers (both formal and informal) of persons other than those with dementia. The first section educates potential trainers about dementia, rural issues, ethnic…

  14. Values and Preferences of Individuals with Dementia: Perceptions of Family Caregivers over Time

    ERIC Educational Resources Information Center

    Reamy, Allison M.; Kim, Kyungmin; Zarit, Steven H.; Whitlatch, Carol J.

    2013-01-01

    Purpose of the Study: Cross-sectional evidence indicates that family caregivers reporting on the importance of daily care values and preferences of individuals with mild-to-moderate dementia consistently report less importance than individuals with dementia (IWDs) self-report. Discrepancy is primarily associated with caregivers' beliefs about…

  15. Home Centered Care: Designing a Family Day Care Program. A Guide for Caregivers and Parents.

    ERIC Educational Resources Information Center

    Garcia, Ronda

    Consistent in its approach to child development and caregiving concepts, this guide for parents and child caregivers explores aspects of family day care in five sections. Section I discusses the design of physically safe environments for children. Section II describes the developing likes and needs of infants, toddlers, preschool children, and…

  16. Values and Preferences of Individuals with Dementia: Perceptions of Family Caregivers over Time

    ERIC Educational Resources Information Center

    Reamy, Allison M.; Kim, Kyungmin; Zarit, Steven H.; Whitlatch, Carol J.

    2013-01-01

    Purpose of the Study: Cross-sectional evidence indicates that family caregivers reporting on the importance of daily care values and preferences of individuals with mild-to-moderate dementia consistently report less importance than individuals with dementia (IWDs) self-report. Discrepancy is primarily associated with caregivers' beliefs about…

  17. Family Caregiving: Impact of Patient Functioning and Underlying Causes of Dependency.

    ERIC Educational Resources Information Center

    Silliman, Rebecca A.; Sternberg, Josef

    1988-01-01

    Notes that diseases affect health and functional status of patients in different ways and have variable impacts on family caregivers. Using hip fracture, dementia, and stroke as examples, illustrates how physical, social, psychological, and cognitive disabilities place different demands on caregivers. (Author)

  18. Family caregiving in dementia: the Asian perspective of a global problem.

    PubMed

    Chan, Sally Wai-Chi

    2010-01-01

    With an increasing life expectancy, the number of people suffering from dementia globally will rise to about 115.4 million by 2050. It is projected that in the 21st century, the majority of the world's older people will be living in Asia. This paper examines the global issues of family caregiving for older persons with dementia from an Asian perspective. Literature review of published empirical studies from 1990 to October 2010. A full understanding of the specific way that culture could influence family caregivers' burdens may play an important part in the development of a holistic model for family-centered care. Well-designed psychoeducation interventions or multicomponent interventions could help in reducing caregivers' burden. With socio-economical and demographical changes, families need to be supported when taking on the caregiving role and be offered alternatives of care. There is a need for future trials with more rigorous randomization and longitudinal follow-up to assess family caregiver burdens at different illness stages. Future studies could focus on protective factors that promote caregivers' resilience. It is essential to develop psychometrically robust measures for family caregiver burden and gain. Copyright © 2011 S. Karger AG, Basel.

  19. The family caregiver experience - examining the positive and negative aspects of compassion satisfaction and compassion fatigue as caregiving outcomes.

    PubMed

    Lynch, Susan H; Shuster, Geoff; Lobo, Marie L

    2017-08-16

    Caregiving results in both positive and negative outcomes for caregivers. The purpose of this study was to examine compassion fatigue and compassion satisfaction in family caregivers. Using a cross sectional descriptive survey design with a convenience sample, 168 family caregivers of individuals with chronic illness completed a web-based survey. Measures included a demographic questionnaire, Caregiver Burden Interview, Brief COPE inventory and Professional Quality of Life (ProQOL). The majority of participants (71%) reported high levels of caregiver burden, moderate to low levels of the compassion fatigue concepts of burnout (59.5%) and secondary traumatic stress (STS) (50%), and moderate levels of compassion satisfaction (82.7%). Regression analyses showed that caregiver burden, time caregiving, coping, social support, and caregiving demands explained a total variance of 57.1%, F(11,119) = 14.398, p < .00 in burnout and a total variance of 56%, F(11, 119) = 13.64, p < .00 in STS. Specifically, behavioral disengagement is a predicator that may indicate early compassion fatigue. Findings suggest that despite high caregiver burden and moderate compassion fatigue, family caregivers are able to provide care and find satisfaction in the role. This study supports the use of compassion fatigue and compassion satisfaction as alternative or additional outcomes to consider in future research.

  20. Caregiver roles in families affected by Huntington's disease: a qualitative interview study.

    PubMed

    Røthing, Merete; Malterud, Kirsti; Frich, Jan C

    2014-12-01

    The objective of this study was to explore family caregivers' experiences with the impact of Huntington's disease (HD) on the family structure and roles in the family. We interviewed 15 family caregivers in families affected by HD, based on a semi-structured interview guide. The participants were recruited through hospital departments and a lay organisation for HD in Norway. Data from the interviews were analysed with systematic text condensation. Huntington's disease could have a substantial impact on the family system, the shape of roles among family members and the hierarchical order between spouses, partners, and parents and children. The relationship between spouses and partners changed during the course of the disease. A reciprocal relationship was difficult to maintain, as the role as carer overshadowed other roles. Children of an affected parent could compensate for impairments by taking on adult responsibilities, and in some families, a child had the role as main caregiver. The increasing need for care could cause conflicts between the role as family member and family caregiver. The burden of care within the family could fragment and isolate the family. Huntington's disease has a major impact on family systems. Caregiver roles are shaped by impairments in the affected family member and corresponding dynamic adoption and change in roles within the family. Making assessments of the family structure and roles, professionals may understand more about how to care for and support individuals in their role as family members and caregivers in different stages of the disease and family life cycle. © 2013 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

  1. Strengthening Incarcerated Families: Evaluating a Pilot Program for Children of Incarcerated Parents and Their Caregivers

    PubMed Central

    Miller, Alison L.; Perryman, Jamie; Markovitz, Lara; Franzen, Susan; Cochran, Shirley; Brown, Shavonnea

    2013-01-01

    Parental incarceration can be devastating for families. Children may experience difficulties, and the stress on caregivers who take on unexpected childrearing is high. We implemented and evaluated a family-level intervention with caregivers and children experiencing parental (typically maternal) incarceration, in a community setting. We partnered with a community-based organization serving families with an incarcerated parent to conduct a pilot trial of the Strengthening Families Program (SFP). Process evaluation indicated high implementation fidelity, satisfaction, engagement, and attendance. Outcome evaluation results indicated positive changes in family-level functioning, caregivers’ positive parenting, and caregiver depression symptoms from pre- to post-intervention, with some changes retained at follow-up 4 months later. Implications for preventive interventions with children of incarcerated parents, and their caregivers, are discussed. PMID:24353363

  2. Shaping mutuality: nurse-family caregiver interactions in caring for older people with depression.

    PubMed

    Jeon, Yun-Hee

    2004-06-01

    This paper reports on the research findings derived from a grounded theory study that examined the processes through which community mental health nurses work with families of older people with depression. Data were collected through semistructured, in-depth interviews with six community mental health nurses and seven family caregivers of older people with depression, and observations of their interactions in natural settings. Data collection and analysis were guided by theoretical sampling and the constant comparative process. The findings indicate that the nurse-family caregiver relationship involves working towards mutuality, which is shaped by both the nurse and family caregiver. It is through the process of "shaping mutuality" that a nurse and family caregiver learn to collaborate, and achieve their individual goals and desired outcomes, both for the patient and for themselves.

  3. Needs of family caregivers of stroke patients: a longitudinal study of caregivers’ perspectives

    PubMed Central

    Tsai, Pei-Chun; Yip, Ping-Keung; Tai, John Jen; Lou, Meei-Fang

    2015-01-01

    Background After a stroke, patients often suffer from varying degrees of disability that require acute inpatient treatment and extended care at home. Therefore, the caregivers assume multiple responsibilities that can result in stress, particularly when their own needs are inadequately addressed during the patient’s recovery. Objectives This study aimed to explore the changing needs of family caregivers of stroke patients and factors related to the needs in four stages, before the transfer from intensive care unit to neurological unit, before discharge, 2 weeks post-hospitalization, and 3 months post-hospitalization. Methods The design of this study was based on longitudinal research, and the participants were family caregivers of stroke patients. Sixty family caregivers were recruited in this study. Data were collected at four time points by questionnaire. Results We found that the total number of needs of family caregivers decreased as the illness duration increased and that needs differed significantly between the four time points (P<0.01). Although the needs were different in each stage, health information, professional support, and community networks were the leading need domains in all four stages. The major factors affecting the care needs of family caregivers were the National Institutes of Health Stroke Scale scores of patients on admission, length of hospital stay, and physical dependence of patients. Conclusion Family caregivers expected to obtain assistance and related care information from professionals during the course of the disease. Assessing the needs of family caregivers is important for health care workers in understanding problems from the caregivers’ perspectives. Relevant information and counseling should be provided to family caregivers to help them access support when needed. PMID:25834409

  4. Families and Futures: Helping Self and Others. Starting a Healthy Family Series/Family and Community Health Through Caregiving.

    ERIC Educational Resources Information Center

    Education Development Center, Inc., Newton, MA.

    This student manual, part of the Family and Community Health Through Caregiving program, focuses on the special needs of teenagers with birth defects. Topics include: (1) the effect of informal contacts with the community, neighbors, and school age peers on the special needs adolescent; (2) society's attempts to meet these needs; (3) problems of…

  5. Partners Plus: Families and Caregivers in Partnerships. Model Demonstration. Final Report.

    ERIC Educational Resources Information Center

    Garland, Corrine W.; Frank, Adrienne; Ownby, Lisa L.

    This final report discusses the activities and outcomes of Partners Plus: Families and Caregivers in Partnerships, a model demonstration project designed to expand respite care options for families of children (birth to 8 years old) with disabilities. The program uses a natural and family-centered model that involves families in the design,…

  6. Effect of location on family medicine residents' training.

    PubMed Central

    Lebel, D.; Hogg, W.

    1993-01-01

    A survey of family medicine residents trained at community-based or hospital-based centres suggested differences in experience and in career plans. Community-based residents saw more patients in the same family, believed they knew the community better, made more housecalls, expected to use allied health professionals more frequently, and were more likely to choose a small community practice. PMID:8499787

  7. Influence of personality on depression, burden, and health-related quality of life in family caregivers of persons with dementia.

    PubMed

    Kim, Sun Kyung; Park, Myonghwa; Lee, Yunhwan; Choi, Seong Hye; Moon, So Young; Seo, Sang Won; Park, Kyung Won; Ku, Bon D; Han, Hyun Jeong; Park, Kee Hyung; Han, Seol-Heui; Kim, Eun-Joo; Lee, Jae-Hong; Park, Sun A; Shim, Yong S; Kim, Jong Hun; Hong, Chang Hyung; Na, Duk L; Ye, Byoung Seok; Kim, Hee Jin; Moon, Yeonsil

    2017-02-01

    Personality may predispose family caregivers to experience caregiving differently in similar situations and influence the outcomes of caregiving. A limited body of research has examined the role of some personality traits for health-related quality of life (HRQoL) among family caregivers of persons with dementia (PWD) in relation to burden and depression. Data from a large clinic-based national study in South Korea, the Caregivers of Alzheimer's Disease Research (CARE), were analyzed (N = 476). Path analysis was performed to explore the association between family caregivers' personality traits and HRQoL. With depression and burden as mediating factors, direct and indirect associations between five personality traits and HRQoL of family caregivers were examined. Results demonstrated the mediating role of caregiver burden and depression in linking two personality traits (neuroticism and extraversion) and HRQoL. Neuroticism and extraversion directly and indirectly influenced the mental HRQoL of caregivers. Neuroticism and extraversion only indirectly influenced their physical HRQoL. Neuroticism increased the caregiver's depression, whereas extraversion decreased it. Neuroticism only was mediated by burden to influence depression and mental and physical HRQoL. Personality traits can influence caregiving outcomes and be viewed as an individual resource of the caregiver. A family caregiver's personality characteristics need to be assessed for tailoring support programs to get the optimal benefits from caregiver interventions.

  8. Work and family conflicts in employees with spinal cord injury and their caregiving partners.

    PubMed

    Fekete, C; Siegrist, J; Tough, H; Brinkhof, M W G

    2017-08-29

    Cross-sectional, observational. To investigate the association of conflicts between work and family life with indicators of health and to examine the antecedents of those conflicts in employees with spinal cord injury (SCI) and their caregiving partners. Community, Switzerland. Data from employed persons with SCI (n=79) and caregiving partners (n=93) who participated in the pro-WELL study were used. Logistic and tobit regressions were performed to assess the association of work-family and family-work conflicts with health indicators, namely mental health (36-item Short Form Health Survey (SF-36)), vitality (SF-36), well-being (WHOQoL BREF) and positive and negative affect (Positive and Negative Affect Scale short form (PANAS-S)). Own and partners' engagement in productive activities and socioeconomic circumstances were evaluated as potential antecedents of work-family and family-work conflicts using logistic regression. Work-family conflicts were related to reduced mental health (caregiving partners only), vitality and well-being. Family-work conflicts were linked to reduced mental health, vitality, well-being and positive affect in SCI and to reduced vitality in caregiving partners. Persons with lower income (SCI only) and lower subjective social position reported more conflicts than persons with higher income and higher subjective position. Higher workload increased work-family conflicts in caregiving partners and decreased family-work conflicts in SCI. Education, amount of caregiving, care-receiving and partners' employment status were not associated with the occurrence of conflicts. The optimal balance between work and family life is important to promote mental health, vitality and well-being in employees with SCI and their caregiving partners. This is especially true in employees perceiving their social position as low and in caregivers with a high workload.Spinal Cord advance online publication, 29 August 2017; doi:10.1038/sc.2017.100.

  9. Barriers to mental health service use among distressed family caregivers of lung cancer patients.

    PubMed

    Mosher, C E; Given, B A; Ostroff, J S

    2015-01-01

    Although family caregivers of patients with lung and other cancers show high rates of psychological distress, they underuse mental health services. This qualitative study aimed to identify barriers to mental health service use among 21 distressed family caregivers of lung cancer patients. Caregivers had not received mental health services during the patient's initial months of care at a comprehensive cancer centre in New York City. Thematic analysis of interview data was framed by Andersen's model of health service use and Corrigan's stigma theory. Results of our analysis expand Andersen's model by providing a description of need variables (e.g. psychiatric symptoms), enabling factors (e.g. finances), and psychosocial factors associated with caregivers' non-use of mental health services. Regarding psychosocial factors, caregivers expressed negative perceptions of mental health professionals and a desire for independent management of emotional concerns. Additionally, caregivers perceived a conflict between mental health service use and the caregiving role (e.g. prioritising the patient's needs). Although caregivers denied stigma associated with service use, their anticipated negative self-perceptions if they were to use services suggest that stigma may have influenced their decision to not seek services. Findings suggest that interventions to improve caregivers' uptake of mental health services should address perceived barriers. © 2014 John Wiley & Sons Ltd.

  10. Attitudes Toward and Predictors of Videoconferencing Use Among Frequent Family Visitors to Nursing Home Residents in Taiwan.

    PubMed

    Tsai, Hsiu-Hsin; Tsai, Yun-Fang

    2015-10-01

    Videoconferencing with family members benefits nursing home residents by decreasing their depression and loneliness. Nevertheless, the rate of participation in videoconferencing by family members is low. The purpose of this study was to explore attitudes toward and factors related to videoconferencing by family visitors to nursing home residents in Taiwan. For this cross-sectional study, data were collected from 231 family members of residents at 16 medium to large (>70 beds) nursing homes in Taiwan. Data were collected on participants' and residents' demographic and clinical characteristics, acceptance of and attitudes toward using videoconferencing as a form of nursing home visit, and reasons for/roles during visits to nursing home residents. Factors related to the use of videoconferencing were analyzed by logistic regression. Family members' acceptance rate of videoconferencing use was low (7.8%). The findings also showed that videoconference use was predicted by hiring a private caregiver (odds ratio=6.90), the role during/reason for family visits being to maintain residents' emotional status (odds ratio=5.46), and the frequency of in-person visits to the nursing home. We recommend encouraging family use of videoconferencing by available equipment such as smartphones or tablet programs that can address residents' emotional issues in a timely fashion. We also suggest developing more interactive content for videoconferencing, such as a family-oriented picture program to help broaden topics of conversation.

  11. A Qualitative Study of Family Caregiver Experiences of Managing Incontinence in Stroke Survivors

    PubMed Central

    Tseng, Chien-Ning; Huang, Guey-Shiun; Yu, Po-Jui; Lou, Meei-Fang

    2015-01-01

    Background Incontinence is a common problem faced by family caregivers that is recognized as a major burden and predictor of institutionalization. However, few studies have evaluated the experiences of family caregivers caring for stroke survivors with incontinence. Purpose To describe experiences of caregivers managing incontinence in stroke survivors. Design This qualitative descriptive study employed a grounded-theory approach. Methods Semi-structured in-depth interviews with ten family caregivers of stroke survivors with incontinence were conducted during 2011. Audiotaped interviews were transcribed and analyzed using content analysis. Findings Data analysis identified four themes: chaos, hypervigilance, exhaustion, and creating a new life. There were nine related subcategories: fluster, dirtiness, urgency, fear of potential health-hazard, physically demanding and time-consuming, mentally draining, financial burden, learning by doing, and attitude adjustment. Together, these described a process of struggling to cope with the care of stroke survivors with urinary/fecal incontinence. Of the four categories, “creating a new life” developed gradually over time to orient caregivers to their new life, while the other three categories occurred in a chronological order. Conclusion The research highlighted unique caring experiences of family caregivers of stroke patients, which focused solely on the ‘incontinence issue’. Understanding these experiences may help nurses provide better support and resources for family caregivers when caring for stroke survivors with incontinence. PMID:26066345

  12. Family caregiver quality of life in multiple sclerosis among Kuwaitis: a controlled study.

    PubMed

    Alshubaili, Asmahan F; Ohaeri, Jude U; Awadalla, Abdel W; Mabrouk, Asser A

    2008-10-07

    Research interest in the quality of life (QOL) of persons with multiple sclerosis (MS) has been spurred by the need to broaden outcome measures. Far less of this interest has been directed at the family caregivers, who bear most of the burden of care. The objectives of the study were: First, to compare the subjective QOL of family caregivers of persons with relapsing remitting and progressive MS, with those of a matched general population sample and caregivers of diabetes and psychiatric patients. Second, to assess the relationship of QOL with caregiver attitudes to MS and patient's variables. Consecutive MS clinic attendees were assessed with the 26 - item WHOQOL Instrument, and for depression and disability. Similarly, caregivers independently rated their own QOL as well as their impression of patients' QOL and attitudes to patients' illness. The 170 caregivers, mean age 35.7 years, had no significant diagnostic differences in QOL domain scores and attitudes to MS. Caregivers had significantly lower QOL than the general population control group for five out of six domains and the general facet (P < 0.01), but higher QOL than the patients. When the scores were corrected for patients' depression and disability, caregivers had similar QOL with the general population group for four domains. Using corrected scores, MS caregivers had lower scores than diabetic and psychiatric caregivers in the physical, psychological and social relations domains. Majority expressed negative attitudes to MS. Caregiver QOL was more affected by their fear of having MS than their feelings about the illness and caregiving role. Caregiver attitudes had mostly no significant impact on their proxy ratings of patients' QOL. The significant predictor of caregivers' overall QOL was their impression of patients' QOL. Caregivers need specific attention if they are less educated, unemployed, afraid of having MS and caring for patients with longer duration of illness and less education. In particular

  13. The Disproportionate Impact Of Dementia On Family And Unpaid Caregiving To Older Adults.

    PubMed

    Kasper, Judith D; Freedman, Vicki A; Spillman, Brenda C; Wolff, Jennifer L

    2015-10-01

    The number of US adults ages sixty-five and older who are living with dementia is substantial and expected to grow, raising concerns about the demands that will be placed on family members and other unpaid caregivers. We used data from the 2011 National Health and Aging Trends Study and its companion study, the National Study of Caregiving, to investigate the role of dementia in caregiving. We found that among family and unpaid caregivers to older noninstitutionalized adults, one-third of caregivers, and 41 percent of the hours of help they provide, help people with dementia, who account for about 10 percent of older noninstitutionalized adults. Among older adults who receive help, the vast majority in both community and residential care settings other than nursing homes rely on family or unpaid caregivers (more than 90 percent and more than 80 percent, respectively), regardless of their dementia status. Caregiving is most intense, however, to older adults with dementia in community settings and from caregivers who are spouses or daughters or who live with the care recipient. Project HOPE—The People-to-People Health Foundation, Inc.

  14. Attachment and caregiving relationships in families affected by parental incarceration

    PubMed Central

    Shlafer, Rebecca J.; Poehlmann, Julie

    2011-01-01

    This longitudinal, mixed method study focused on 57 families of children who participated in a mentoring program for children of incarcerated parents. Children ranged in age from 4 to 15 years. Monthly interviews were conducted with children, caregivers, and mentors during the first six months of program participation, and questionnaires were administered at intake and six months to assess caregiver–child and incarcerated parent–child relationships, contact with incarcerated parents, and children’s behavior problems. Although some children viewed their incarcerated parents as positive attachment figures, other children reported negative feelings toward or no relationship with incarcerated parents. In addition, our assessments of children nine years old and older revealed that having no contact with the incarcerated parent was associated with children reporting more feelings of alienation toward that parent compared to children who had contact. Children’s behavior problems were a primary concern, often occurring in a relational context or in reaction to social stigma associated with parental imprisonment. PMID:20582847

  15. Parental psychopathology and treatment outcome for anxious youth: Roles of family functioning and caregiver strain

    PubMed Central

    Schleider, Jessica L.; Ginsburg, Golda S.; Keeton, Courtney P.; Weisz, John R.; Birmaher, Boris; Kendall, Phillip C.; Piacentini, John; Sherrill, Joel; Walkup, John T.

    2014-01-01

    Objective Research has examined the effects of parental psychopathology, family functioning, and caregiver strain on treatment response in anxious youths. Although these variables have shown individual links to youth treatment response, theoretical models for their combined effects remain unexplored. This study tested the hypothesis that improvements in family functioning and reductions in caregiver strain explained the effects of parental psychopathology on youth treatment outcome in an anxiety treatment trial. Method A multiple mediation technique was used to test the proposed model across independent evaluator (IE), parent, and youth informants in 488 youths, aged 7–17 years (50% female; mean age 10.7) meeting DSM-IV-TR criteria for social phobia, separation anxiety, and/or generalized anxiety disorder. Youths were randomized to receive 12 weeks of cognitive-behavioral treatment (Coping Cat), medication (sertraline), their combination, or a pill placebo. At pre- and post-treatment, parents completed self-report measures of global psychopathology symptoms, family functioning, and caregiver strain; parents, youths, and IEs rated youths’ anxiety symptom severity. Results Changes in family functioning and caregiver strain jointly explained relations between parental psychopathology and reductions in youth anxiety. Specifically, across IE and parent informants, families with higher pre-treatment parental psychopathology showed more improvement in family functioning and caregiver strain, which in turn predicted greater youth anxiety reductions. Further, higher pre-treatment parental psychopathology predicted greater caregiver strain reductions, and in turn, greater youth anxiety reductions, based on youths’ reports of their own anxiety. Conclusions Findings suggest that improvements in family functioning and reductions in caregiver strain can influence treatment outcomes for anxious youths, especially among youths with more distressed parents. Public health

  16. Using multiple views of family dynamics to predict the mental health of individuals with TBI and their caregivers in Mexico.

    PubMed

    Stevens, Lillian F; Perrin, Paul B; Hubbard, Rebecca; Díaz Sosa, Dulce María; Espinosa Jove, Irma Guadalupe; Arango-Lasprilla, Juan Carlos

    2013-01-01

    To examine differences in ratings of family dynamics between individuals with traumatic brain injury (TBI) and their family caregivers in Mexico, as well as differences in the prediction of caregiver and patient mental health outcomes from those ratings. Forty-two patient-caregiver dyads (n = 84) from the National Institute of Rehabilitation in México City participated in a comprehensive evaluation of their family dynamics and mental health. Patients' and caregivers' ratings of family dynamics were significantly correlated and did not differ across five of six types of family dynamics, but caregivers rated their family's level of empathy higher than patients, p < 0.001. Additionally, all patient and caregiver ratings of family dynamics were significantly correlated. Patients', caregivers', and combined (using structural equation modeling latent constructs) ratings of family dynamics robustly predicted four times as many caregiver mental health outcomes as patient mental health outcomes. Family dynamics influence both TBI patient and caregiver mental health but much more so in caregivers. Research on families of individuals with TBI in Mexico should incorporate both patient and caregiver perspectives to more comprehensively depict the environment in which TBI rehabilitation occurs.

  17. Self-efficacy for controlling upsetting thoughts and emotional eating in family caregivers.

    PubMed

    MacDougall, Megan; Steffen, Ann

    2017-10-01

    Self-efficacy for controlling upsetting thoughts was examined as a predictor of emotional eating by family caregivers of physically and cognitively impaired older adults. Adult women (N = 158) providing healthcare assistance for an older family member completed an online survey about caregiving stressors, depressive symptoms, self-efficacy, and emotional eating. A stress process framework was used as a conceptual model to guide selection of variables predicting emotional eating scores. A hierarchical multiple regression was conducted and the overall model was significant (R(2) = .21, F(4,153) = 10.02, p < .01); self-efficacy for controlling upsetting thoughts was a significant predictor of caregivers' emotional eating scores after accounting for IADL, role overload, and depression scores. These findings replicate previous research demonstrating the relationship between managing cognitions about caregiving and behavioral responses to stressors, and point to the importance of addressing cognitive processes in efforts to improve caregiver health behaviors.

  18. Death with dignity from the perspective of the surviving family: a survey study among family caregivers of deceased older adults.

    PubMed

    van Gennip, Isis E; Pasman, H Roeline W; Kaspers, Pam J; Oosterveld-Vlug, Mariska G; Willems, Dick L; Deeg, Dorly J H; Onwuteaka-Philipsen, Bregje D

    2013-07-01

    Death with dignity has been identified as important both to patients and their surviving family. While research results have been published on what patients themselves believe may affect the dignity of their deaths, little is known about what family caregivers consider to be a dignified death. (1) To assess the prevalence of death with dignity in older adults from the perspective of family caregivers, (2) to determine factors that diminish dignity during the dying phase according to family caregivers, and (3) to identify physical, psychosocial, and care factors associated with death with dignity. A survey study with a self-administered questionnaire. Family caregivers of 163 deceased older (>55 years of age) adults ("patients") who had participated in the Longitudinal Aging Study Amsterdam. Of the family caregivers, 69% reported that their relative had died with dignity. Factors associated with a dignified death in a multivariate regression model were patients feeling peaceful and ready to die, absence of anxiety and depressive mood, presence of fatigue, and a clear explanation by the physician of treatment options during the final months of life. The physical and psychosocial condition of the patient in combination with care factors contributed to death with dignity from the perspective of the family caregiver. The patient's state of mind during the last phase of life and clear communication on the part of the physician both seem to be of particular importance.

  19. Perception Gap in Quality-of-Life Ratings: An Empirical Investigation of Nursing Home Residents and Caregivers

    ERIC Educational Resources Information Center

    Mittal, Vikas; Rosen, Jules; Govind, Rahul; Degenholtz, Howard; Shingala, Sunil; Hulland, Shelley; Rhee, YongJoo; Kastango, Kari B.; Mulsant, Benoit H.; Castle, Nick; Rubin, Fred H.; Nace, David

    2007-01-01

    Purpose: Several studies have previously documented the existence of a perception gap--the extent to which quality-of-life ratings provided by nursing home residents and caregivers diverge. In this study we use Helson's adaptation-level theory to investigate three types of antecedents: (a) focal factors, (b) background factors, and (c) residual…

  20. Perception Gap in Quality-of-Life Ratings: An Empirical Investigation of Nursing Home Residents and Caregivers

    ERIC Educational Resources Information Center

    Mittal, Vikas; Rosen, Jules; Govind, Rahul; Degenholtz, Howard; Shingala, Sunil; Hulland, Shelley; Rhee, YongJoo; Kastango, Kari B.; Mulsant, Benoit H.; Castle, Nick; Rubin, Fred H.; Nace, David

    2007-01-01

    Purpose: Several studies have previously documented the existence of a perception gap--the extent to which quality-of-life ratings provided by nursing home residents and caregivers diverge. In this study we use Helson's adaptation-level theory to investigate three types of antecedents: (a) focal factors, (b) background factors, and (c) residual…

  1. Effects of family treatment on parenting beliefs among caregivers of youth with poorly controlled asthma.

    PubMed

    Ellis, Deborah A; King, Pamela; Naar-King, Sylvie; Lam, Phebe; Cunningham, Phillippe B; Secord, Elizabeth

    2014-10-01

    Caregiver involvement is critical in ensuring optimal adolescent asthma management. The study investigated whether multisystemic therapy (MST), an intensive home-based family therapy, was superior to family support for changing beliefs regarding asthma-related positive parenting among caregivers of African-American youth with poorly controlled asthma. The relationship between parenting beliefs and asthma management at the conclusion of the intervention was also assessed. A randomized controlled trial was conducted with 167 adolescents with moderate-to-severe, persistent, poorly controlled asthma and their primary caregivers. Families were randomly assigned to MST or family support (FS), a home-based family support condition. Data were collected at baseline and 7-month posttest. Changes in caregiver ratings of importance and confidence for engaging in asthma-related positive parenting were assessed through questionnaire. Illness management was assessed by the Family Asthma Management System Scale. Participation in MST was associated with more change in caregiver beliefs as compared with FS for both importance (t = 2.39, p = .02) and confidence (t = 2.04, p = .04). Caregiver beliefs were also significantly related to youth controller medication adherence at the conclusion of treatment (importance: r = .21, p = .01; confidence: r = .23, p = .004). Results support the effectiveness of MST for increasing parental beliefs in the value of asthma-related positive parenting behaviors and parental self-efficacy for these behaviors among families of minority adolescents with poorly controlled asthma.

  2. Randomized Controlled Trial of CARE: An Intervention to Improve Outcomes of Hospitalized Elders and Family Caregivers

    PubMed Central

    Li, Hong; Powers, Bethel Ann; Melnyk, Bernadette Mazurek; McCann, Robert; Koulouglioti, Christina; Anson, Elizabeth; Smith, Joyce A.; Xia, Yinglin; Glose, Susan; Tu, Xin

    2012-01-01

    In this randomized controlled trial we tested the efficacy of an intervention program (CARE: Creating Avenues for Relative Empowerment) for improving outcomes of hospitalized older adults and their family caregivers. Family caregiver-patient dyads (n=407) were randomized into two groups. The CARE group received a two-session empowerment-educational program 1-2 days post-admission and 1-3 days pre-discharge. The attention control group received a generic information program during the same timeframe. Follow-up was at 2 weeks and 2 months post-discharge. There were no statistically significant differences in patient or family caregiver outcomes. However, inconsistent evidence of role outcome differences suggests that CARE may benefit certain family caregiver subgroups instead of being a one-size-fits-all intervention strategy. Closer examination of CARE's mechanisms and effects is needed. PMID:22736271

  3. Advantages and Challenges: The Experience of Geriatrics Health Care Providers as Family Caregivers.

    PubMed

    Wohlgemuth, Clare M; Auerbach, Heidi P; Parker, Victoria A

    2015-08-01

    Very little is known about family caregivers who are also geriatrics health care professionals. This exploratory study examines the dual roles of such professionals, the impact of their geriatrics expertise on the care of family members, and the influence of those caregiver experiences on their clinical practice. The research team recruited 16 geriatrics health care professionals who participated in 60- to 90-min individual interviews, based on a semistructured guide. Questions explored participants' dual experiences as geriatrics professionals and as family caregivers. Interviews were audio recorded, transcribed, and analyzed using qualitative data analysis software. Using a thematic analysis approach, the authors identified recurring themes, coding responses into both major themes and subthemes. The authors found 3 major themes: (a) dual role advantages and disadvantages, (b) emotional impact of dual roles, and (c) professional impact of family caregiving. Participants reported their own geriatrics expertise provided both advantages and disadvantages in caring for their older family members. Although their expertise introduced a significant emotional intensity to their personal caregiving experiences, those experiences positively influenced their professional insight, empathy, and advocacy for the caregivers of their own patients. In addition to the well-known burdens of caregiving, a further set of complex stressors is imposed on geriatrics health care professionals serving as family caregivers. The challenges they face despite their expertise also highlight critical challenges facing all caregivers. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Quality of Life of Patients with Cancer: A Determinant of the Quality of Life of Their Family Caregivers.

    PubMed

    Padmaja, Gadiraju; Vanlalhruaii, C; Rana, Suvashisa; Tiamongla; Kopparty, Swarajya

    2017-09-01

    Cancer disrupts the quality of life of both the patients and their family caregivers. This study attempted to explore the relationship between the quality of life of cancer patients and their family caregivers and to examine whether the quality of life, age, and gender of the patients contributed to the quality of life of their family caregivers. This correlational study involved 206 pairs of participants consisting of cancer patients and their corresponding family caregivers. The European Organization for the Treatment and Research of Quality of Life Questionnaire C-30 (version 3) was administered on the patients and the Caregiver Quality of Life-Cancer was administered on their family caregivers. The result revealed that social functioning, appetite loss, physical functioning, and gender of the patients contributed significantly to the quality of life of their family caregivers. Implications, shortcomings, and future directions were discussed.

  5. The Impact of Resident Training on Communication with Families in the Intensive Care Unit. Resident and Family Outcomes.

    PubMed

    Sullivan, Amy M; Rock, Laura K; Gadmer, Nina M; Norwich, Diana E; Schwartzstein, Richard M

    2016-04-01

    In high-acuity settings such as intensive care units (ICUs), the quality of communication with patients' families is a particularly important component of care. Evidence shows that ICU communication is often inadequate and can negatively impact family outcomes. To assess the impact of a communication training program on resident skills in communicating with families in an ICU and on family outcomes. We conducted a prospective, single-site educational intervention study. The intervention featured a weekly required communication training program (4 h total) during the ICU rotation, which included interactive discussion, and role play with immediate feedback from simulated family members. All internal medicine residents on ICU rotation between July 2012 and July 2014 were invited to participate in the study. Family members who had a meeting with an enrolled resident were approached for a survey or interview. The primary outcome was family ratings of how well residents met their informational and emotional needs. The response rate for the resident baseline survey was 93% (n = 149 of 160), and it was 90% at postcourse and 84% at 3-month follow-up. Of 303 family members approached, 237 were enrolled. Enrolled family members who had a confirmed meeting with a resident were eligible to complete a survey or interview. The completion rate was 86% (n = 82 of 95). Family members were more likely to describe residents as having "fully met" (average rating of 10/10 on 0-10 scale) their informational and emotional needs when the resident had completed two or three course sessions (84% of family members said conversation with these residents "fully met" their needs), as compared with residents who had taken one session or no sessions (25% of family members said needs were "fully met") (P < 0.0001). Residents described improvements across all domains. All differences are statistically significant, most with large effect sizes. At our institution, an on-site communication training

  6. The costs of a family practice residency ambulatory care program.

    PubMed

    Pawlson, L G; Watkins, R

    1979-12-01

    The cost of patient care service and education occurring in a family practice residency unit of a community based prepaid health program was determined from accounting records. The cost of producing the same number of patient visits in comparable family practice units which did not have residents on-site was determined in a similar manner. The cost per visit in the residency unit was $15.53 while that in the nonresidency unit was $13.92. There was an excess cost of $1.61 per visit in the residency, or, based on the number of residents present, a net cost of $7 per resident per day. None of the costs of central residency program administration or of ambulatory based subspecialty rotations were included. While a small increase (ten percent) in productivity or efficiency would result in the residency patient care unit itself being self-sustaining, this study casts considerable doubt on the ability of the model family practice residency unit to offset the full costs of the ambulatory care portion of family practice residency training.

  7. The ACTive Intervention in Hospice Interdisciplinary Team Meetings: Exploring family caregiver and hospice team communication.

    PubMed

    Wittenberg-Lyles, Elaine; Parker Oliver, Debra; Demiris, George; Baldwin, Paula

    2010-04-01

    This paper presents the theoretical framework and rationale for the ACTive intervention which proposes the use of video technology to facilitate patient and family participation in hospice interdisciplinary team meetings where plans of care are determined. It is surmised that patient and family involvement will improve communication and compliance in hospice care. An analysis of data from a pilot project of the ACTive intervention was conducted to explore active participation among family caregivers and the hospice team. Through the use of videophone technology caregivers participated in video-recorded team meetings. The actual communication behaviors of caregivers and team members were analyzed for active participation. Findings revealed that team-prompted caregiver participation was most common, however, team use of supportive talk in this context was considerably less frequent. The study also found that the team's use of active participation behaviors elicits caregiver active participation behaviors. The results of this study suggest the intervention was an effective way to involve family caregivers as active participants in the designing of care for their loved one. Findings also suggest that hospice staff would benefit from education and training on best practices for communicating with caregivers in the team meeting setting.

  8. The ACTive Intervention in Hospice Interdisciplinary Team Meetings: Exploring family caregiver and hospice team communication

    PubMed Central

    Wittenberg-Lyles, Elaine; Parker Oliver, Debra; Demiris, George; Baldwin, Paula

    2010-01-01

    This paper presents the theoretical framework and rationale for the ACTive intervention which proposes the use of video technology to facilitate patient and family participation in hospice interdisciplinary team meetings where plans of care are determined. It is surmised that patient and family involvement will improve communication and compliance in hospice care. An analysis of data from a pilot project of the ACTive intervention was conducted to explore active participation among family caregivers and the hospice team. Through the use of videophone technology caregivers participated in video-recorded team meetings. The actual communication behaviors of caregivers and team members were analyzed for active participation. Findings revealed that team–prompted caregiver participation was most common, however, team use of supportive talk in this context was considerably less frequent. The study also found that the team’s use of active participation behaviors elicits caregiver active participation behaviors. The results of this study suggest the intervention was an effective way to involve family caregivers as active participants in the designing of care for their loved one. Findings also suggest that hospice staff would benefit from education and training on best practices for communicating with caregivers in the team meeting setting. PMID:20543889

  9. Positive psychology outcome measures for family caregivers of people living with dementia: a systematic review.

    PubMed

    Stansfeld, Jacki; Stoner, Charlotte R; Wenborn, Jennifer; Vernooij-Dassen, Myrra; Moniz-Cook, Esme; Orrell, Martin

    2017-08-01

    Family caregivers of people living with dementia can have both positive and negative experiences of caregiving. Despite this, existing outcome measures predominately focus on negative aspects of caregiving such as burden and depression. This review aimed to evaluate the development and psychometric properties of existing positive psychology measures for family caregivers of people living with dementia to determine their potential utility in research and practice. A systematic review of positive psychology outcome measures for family caregivers of people with dementia was conducted. The databases searched were as follows: PsychINFO, CINAHL, MEDLINE, EMBASE, and PubMed. Scale development papers were subject to a quality assessment to appraise psychometric properties. Twelve positive outcome measures and six validation papers of these scales were identified. The emerging constructs of self-efficacy, spirituality, resilience, rewards, gain, and meaning are in line with positive psychology theory. There are some robust positive measures in existence for family caregivers of people living with dementia. However, lack of reporting of the psychometric properties hindered the quality assessment of some outcome measures identified in this review. Future research should aim to include positive outcome measures in interventional research to facilitate a greater understanding of the positive aspects of caregiving and how these contribute to well-being.

  10. Fellowship or Further Training for Family Medicine Residents?

    PubMed

    Sairenji, Tomoko; Dai, Mingliang; Eden, Aimee R; Peterson, Lars E; Mainous, Arch G

    2017-09-01

    The breadth of family medicine (FM) generates debate about the length of residency training. One argument used by proponents for lengthening training is that residents feel unprepared for practice. The objectives of our study were to (1) identify the proportion of FM residency graduates intending to pursue fellowship training and those who would have done an additional year of core residency training had it been available, and (2) determine whether an association exists between these two variables. We used data collected by the American Board of Family Medicine (ABFM) as part of resident certification examination application in 2014 and 2015. Data included fellowship intention, and interest in pursuing another year of residency training if it were available. We used descriptive and bivariate statistics. The questionnaire was completed by 6,235 residents, of which 17.0% (n=1,063) intended to enroll in a fellowship. Overall 54.2% of residents were "not at all likely" to extend residency training, with 19.9% "extremely/moderately likely". Forty-six percent of those intending a fellowship were "not at all likely" to extend training and only 29% of those "extremely/moderately likely" to extend residency training intended to enroll in a fellowship. We found a disconnect between fellowship intention and desire for another year of residency training. Desire for fellowship may be more about obtaining specific skills and expertise or additional certifications, and less about being prepared for general practice in family medicine.

  11. Value of a regional family practice residency training program site: perceptions of residents, nurses, and physicians.

    PubMed

    Fletcher, Sarah; Mullett, Jennifer; Beerman, Steve

    2014-09-01

    To examine the perceptions of residents, nurses, and physicians about the effect of a regional family practice residency site on the delivery of health services in the community, as well as on the community health care providers. Interviews and focus groups were conducted. Nanaimo, BC. A total of 16 residents, 15 nurses, and 20 physicians involved with the family practice residency training program at the Nanaimo site. A series of semistructured interviews and focus groups was conducted. Transcripts of interviews and focus groups were analyzed thematically by the research team. Overall, participants agreed that having a family practice residency training site in the community contributed to community life and to the delivery of health services in the following ways: increased community capacity and social capital; motivated positive relationships and attitudes in the hospital and community settings; improved communication and teamwork, as well as accessibility and understanding of the health care system; increased the standard of care; and facilitated the recruitment and retention of family physicians. This family practice residency training site was beneficial for the community it served. Future planning for distributed medical education sites should take into account the effects of these sites on the health care community and ensure that they continue to be positive influences. Further research in this area could focus on patients' perceptions of how residency programs affect their care, as well as on the effect of residency programs on wait times and workload for physicians and nurses. Copyright© the College of Family Physicians of Canada.

  12. Putting theory to the test: Examining family context, caregiver motivation, and conflict in the Family Check-Up model

    PubMed Central

    Fosco, Gregory M.; Van Ryzin, Mark; Stormshak, Elizabeth A.; Dishion, Thomas J.

    2014-01-01

    This study examined contextual factors (caregiver depression, family resources, ethnicity, and initial levels of youth problem behavior) related to the effectiveness of the Family Check-Up (FCU) and evaluated family processes as a mediator of FCU intervention response and adolescent antisocial behavior. We followed a sample of 180 ethnically diverse youths of families who engaged in the FCU intervention. Family data were collected as part of the FCU assessment, and youth data were collected over 4 years, from sixth through ninth grade. Findings indicated that caregiver depression and minority status predicted greater caregiver motivation to change. In turn, caregiver motivation was the only direct predictor of FCU intervention response during a 1-year period. Growth in family conflict from sixth through eighth grade mediated the link between FCU response and ninth-grade antisocial behavior. This study explicitly tested core aspects of the FCU intervention model and demonstrated that caregiver motivation is a central factor that underlies family response to the FCU. The study also provided support for continued examination of family process mechanisms that account for enduring effects of the FCU and other family-centered interventions. PMID:24438894

  13. Putting theory to the test: examining family context, caregiver motivation, and conflict in the Family Check-Up model.

    PubMed

    Fosco, Gregory M; Van Ryzin, Mark; Stormshak, Elizabeth A; Dishion, Thomas J

    2014-05-01

    This study examined contextual factors (caregiver depression, family resources, ethnicity, and initial levels of youth problem behavior) related to the effectiveness of the Family Check-Up (FCU) and evaluated family processes as a mediator of FCU intervention response and adolescent antisocial behavior. We followed a sample of 180 ethnically diverse youths of families who engaged in the FCU intervention. Family data were collected as part of the FCU assessment, and youth data were collected over 4 years, from sixth through ninth grade. Findings indicated that caregiver depression and minority status predicted greater caregiver motivation to change. In turn, caregiver motivation was the only direct predictor of FCU intervention response during a 1-year period. Growth in family conflict from sixth through eighth grade mediated the link between FCU response and ninth-grade antisocial behavior. This study explicitly tested core aspects of the FCU intervention model and demonstrated that caregiver motivation is a central factor that underlies family response to the FCU. The study also provided support for continued examination of family process mechanisms that account for enduring effects of the FCU and other family-centered interventions.

  14. Health Related Quality of Life in Family Caregivers of Patients Suffering from Mental Disorders

    PubMed Central

    Noghani, Fatemeh; Seyedfatemi, Naiemeh; Akbarzadeh, Arash; Hasanpour-Dehkordi, Ali

    2016-01-01

    Introduction In the light of the advances in treatment measures and early discharge of patients with mental disorders from psychiatric hospitals, families play important role in caring for such patients. Aim The aim of this study is to determine the Quality of Life (QoL) of the family caregivers of patients with mental disorders. Materials and Methods This cross-sectional study was conducted in teaching health care centers affiliated with medical universities in Tehran, Iran. Sampling was conducted by convenience random technique. Participants were 238 family caregivers of mental disorder patients and the Short-Form Health Survey Questionnaire was used to gather data. The data were analyzed by Spearman’s correlation, t-test and ANOVA in SPSS 18.0. Results The women’s mean QoL was lower than the men’s. Regarding family relationship with the patients, the lowest QoL was observed among the mothers. There was a significant relationship between the caregivers QoL and economic status, the caregivers gender, family relationship with the patients and the patients’ gender (p<0.05). Conclusion The caregivers of mental disorder patients have lower QoL compared with general population. Appropriately developed plans should be implemented to improve QoL among the family caregivers of these patients. PMID:28050483

  15. Effects of Family Treatment on Parenting Beliefs Among Caregivers of Youth with Poorly Controlled Asthma

    PubMed Central

    Ellis, Deborah A.; King, Pamela; Naar-King, Sylvie; Lam, Phebe; Cunningham, Phillippe B.; Secord, Elizabeth

    2014-01-01

    Objective Caregiver involvement is critical to ensuring optimal adolescent asthma management. The study investigated whether Multisystemic Therapy (MST), an intensive, home-based family therapy, was superior to family support for changing beliefs regarding asthma-related positive parenting among caregivers of African-American youth with poorly controlled asthma. The relationship between parenting beliefs and asthma management at the conclusion of the intervention was also assessed. Methods A randomized controlled trial was conducted with 167 adolescents with moderate to severe persistent, poorly controlled asthma and their primary caregivers. Families were randomly assigned to MST or FS, a home-based family support condition. Data were collected at baseline and seven month post-test. Changes in caregiver ratings of importance and confidence for engaging in asthma-related positive parenting were assessed via questionnaire. Illness management was assessed by the Family Asthma Management System Scale (FAMSS). Results Participation in MST was associated with more change in caregiver beliefs as compared to FS for both importance (t =2.39, p=.02) and confidence (t =2.04, p=.04). Caregiver beliefs were also significantly related to youth controller medication adherence at the conclusion of treatment (importance: r=.21, p=.01; confidence: r=.23, p=.004). Conclusion Results support the effectiveness of MST for increasing parental beliefs in the value of asthma-related positive parenting behaviors and parental self-efficacy for these behaviors among families of minority adolescents with poorly controlled asthma. PMID:25186121

  16. Exploring the connections between traumatic brain injury caregiver mental health and family dynamics in Mexico City, Mexico.

    PubMed

    Perrin, Paul B; Stevens, Lillian F; Sutter, Megan; Hubbard, Rebecca; Díaz Sosa, Dulce María; Espinosa Jove, Irma Guadalupe; Arango-Lasprilla, Juan Carlos

    2013-10-01

    To examine the patterns of family dynamics that are most associated with the mental health of traumatic brain injury (TBI) caregivers from Mexico. It was hypothesized that healthier family dynamics would be associated with better caregiver mental health. A cross-sectional study of self-reported data collected from TBI caregivers through the Mexican National Institute of Rehabilitation in Mexico City, Mexico, the premier public medical facility in Mexico that provides rehabilitation services to patients with various disabilities. One public outpatient medical and rehabilitation facility. Sixty-eight caregivers of individuals with moderate-to-severe TBI from Mexico City, Mexico, were related to an individual with TBI who was ≥3 months after injury, a primary caregiver for ≥3 months, familiar with the patient's history, and without neurologic or psychiatric conditions. The average (standard deviation) age of caregivers was 50.94 ± 12.85 years), and 82% were women. The caregivers completed Spanish versions of instruments that assessed their own mental health and family dynamics. Outcomes assessed included family dynamics (Family Adaptability and Cohesion Evaluation Scale-Fourth Edition; Family Communication Scale; Family Satisfaction Scale; Family Assessment Device-General Functioning; and Relationship-Focused Coping Scale), and caregiver mental health (Patient Health Questionnaire-9, Zarit Burden Interview, and Satisfaction with Life Scale). Results of canonical correlation analyses suggested that caregiver mental health and family dynamics were positively related, with a large effect size. Caregivers with high family satisfaction and cohesion tended to have a low burden and high satisfaction with life. In addition, caregiver depression and burden were positively related to each other and were both inversely related to caregiver satisfaction with life. TBI caregiver interventions in Latino populations would likely benefit from including programming or

  17. Psychosocial correlates of nutritional status of family caregivers of persons with dementia.

    PubMed

    Rullier, Laetitia; Lagarde, Alexia; Bouisson, Jean; Bergua, Valérie; Torres, Marion; Barberger-Gateau, Pascale

    2014-01-01

    This exploratory study investigated the associations of individual characteristics of both persons with dementia and family caregivers with the nutritional status of caregivers. This cross-sectional study was conducted at home by psychogerontologist within the frame of a community gerontological center in rural areas of south west France. The study participants comprised 56 community-dwelling persons with dementia (mean 80.7 years, SD 6.5) and 56 family caregivers (mean 70.9 years, SD 11.0). Persons with dementia were assessed with Mini-Mental State Examination (MMSE), Basic Activities Of Daily Living (ADL), Instrumental ADL (IADL), and NeuroPsychiatric Inventory (NPI), and family caregivers with the Burden Interview (Zarit scale), the State-Trait Anxiety Inventory (STAI Y-B), the Center for Epidemiologic Studies Depression Scale (CES-D), the emotional impact measure of NPI and the Autonomy, Gerontology and Group Resources scale (AGGIR scale). For both, nutritional status was evaluated using the Mini Nutritional Assessment (MNA®). Among family caregivers, 32.1% were at risk of malnutrition and 5.4% were malnourished, and among people with dementia, 58.9% and 23.2%, respectively. NPI severity score of apathy of persons with dementia (Beta = -0.342, p = 0.001), dependency on AGGIR scale (Beta = -0.336, p = 0.002), and CES-D score of caregivers (Beta = -0.365, p = 0.001) were associated with caregivers' MNA score (Adjusted R 2 = 0.480, p < 0.001). These preliminary findings emphasize the need for routine assessment of depressive symptoms, functional and nutritional status in dementia family caregivers, and confirm the value of investigating caregivers' nutritional risk through an integrative view including psychosocial approach.

  18. The relationship between socio-demographic characteristics, family environment, and caregiver coping in families of children with cancer.

    PubMed

    Gage-Bouchard, Elizabeth A; Devine, Katie A; Heckler, Charles E

    2013-12-01

    The factors that influence caregiver coping mechanism preferences after a child's diagnosis with cancer are not fully understood. This study examines the relationship between caregivers' socio-demographic characteristics and the coping strategies they use to adapt to childhood cancer. Sixty caregivers of pediatric cancer patients completed a socio-demographic questionnaire, the Family Environment Scale, and the COPE inventory. There were no significant differences in family environment by income or education. Caregiver educational attainment was positively associated with use of planning and active coping styles, while income was not associated with caregiver coping style. Mothers were more likely than fathers to use active coping, instrumental support, religious coping, and emotional support. Men with lower education engaged in greater substance use coping and lower planning. The findings show that educational attainment and caregiver gender influence caregiver coping styles following a pediatric cancer diagnosis and suggest that educational attainment rather than financial resources drive the association between SES and coping. Programs that address educational gaps and teach caregivers planning and active coping skills may be beneficial for parents with lower educational attainment, particularly men.

  19. Understanding the concept of a "good death" among bereaved family caregivers of cancer patients in Singapore.

    PubMed

    Lee, Geok Ling; Woo, Ivan Mun Hong; Goh, Cynthia

    2013-02-01

    The aim of this study was to examine the concept of a good death from the perspectives of both the dying person and the family caregiver, as perceived by bereaved family caregivers of advanced cancer patients. The data were gathered from five focus group discussions and one face-to-face qualitative interview conducted over 8 months among 18 bereaved family caregivers recruited from a local hospice. The transcripts of the focus groups and the interview were entered into NVivo Version 8 and were analyzed using the thematic approach. A good death may be understood as having the biopsychosocial and spiritual aspects of life handled well at the end of life. Five major themes were identified. These were preparation for death, family and social relationships, moments at or near death, comfort and physical care, and spiritual well-being. Differences were also noted in what is important at the end of life between the patients and caregivers. Having a quick death with little suffering was perceived to be good by the patient, but the family caregiver wanted to be able to say a final goodbye to the patient. Patients tend to prefer not to die in their children's presence but the children wished to be present for the final moment. In addition, family caregivers reported it was important for them to be able to give the patients permission to die, to feel recognized for the efforts made, and to have had a fulfilling caregiving experience. Whereas there are global attributes of a good death, our findings suggest that patients and family caregivers may define a good death differently. Therefore, there is a need to respect, address, and reconcile the differences, so that all parties may have a good experience at the end of a person's life.

  20. Evaluating life in foster homes for persons with serious mental illness: Resident and caregiver perspectives

    PubMed Central

    PIAT, MYRA; RICARD, NICOLE; LESAGE, ALAIN

    2016-01-01

    Background In Montreal Canada, the majority of persons with serious mental illness discharged from psychiatric hospitals were placed into foster homes. Very little updated information exists on life in foster homes, and the level of autonomy allowed in this residential setting. Aims The purpose of the study was to elicit the foster home residents’ opinions about their lives in this setting and their caregiver’s perception of the level of autonomy allowed. Method Two questionnaires were administered to 102 foster home residents and their caregivers: (1) Patient Attitude Questionnaire and (2) Hospital and Hostel Practices Profile Survey. Results Consumers are satisfied living in this type of milieu and do not desire to change their housing. The foster home provides residents with a sense of security and well being. Foster homes rank second in terms of autonomy when compared to hospitals and hostels. Only supported apartments rank higher. Conclusion These findings shed a new light on this type of residential milieu. Over time the structure of foster homes has evolved. This study points to the need to value the opinions of consumers and not force people to move onto other types of housing. PMID:27182124

  1. Sleep characteristics of family caregivers of individuals with a primary malignant brain tumor.

    PubMed

    Pawl, Jean D; Lee, Shih-Yu; Clark, Patricia C; Sherwood, Paula R

    2013-03-01

    To describe the sleep characteristics of family caregivers of individuals with a primary malignant brain tumor (PMBT). Cross-sectional, correlational design using baseline data from a longitudinal study. Neuro-oncology and neurosurgery clinics at an urban tertiary medical center in the United States. 133 family caregivers recruited one to two months following diagnosis of family member's PMBT. Subjective and objective measures of sleep were obtained via self-report and the use of accelerometers (three nights). Sleep characteristics including sleep latency, total sleep time, wake after sleep onset, number of naps, number of arousals, sleep-wake cycle, and sleep quality. Sleep latency in caregivers was, on average, 35 minutes (SD = 34.5)-more than twice as long as the norm of 15 minutes (t[113]) = 6.18, p < 0.01). Caregivers averaged a total sleep time of 5 hours and 57 minutes (SD = 84.6), significantly less than the recommended 7 hours (t[113] = -8, p < 0.01), and were awake in the night 15% of the time, significantly more than the norm of 10% (t[111] = 5.84, p < 0.01). Caregivers aroused an average of 8.3 times during nocturnal sleep (SD = 3.5, range = 2-21), with about 32% reporting poor or very poor sleep quality. Caregivers experienced sleep impairments that placed them at risk for poor mental and physical health, and may compromise their ability to continue in the caregiving role. Nurses need to assess sleep in caregivers of individuals with PMBT and implement interventions to improve sleep. Sleep deprivation is common in family caregivers during the early stages of care for individuals with a PMBT. A single-item sleep quality question could be an easy but valuable tool in assessing sleep disturbances in family caregivers of individuals with a PMBT. The health trajectory of family caregivers warrants further longitudinal study, in addition to the examination of the bidirectional relationship of health status of care recipients and their family caregiver.

  2. Hearing Their Voice: A Systematic Review of Dementia Family Caregivers' Needs.

    PubMed

    McCabe, Marita; You, Emily; Tatangelo, Gemma

    2016-10-01

    The number of Australians living with dementia is expected to increase from currently 332,000 to 900,000 by 2050. Around 200,000 unpaid caregivers are caring for community-dwelling people living with dementia, and therefore, supporting the caregivers' needs is of paramount importance. The aim of this systematic review was to understand the perceived needs of immediate family caregivers of community-dwelling older adults with dementia. We examined qualitative studies that reported on the self-perceived needs of partner and/or offspring caregivers who were caring for community-dwelling older adults with dementia. Two themes were developed from 12 studies: caregiver needs related to the management of older people with dementia and caregivers' personal needs. The first theme further included four subthemes: information and knowledge needs; activities of daily living, instrumental activities of daily living and Behavioural and Psychological Symptoms of Dementia support needs; formal care support needs; and informal care support needs. The second theme consisted of two subthemes: the need to address caregivers' physical and psychological health and the need to manage caregivers' own lives. The findings have important implications for the development of interventions that comprehensively address caregivers' individual needs. Caregivers' unmet needs highlight key areas for improvement in policy and service provision. The findings demonstrate the need for more rigorous qualitative studies exploring the perceived needs of partner and offspring caregivers respectively. Furthermore, examining the underlying relationships between different caregiver needs is warranted. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Caring stress, suicidal attitude and suicide care ability among family caregivers of suicidal individuals: a path analysis.

    PubMed

    Chiang, C-Y; Lu, C-Y; Lin, Y-H; Lin, H-Y; Sun, F-K

    2015-12-01

    What is known on the subject? Suicide is a global mental health issue. Taking care of suicidal individuals is a substantial challenge. Most studies emphasize the suicidal individual. Few studies have emphasized the family caregivers of suicidal individuals. No study has explored the relationship between family caregivers' caring stress with suicidal attitudes and suicide care ability. What this paper adds to existing knowledge? The main results indicated that the older family caregivers tended to have a more negative attitude towards suicidal individuals. Female family caregivers' stress was higher than that of male family caregivers. A mild level of caring stress would help family caregivers have a more positive attitude towards suicidal individuals. Furthermore, a positive attitude would help family caregivers improve their caring ability. What are the implications for practice? Mental health nurses could help family caregivers, especially female family caregivers, reduce their holistic caring burden by looking for support resources and enhancing their coping strategies. Mental health nurses could help family caregivers promote positive attitudes towards suicidal relatives by understanding suicidal individuals' suffering. Suicide is a global mental health issue. Family caregivers play a key role in preventing suicide attempts. The aim of this study was to examine the relationship among stress due to the family caregiver's role, suicidal attitude of the family caregiver and suicide care ability among family caregivers. Additionally, instruments of caring stress, attitudes towards suicidal relatives and caring abilities used in the study were tested to measure construct validity. A cross-sectional correlational study was conducted with 164 family caregivers of people who are suicidal. The following three questionnaires were used: the Caring Stress Scale, the Suicidal Attitudes Scale and the Suicidal Caring Ability Scale. Structural equation modelling was performed

  4. Linking family cohesion and flexibility with expressed emotion, family burden and psychological distress in caregivers of patients with psychosis: A path analytic model.

    PubMed

    Koutra, Katerina; Simos, Panagiotis; Triliva, Sofia; Lionis, Christos; Vgontzas, Alexandros N

    2016-06-30

    The present study aimed to evaluate a path analytic model accounting for caregivers' psychological distress that takes into account perceived family cohesion and flexibility, expressed emotion and caregiver's burden associated with the presence of mental illness in the family. 50 first-episode and 50 chronic patients diagnosed with schizophrenia or bipolar disorder (most recent episode manic severe with psychotic features) recruited from the Inpatient Psychiatric Unit of the University Hospital of Heraklion, Crete, Greece, and their family caregivers participated in the study. Family functioning was assessed in terms of cohesion and flexibility (FACES-IV), expressed emotion (FQ), family burden (FBS) and caregivers' psychological distress (GHQ-28). Structural equation modelling was used to evaluate the direct and indirect effects of family dynamics on caregivers' psychological distress. The results showed that neither family cohesion nor family flexibility exerted significant direct effects on caregivers' psychological distress. Instead, the effect of flexibility was mediated by caregivers' criticism and family burden indicating an indirect effect on caregivers' psychological distress. These results apply equally to caregivers of first episode and chronic patients. Family interventions aiming to improve dysfunctional family interactions by promoting awareness of family dynamics could reduce the burden and improve the emotional well-being of family caregivers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Differences in the Experience of Caregiver Strain between Families Caring for Youth with Substance Use Disorders and Families of Youth with Mental Health Problems

    ERIC Educational Resources Information Center

    Heflinger, Craig Anne; Brannan, Ana Maria

    2006-01-01

    This study examined caregiver strain (i.e., burden of care, caregiver burden) among families of adolescents in treatment for substance abuse disorders compared to youth with mental health problems. We used descriptive and regression analyses to compare groups and to examine the youth and family variables associated with caregiver strain across the…

  6. Reintegration of Women Post Obstetric Fistula Repair: Experience of Family Caregivers.

    PubMed

    Jarvis, Kimberly; Richter, Solina; Vallianatos, Helen; Thornton, Lois

    2017-01-01

    In northern Ghana, families traditionally function as the main provider of care. The role of family, however, is becoming increasingly challenged with the social shifts in Ghanaian culture moving from extended kinship to nuclear households. This has implications for the care of women post obstetric fistula (OF) repair and their family members who assist them to integrate back into their lives prior to developing the condition. This research is part of a larger critical ethnographic study which explores a culture of reintegration. For this article, we draw attention to the findings related to the experience of family caregivers who care for women post OF repair in northern Ghana. It is suggested that although family caregivers are pleased to have their family member return home, there are many unanticipated physical, emotional, and economic challenges. Findings lead to recommendations for enhancing the reintegration process and the need for adequate caregiving support.

  7. Reintegration of Women Post Obstetric Fistula Repair: Experience of Family Caregivers

    PubMed Central

    Jarvis, Kimberly; Richter, Solina; Vallianatos, Helen; Thornton, Lois

    2017-01-01

    In northern Ghana, families traditionally function as the main provider of care. The role of family, however, is becoming increasingly challenged with the social shifts in Ghanaian culture moving from extended kinship to nuclear households. This has implications for the care of women post obstetric fistula (OF) repair and their family members who assist them to integrate back into their lives prior to developing the condition. This research is part of a larger critical ethnographic study which explores a culture of reintegration. For this article, we draw attention to the findings related to the experience of family caregivers who care for women post OF repair in northern Ghana. It is suggested that although family caregivers are pleased to have their family member return home, there are many unanticipated physical, emotional, and economic challenges. Findings lead to recommendations for enhancing the reintegration process and the need for adequate caregiving support. PMID:28835910

  8. Family-to-work spillover and appraisals of caregiving by employed women caring for their elderly parents in Japan

    PubMed Central

    SAKKA, Mariko; SATO, Iori; IKEDA, Mari; HASHIZUME, Hirofumi; UEMORI, Masayo; KAMIBEPPU, Kiyoko

    2016-01-01

    We examined the differences in family-to-work spillover between employed women who did and did not have caregiving responsibilities for elderly parents and the relationship between family-to-work spillover and negative and positive appraisals of caregiving using moderation analysis. A cross-sectional survey was conducted with middle-aged employed women (age ≥40 years) from four large companies. Negative and positive family-to-work spillover (FWNS and FWPS, respectively) and negative and positive appraisals of caregiving were measured. Data from 386 non-caregivers and 82 caregivers were analyzed using Fisher’s exact tests, Welch’s t-tests, and hierarchical multiple regression. Results showed that FWNS was higher in caregivers than in non-caregivers, while there was no significant difference in FWPS. Caregiver “fulfillment from the caregiving role” (a subscale of positive appraisal) buffered the effects of caregiver “feelings of social restriction” (a subscale of negative appraisal) on FWNS. On the other hand, caregiver “commitment to caregiving tasks” (another positive subscale) intensified the effects of “feelings of social restriction” on FWNS. However, there was no relationship between negative and positive appraisals of caregiving and FWPS. These findings suggest that both negative and positive appraisals of caregiving are important contributors to FWNS among employed women caring for their parents. PMID:26829970

  9. The Thoughts Questionnaire (TQ) for family caregivers of people with dementia.

    PubMed

    Sullivan, Karen A; Beattie, Elizabeth; Khawaja, Nigar G; Wilz, Gabriele; Cunningham, Lauren

    2016-11-01

    To develop a new measure of dysfunctional thoughts for family caregivers of people living with dementia. These thoughts can contribute to negative outcomes, but they may be modifiable. A stepwise process was used to develop the Thoughts Questionnaire, commencing with item generation, concept mapping, and pilot testing in a sample of professional and nonprofessional caregivers of people with dementia (n = 18). Next, an independent sample of 35 family caregivers of people with dementia (30 female; Mage = 64.30, standard deviation = 10.65) completed: (a) the Thoughts Questionnaire; (b) an existing measure of dysfunctional thoughts, the Dementia Thoughts Caregivers Questionnaire; and (c) separate validated measures of depressive symptoms, caregiver stress, and coping, respectively. The level of agreement with dysfunctional thought statements from the Dementia Thoughts Caregivers Questionnaire and Thoughts Questionnaire was low. However, a small number of Thoughts Questionnaire statements were strongly endorsed by over 85% of the sample. Both dysfunctional thought measures had adequate reliability, but total scores were not significantly intercorrelated (r = .287, p = .095). Only the Thoughts Questionnaire was significantly, positively correlated with most caregiver stress measures. Thoughts Questionnaire items required a much lower reading level than the Dementia Thoughts Caregivers Questionnaire items. This study provides preliminary data on a tool for assessing the negative role-related thoughts that family caregivers of people with dementia may experience. Given that these thoughts are implicated in depression but they may be modified, the capacity to identify dysfunctional thoughts may prove useful in caregiver support programs. © The Author(s) 2014.

  10. Multiple Family Groups for Child Behavior Difficulties: Retention Among Child Welfare-Involved Caregivers

    ERIC Educational Resources Information Center

    Gopalan, Geetha; Fuss, Ashley; Wisdom, Jennifer P.

    2015-01-01

    Purpose: The Multiple Family Group (MFG) service delivery model to reduce childhood disruptive behavior disorders has shown promise in engaging child welfare-involved families. This qualitative study examines caregivers' perceptions of factors that influence retention in MFGs among child welfare-involved families. Methods: Twenty-five…

  11. Multiple Family Groups for Child Behavior Difficulties: Retention Among Child Welfare-Involved Caregivers

    ERIC Educational Resources Information Center

    Gopalan, Geetha; Fuss, Ashley; Wisdom, Jennifer P.

    2015-01-01

    Purpose: The Multiple Family Group (MFG) service delivery model to reduce childhood disruptive behavior disorders has shown promise in engaging child welfare-involved families. This qualitative study examines caregivers' perceptions of factors that influence retention in MFGs among child welfare-involved families. Methods: Twenty-five…

  12. Caregiver Positive and Negative Appraisals: Effects of the National Alliance on Mental Illness Family-to-Family Intervention

    PubMed Central

    Toohey, Michael J.; Muralidharan, Anjana; Medoff, Deborah; Lucksted, Alicia; Dixon, Lisa

    2015-01-01

    The 3-month long Family-to-Family intervention (FTF) has been shown to increase empowerment, knowledge, and coping, and to reduce distress among caregivers of people with serious mental illness. We sought to determine the influence of FTF on caregivers’ appraisal of their caregiving experience. Family members of individuals with mental illness who sought enrollment in FTF (N=318) were randomly assigned to FTF or a waitlist condition. Positive and negative appraisals were measured using the Experiences of Caregiving Inventory (ECI) at baseline and 3 months later; 259 participants completed both assessments. Regression analyses found significant increases in positive appraisal but no significant decreases in negative appraisals for those in the FTF condition. In the context of overall benefits from taking FTF, these relationships reflect the FTF curriculum’s emphasis on positive coping (e.g., strength and empowerment) and the potential value of strategies that help caregivers increase positive appraisal. PMID:26825266

  13. Health-related quality of life profiles among family caregivers of patients with schizophrenia.

    PubMed

    Lua, Pei Lin; Bakar, Zanariah Abu

    2011-01-01

    This cross-sectional study aims to determine and compare health-related quality of life profiles of schizophrenia family caregivers on the basis of their sociodemographic characteristics. Thirty outpatient family caregivers completed the generic 36-Item Short Form Health Survey instrument (male = 53.5%; mean age = 51 years; married = 76.7%). The highest mean score was reported for social functioning while role limitation-emotional was rated the worst. Significantly better health-related quality of life profiles were demonstrated by caregivers who were male, younger than 50 years, adequately educated, employed, and without health problems and were receiving monthly income. Understanding of on health-related quality of life matters for family caregivers is crucial to improve the quality of care for schizophrenia patients.

  14. Canada's Compassionate Care Benefit: views of family caregivers in chronic illness.

    PubMed

    Williams, Allison; Crooks, Valorie A; Stajduhar, Kelli I; Allan, Diane; Cohen, S Robin

    2006-09-01

    Based on a pilot evaluation of Canada's recently introduced Compassionate Care Benefit (CCB), the purpose of this paper is to highlight the experiences of family caregivers caring for people with non-malignant advanced chronic illness. Using Patton's (1997) utilization-focused evaluation approach, 25 telephone interviews were conducted with three groups of family caregivers: those who had successfully applied for the CCB; those who were unsuccessful in their applications; those who had never applied for the benefit. The CCB has a number of limitations, particularly for caregivers of patients diagnosed with non-malignant advanced chronic illness. The central limitations are: difficulties associated with accurate prognostication; limited definition of "family member"; insufficient length of the funding period. By modelling similar programmes internationally, such as those in Sweden, Norway, and the Netherlands, Canada would likely find the CCB to have greater relevance and accessibility to Canadian caregivers, particularly those caring for people with non-malignant advanced chronic illness.

  15. Attitude Survey of Military Family Housing Residents, Hawaii 1987.

    DTIC Science & Technology

    1987-09-01

    service member. I. Male 2. Female 6. Marital status. 1. Married 2. Separated , divorced or widowed 3. Single, never married 7. Is spouse living with...C) Attitude Suvyof Military Family HousingUP Residents, OlIG- Ha ai18 . ...... .. . .. . -’le 88I C DEPARTMENT OF THE NAVY NAVY P9RSONN r L RESrARC14...ATTITUDE SURVEY OF MILITARY FAMILY HOUSING RESIDENTS, HAWAII, 1937 Enc: (1) NPRDC TN 87-48 I. This survey of residents of military family housing in

  16. Value of a regional family practice residency training program site

    PubMed Central

    Fletcher, Sarah; Mullett, Jennifer; Beerman, Steve

    2014-01-01

    Abstract Objective To examine the perceptions of residents, nurses, and physicians about the effect of a regional family practice residency site on the delivery of health services in the community, as well as on the community health care providers. Design Interviews and focus groups were conducted. Setting Nanaimo, BC. Participants A total of 16 residents, 15 nurses, and 20 physicians involved with the family practice residency training program at the Nanaimo site. Methods A series of semistructured interviews and focus groups was conducted. Transcripts of interviews and focus groups were analyzed thematically by the research team. Main findings Overall, participants agreed that having a family practice residency training site in the community contributed to community life and to the delivery of health services in the following ways: increased community capacity and social capital; motivated positive relationships and attitudes in the hospital and community settings; improved communication and teamwork, as well as accessibility and understanding of the health care system; increased the standard of care; and facilitated the recruitment and retention of family physicians. Conclusion This family practice residency training site was beneficial for the community it served. Future planning for distributed medical education sites should take into account the effects of these sites on the health care community and ensure that they continue to be positive influences. Further research in this area could focus on patients’ perceptions of how residency programs affect their care, as well as on the effect of residency programs on wait times and workload for physicians and nurses. PMID:25217693

  17. Understanding the needs of family caregivers of older adults dying with dementia.

    PubMed

    Thompson, Genevieve N; Roger, Kerstin

    2014-06-01

    A challenge in understanding the needs of dementia family caregivers (DFC) within the purview of dementia as a terminal illness rests on the fact that literature in this area is dispersed across disciplines and not specifically grounded within the realm of palliative care. The objective of this paper is to describe the domains of DFC needs and their impact on the delivery of palliative care services. A literature search pertaining to dementia family caregivers and palliative/end-of-life care was conducted using the databases Medline, CINHAL, Ageline, PsychInfo, and Scopus for articles published in the English language between 1997 and 2011. Supporting family caregivers of individuals with dementia throughout the disease trajectory requires consideration of caregivers : (1) physical, emotional, and psychological needs; (2) information and decisional support needs; and (3) instrumental support needs. The unique nature and prolonged duration of these needs directly influences the palliative care services and supports required by these family caregivers. Understanding the scope of DFC needs help further our understanding of how these needs may impact the delivery of palliative care services, and assists in developing a model of care for those dying from dementia and for their family caregivers.

  18. Nurses as family caregivers - barriers and enablers facing nurses caring for children, parents or both.

    PubMed

    Clendon, Jill; Walker, Léonie

    2017-03-01

    To examine the dual caregiving and nursing responsibilities of nurses in New Zealand with a view to identifying potential strategies, policies and employment practices that may help to retain nurses with caregiving responsibilities in the workplace. As the nursing workforce ages, child-bearing is delayed and older family members are living longer, family caregiving responsibilities are impacting more on the working life of nurses. This may complicate accurate workforce planning assumptions. An explorative, descriptive design using interviews and focus groups with 28 registered nurses with family caregiving responsibilities. A depth of (largely hidden) experience was exposed revealing considerable guilt, physical, emotional and financial hardship. Regardless of whether the nurse chose to work or had to for financial reasons, family always came first. Demographic and societal changes related to caregiving may have profound implications for nursing. Workplace support is essential to ensure that nurses are able to continue to work. Increased awareness, support, flexibility and specific planning are required to retain nurses with family caregiving responsibilities. © 2016 John Wiley & Sons Ltd.

  19. Hospitalist involvement in family medicine residency training: A CERA study.

    PubMed

    Baldor, Robert; Savageau, Judith A; Shokar, Navkiran; Potts, Stacy; Gravel, Joseph; Eisenstock, Kimberly; Ledwith, James

    2014-02-01

    Little is known about the impact of hospitalists on family medicine residencies. We surveyed family medicine residency directors to assess attitudes about hospitalists and their involvement in residency teaching. Questions were included in the 2012 Council of Academic Family Medicine Educational Research Alliance (CERA) survey of family medicine residency directors. Univariate statistics were used to describe programs, directors, and our questions on the use of hospitalists. Bivariate statistics were used to examine relationships between the use of hospitalists to teach and program characteristics. Forty-one percent (n=175) of residency directors completed the hospitalist section of the CERA survey. Sixty-six percent of residency programs were community based/university affiliated. The majority of directors who have, or are planning to develop, a hospitalist service currently use an internal medicine service (92.5%), followed by family medicine (39.1%), pediatrics (35.4%), OB/laborists (18.0%), and combined services (8.7%). The majority of programs with a hospitalist training track (or plans to develop one) indicated that this was for a family medicine service. Sixty percent of programs that have a hospitalist service involve hospitalists in teaching. Twenty percent of directors reported that hospitalists serve as family medicine faculty, and 63% viewed them as "good educators." However, 85% reported no reduction in inpatient teaching by family medicine faculty despite using hospitalist teaching services. Hospitalists have a significant educational role in family medicine resident training. Further research is needed to explore how hospitalists and family medicine faculty can collaborate to promote enhanced efficiency and effectiveness as residency teachers.

  20. Spousal role and caregiver burden in HIV affected families in Anhui Province, China.

    PubMed

    Hsieh, Julie; Li, Li; Lin, Chunqing; Luo, Sitong; Ji, Guoping

    2017-03-09

    This study examined the burden experienced by various roles of family caregivers of people living with HIV (PLH), in particular spouses vs. non-spouses. A total of 475 family members of PLH were recruited from Anhui Province, China. Participants responded to a survey using the Computer Assisted Personal Interview method. The assessment collected data on demographic characteristics and their perceived caregiver burden, which was compared between spouses and non-spouses. Multiple regression models were built to identify factors associated with caregiver burden. About 64.4% of our study participants were female and the mean age was 42.1 years. Among various relationships to PLH, almost half reported being a spouse. Spouses reported significantly higher caregiver burden than non-spouses. In addition, older age and lower family income were significantly associated with higher level of caregiver burden. Among the subsample of spouses, significantly higher level of caregiver burden was identified among wives. Future studies should give special consideration to address the needs of female spouses in order to reduce their caregiver burden.

  1. Supporting the dementia family caregiver: the effect of home care intervention on general well-being.

    PubMed

    Schoenmakers, Birgitte; Buntinx, Frank; DeLepeleire, Jan

    2010-01-01

    Although high volumes of literature have been written on interventions in dementia home care, only a poor efficiency has been proved. Nevertheless, caregivers often express strong feelings of satisfaction about the proposed support. In this meta-analytic review, a quantitative analysis of the effect of the different types of professional dementia home care interventions was made. A systematic literature search, covering the years 1980 until 2007, was performed using Medline, Embase, Cochrane DSR, Dare, CCTR, and ACP Journal Club). Limitations on publication type were determined as randomized controlled trial and controlled trial. Psychosocial intervention in dementia home care was found to be beneficial in a non-significant way on caregivers' burden. An almost negligible decrease in depression was found in the psychosocial intervention arm while multidisciplinary case management contributed to a larger though insignificant decrease of depression in caregivers. Respite care was responsible for an increase in burden. This review demonstrated, in accordance with other qualitative reviews, the weak evidence that supporting family caregivers could be beneficial. Although the rather small benefits of formal support, supporting family caregivers is an indispensable issue in dementia home care. Professional caregivers should keep in mind that family caregivers highly appreciate the intervention and that they feel less burdened or depressed in the short time follow up but that premature home care remains more rule than exception.

  2. Informational needs and related problems of family caregivers of heart failure patients: A qualitative study

    PubMed Central

    Bahrami, Masoud; Etemadifar, Shahram; Shahriari, Mohsen; Farsani, Alireza Khosravi

    2014-01-01

    Background: Heart failure is incurable disease and patients often have an ongoing decline once diagnosed. The symptoms of heart failure may impair the ability of patient to perform activities of daily living. As heart failure progresses, patients normally increase their reliance on family caregivers. Aims: This paper explored the informational needs and related problems of family caregivers of heart failure patients as a part of the findings of a study exploring experiences of family caregivers in the caregiving situation. Setting and Design: Using a qualitative design, 19 family caregivers from three educational hospitals in Isfahan, Iran, were recruited. Materials and Methods: Participants were selected by purposive sampling. Data were collected through semi-structured interviews. Interviews were transcribed verbatim and analyzed concurrently. Results: Four major themes were emerged from the analysis of the transcripts: “Lack of care-related knowledge”, “Inaccessibility to responsible source of information”, “Lack of guidance from healthcare team” and “caring with ambiguity due to unpredictable nature of the disease”. Caregivers believed that they did not have the basic knowledge related to disease and medication administration. They received little guidance and support from the health care team on the caregiving roles. They experienced high level of ambiguity and stress in caregiving tasks due to lack of care-related knowledge and unpredictable nature of disease. Conclusion: The care, which was performed by the caregivers of HF patients, is beyond of their knowledge, capabilities, and resources. Nurses and other healthcare providers can use the findings of this study to develop effective educational and supportive programs to facilitate these needs. PMID:25540786

  3. Training family medicine residents to care for children

    PubMed Central

    Duke, Pauline; Curran, Vernon; Hollett, Ann

    2011-01-01

    Abstract Problem addressed There is a lack of consensus around the optimal way to train family medicine residents to care for children. Objective of program Evaluation of an ambulatory versus an inpatient pediatrics rotation for family medicine residents. Program description A 4-week pediatrics rotation for second-year family medicine residents was introduced involving half-day ambulatory pediatric clinics. A nonequivalent control group evaluation study design was followed. Patient logbook entries, as well as residents’ satisfaction, knowledge, and self-reported confidence outcomes were compared between family medicine residents completing the new ambulatory rotation and those completing a traditional inpatient-ambulatory pediatrics rotation. Conclusion An ambulatory rotation in pediatrics is a feasible option for facilitating family medicine resident learning in child health care. Residents report exposure to more patient cases that reflect a family practice office setting and the same level of knowledge and confidence as residents completing an inpatient-ambulatory rotation. Intraprofessional collaboration, flexibility in scheduling, and the support of pediatric preceptors are key factors in the organization and implementation of an ambulatory rotation. PMID:21321160

  4. Family medicine residency training and burnout: a qualitative study

    PubMed Central

    Rutherford, Kimberly; Oda, Joanna

    2014-01-01

    Background Almost three-quarters of family practice residents in British Columbia (BC) meet criteria for burnout. We sought to understand how burnout is perceived and experienced by family medicine residents, and to identify both contributory and protective factors for resident burnout. Method Two semi-structured focus groups were conducted with ten family practice residents from five distinct University of British Columbia training sites. Participants completed the Maslach Burnout Inventory (MBI). The data were analyzed using a thematic analysis approach. Results Seventy percent of the focus group participants met criteria for burnout using the MBI. The experience of burnout was described as physical and emotional exhaustion, loss of motivation, isolation from loved ones, and disillusionment with the medical profession. Contributory factors included high workload, burned-out colleagues, perceived undervaluing of family medicine, lack of autonomy, and inability to achieve work-life balance. Protective factors included strong role models in medicine, feeling that one’s work is valued and rotations in family medicine. Conclusions The high level of burnout in family medicine residents in BC is a multifactorial and complex phenomenon. Training programs and faculty should be aware of burnout risk factors and strive to implement changes to reduce burnout, including allowing residents increased control over scheduling, access to counseling services and training for resident mentors. PMID:26451218

  5. Family caregivers' conceptualisation of quality end-of-life care for people with dementia: A qualitative study.

    PubMed

    Davies, Nathan; Rait, Greta; Maio, Laura; Iliffe, Steve

    2017-09-01

    People with dementia have been described as the 'disadvantaged dying' with poor end-of-life care. Towards the end of life, people with dementia cannot report on the care they receive. It is therefore important to talk to caregivers; however, few have explored the views about end-of-life care from the caregivers' perspective. The majority of research on family caregivers has focussed on the burden and psychological impact of caring for a relative with dementia. This study aimed to explore the views of family caregivers about quality end-of-life care for people with dementia. Qualitative study using in-depth interviews and analysed using thematic analysis. Purposive sampling from a third sector organisation's caregiver network was used to recruit 47 caregivers in England (2012-2013), consisting of (1) family caregivers of someone who had recently received a diagnosis of dementia, (2) family caregivers currently caring for someone with dementia and (3) bereaved family caregivers. Three over-arching themes were derived from the interviewees' discourse, including maintaining the person within, fostering respect and dignity and showing compassion and kindness. End-of-life care for people with dementia does not differ from care throughout the dementia trajectory. Throughout the findings, there is an implicit underlying theme of conflict: conflict between family caregivers and an increasingly systematised service of care and conflict between family caregivers and professionals. This study has in particular demonstrated the importance of the psycho-social aspects of care, aligning with the holistic definition of palliative care.

  6. Teen mothers at midlife: the long shadow of adversarial family caregiving.

    PubMed

    Smithbattle, Lee; Leonard, Victoria

    2014-01-01

    Despite keen interest in teen mothers' outcomes, few studies have followed teen mothers prospectively or examined how outcomes are shaped by family relationships and practices over time. This multigenerational, hermeneutic study began 21 years ago when 16 families were interviewed after the teen's infant reached 8 to 10 months of age. Families were re-interviewed every 4 to 5 years. This article describes the 3 families who exemplified adversarial caregiving at the first study and how their relationships unfolded and shaped long-term outcomes. Findings alert clinicians to the importance of recognizing red flags and intervening early to interrupt adversarial caregiving.

  7. Intervention to improve social and family support for caregivers of dependent patients: ICIAS study protocol

    PubMed Central

    2014-01-01

    Background Despite the existence of formal professional support services, informal support (mainly family members) continues to be the main source of eldercare, especially for those who are dependent or disabled. Professionals on the primary health care are the ideal choice to educate, provide psychological support, and help to mobilize social resources available to the informal caregiver. Controversy remains concerning the efficiency of multiple interventions, taking a holistic approach to both the patient and caregiver, and optimum utilization of the available community resources. .For this reason our goal is to assess whether an intervention designed to improve the social support for caregivers effectively decreases caregivers burden and improves their quality of life. Methods/design Design: Controlled, multicentre, community intervention trial, with patients and their caregivers randomized to the intervention or control group according to their assigned Primary Health Care Team (PHCT). Study area: Primary Health Care network (9 PHCTs). Study participants: Primary informal caregivers of patients receiving home health care from participating PHCTs. Sample: Required sample size is 282 caregivers (141 from PHCTs randomized to the intervention group and 141 from PHCTs randomized to the control group. Intervention: a) PHCT professionals: standardized training to implement caregivers intervention. b) Caregivers: 1 individualized counselling session, 1 family session, and 4 educational group sessions conducted by participating PHCT professionals; in addition to usual home health care visits, periodic telephone follow-up contact and unlimited telephone support. Control: Caregivers and dependent patients: usual home health care, consisting of bimonthly scheduled visits, follow-up as needed, and additional attention upon request. Data analysis Dependent variables: Caregiver burden (short-form Zarit test), caregivers’ social support (Medical Outcomes Study), and

  8. Family caregiving at the intersection of private care by migrant home care workers and public care by nursing staff.

    PubMed

    Ayalon, Liat; Halevy-Levin, Sara; Ben-Yizhak, Zvi; Friedman, Gideon

    2013-09-01

    This study evaluated private family caregiving at the intersection of private migrant home care and public nursing care on the hospitalization of an older patient. Seventy-three individuals were interviewed, including older hospitalized patients, their family members, accompanying migrant home care workers, and nursing personnel. There was no clear consensus concerning the role of family members. Although family members emphasized care management as their main role, the other three groups emphasized that the family members' mere physical presence was their main role. All four groups identified potential barriers to family caregiving, rather than motives for family caregiving, hence pointing to a potential discrepancy between expected and performed family caregiving roles. An indication of the lack of clarity concerning family caregiving roles stems from the finding that family members were frequently viewed as unengaged and neglectful, yet at times they were criticized for being overly involved in patient care. Implications for the care of hospitalized older adults are discussed.

  9. Responsibility and burden from the perspective of seniors' family caregivers: a qualitative study in Shanghai, China.

    PubMed

    Zeng, Li; Zhu, Xiaoping; Meng, Xianmei; Mao, Yafen; Wu, Qian; Shi, Yan; Zhou, Lanshu

    2014-01-01

    This study aimed to explore the experience of seniors' family caregivers with regarding the responsibility, burden and support needs during caregiving in Shanghai, China. An exploratory, descriptive, qualitative design was used and a semi-structure interview was conducted. A convenience sample of 11 participants in two community service centers in Shanghai was recruited. Data saturation guided the size of the sample. The Colaizzi method of empirical phenomenology was used for interviewing and analyzing data obtained from 11 caregivers. Three major themes were found: It is a hard work; It is my responsibility; Social support is not enough. The findings of the study are practical and helpful for health care providers to develop appropriate caregiver support services, to balance the responsibility and burden of caregivers, and to consider the factors influencing the utility of support services.

  10. Health economic analysis on a psychosocial intervention for family caregivers of persons with dementia.

    PubMed

    Dahlrup, Beth; Nordell, Eva; Steen Carlsson, Katarina; Elmståhl, Sölve

    2014-01-01

    Psychosocial intervention has shown positive effects on the caregivers' burden and satisfaction. The aims of this study were to describe the cost and cost-effectiveness of such an intervention. We analyzed resource use and costs of formal care for 308 persons with dementia and their caregivers' health-related quality of life (HRQoL). The costs of home help services were lower in the subgroup of spouse caregivers in the intervention group and the cost of nursing home placement was lower in the intervention group. While the person with dementia lived at home, caregivers in the intervention group reported a higher HRQoL (p < 0.01). After the person with dementia had moved to a nursing home, spouses in the control group had a lower HRQoL (p < 0.001). The result can be interpreted as a positive effect of the intervention focusing on the identified specific needs of the family caregivers.

  11. Responsibility and burden from the perspective of seniors’ family caregivers: a qualitative study in Shanghai, China

    PubMed Central

    Zeng, Li; Zhu, Xiaoping; Meng, Xianmei; Mao, Yafen; Wu, Qian; Shi, Yan; Zhou, Lanshu

    2014-01-01

    Objectives: This study aimed to explore the experience of seniors’ family caregivers with regarding the responsibility, burden and support needs during caregiving in Shanghai, China. Materials and methods: An exploratory, descriptive, qualitative design was used and a semi-structure interview was conducted. A convenience sample of 11 participants in two community service centers in Shanghai was recruited. Data saturation guided the size of the sample. The Colaizzi method of empirical phenomenology was used for interviewing and analyzing data obtained from 11 caregivers. Results: Three major themes were found: It is a hard work; It is my responsibility; Social support is not enough. Conclusion: The findings of the study are practical and helpful for health care providers to develop appropriate caregiver support services, to balance the responsibility and burden of caregivers, and to consider the factors influencing the utility of support services. PMID:25126186

  12. Family needs in caregivers of individuals with traumatic brain injury from Colombia, South America.

    PubMed

    Arango-Lasprilla, Juan Carlos; Quijano, Maria Cristina; Aponte, Monica; Cuervo, Maria Teresa; Nicholls, Elizabeth; Rogers, Heather Lynn; Kreutzer, Jeffrey

    2010-01-01

    The aim of the present study was to determine the most and least important family needs in a group of family caregivers of individuals with TBI from Cali, Colombia, and to examine which of those needs were more likely to be met and unmet. Cross-sectional descriptive study. Valle University Hospital in Cali, Colombia. Twenty-nine family caregivers of individuals with traumatic brain injury. The Family Needs Questionnaire, a 40-item questionnaire divided into six sub-scales. Health Information, Community Support Network and Professional Support Network sub-scales were the most important needs reported by this group of Colombian TBI family caregivers. The most frequently met needs in the present study fell within Health Information, Involvement with Care and Instrumental Support sub-scales and the most frequently unmet needs fell within the Emotional Support, Instrumental Support and Professional Support sub-scales. Family needs in caregivers of individuals with TBI from Colombia are similar, but more likely to be unmet, than those reported in previous studies. Interventions designed to meet family caregivers' needs in these areas should be implemented in Colombia.

  13. Caregiver Assessment

    ERIC Educational Resources Information Center

    Feinberg, Lynn

    2008-01-01

    Assessment is a critical step in determining appropriate support services. This article discusses "caregiver assessment," a systematic process of gathering information to describe a caregiving situation. Caregiver assessment identifies the particular problems, needs, resources, and strengths of the family caregiver and approaches issues from the…

  14. Caregiver Assessment

    ERIC Educational Resources Information Center

    Feinberg, Lynn

    2008-01-01

    Assessment is a critical step in determining appropriate support services. This article discusses "caregiver assessment," a systematic process of gathering information to describe a caregiving situation. Caregiver assessment identifies the particular problems, needs, resources, and strengths of the family caregiver and approaches issues from the…

  15. Family caregivers' assessments of caring for a relative with dementia: a comparison of urban and rural areas.

    PubMed

    Ehrlich, Kethy; Boström, Anne-Marie; Mazaheri, Monir; Heikkilä, Kristiina; Emami, Azita

    2015-03-01

    This study aimed to describe and compare urban and rural family caregivers' reactions to caring for a relative with dementia and to examine the associations between caregiving and socio-demographic factors. Most studies on family caregivers' experiences caring for older people with dementia have been conducted in urban areas, and little is known about the experiences of family caregivers living in rural areas. A cross-sectional study design was used. A total of 102 caregivers (response rate 85%) from urban (n=57) and rural (n=46) areas completed the Caregiver Reaction Assessment (CRA) Scale and demographic information. Data were analysed using descriptive and inferential statistics and linear regression models. Overall, family caregivers reported high satisfaction even if they also reported high impact on finances and daily living. Rural caregivers experienced a higher negative impact on finances but reported more support from family members than urban caregivers. Age, gender and relationship were significantly associated with four of the five CRA subscales. Educational level and geographical setting were not associated with any of the CRA subscales. The results of the study raise questions about the financial situation of older female caregivers and on the expectations of built-in family structures in urban and rural areas. Further studies focusing on the meaning and constitution of a family would help us to understand how these factors influence family caregiving both in rural and urban areas. To provide person-centred care and to avoid stereotyped caregiving, a better picture of traditions in family caregiving can improve a more differentiated and appropriate professional caregiving pliable with the cultural context in which it is carried out. © 2014 John Wiley & Sons Ltd.

  16. An educative support group for female family caregivers: impact on caregivers psychological distress and patient's neuropsychiatry symptoms.

    PubMed

    Javadpour, Ali; Ahmadzadeh, Laaya; Bahredar, Mohammad Jafar

    2009-05-01

    In developing world most patients with dementia live in the community. And female family caregivers are the primary source to delivering care to patients. Educating and supporting the careers may reduce psychological distress and the challenging behavior as well. We run a non pharmacological intervention focusing on education regarding dementia, behavioral problems and interactive self support group. Twenty nine female family caregivers were assigned and divided in two groups of 15 and 14. Two hours weekly sessions were conducted for 8 weeks. Baseline and outcome measures were assessed using neuropsychiatry Inventory (NPI), general health questionnaire and perceived stress scale (PSS). Initial co relational analysis demonstrated a significant correlation between GHQ and total NPI scores but not for PSS. Paired sample test revealed significant change from baseline and at the end in both GHQ score and neuropsychiatry symptoms. This study supports the use of a non-pharmacologic intervention focusing on education in a feasible and cost benefit setting for dementia caregivers. (c) 2008 John Wiley & Sons, Ltd.

  17. Measures of psychological stress and physical health in family caregivers of stroke survivors: a literature review.

    PubMed

    Saban, Karen L; Sherwood, Paula R; DeVon, Holli A; Hynes, Denise M

    2010-06-01

    Studies have demonstrated that the stress of family caregiving places caregivers at risk for developing depression, poor quality of life, and health problems. The purpose of this review was to identify the ways in which variables are operationalized in studies addressing psychological stressors and physical health of family caregivers of stroke survivors. The adapted Pittsburgh Mind-Body Center model provides the organizing conceptual framework for this literature review. A literature search for relevant articles was conducted using Ovid Medline, PsycINFO, and Ovid Nursing Database for the period of July 1999 through June 2009 using the following search terms: caregiver (or family caregiver), stroke, stress, and health. Articles were included if they met the following inclusionary criteria: (a) written in English, (b) published in peer-reviewed journal, (c) focused on adults who were caring for an adult who experienced stroke, (d) included measures of stress and physical health or health-related quality of life, and (e) primarily used quantitative research methods. Twenty-four articles were identified that met the inclusion criteria. Findings related to the variables included in the adapted Pittsburgh Mind-Body Center model are discussed. Variables were not well defined, a wide array of measurement instruments were used, and measures were taken at broadly divergent time frames following stroke. Future research guided by a theoretical framework, consistent measures of variables, and standardized measurement time points would allow for better comparison of findings across studies, thus enabling clinicians to better understand the health risks of family caregivers.

  18. Comparing Affiliate Stigma Between Family Caregivers of People With Different Severe Mental Illness in Taiwan.

    PubMed

    Chang, Chih-Cheng; Yen, Cheng-Fang; Jang, Fong-Lin; Su, Jian-An; Lin, Chung-Ying

    2017-07-01

    The family caregivers of people with mental illness may internalize the public stereotypes into the affiliate stigma (i.e., the self-stigma of family members). This study aimed to compare the affiliate stigma across schizophrenia, bipolar disorder, and major depressive disorder, and to investigate potential factors associated with affiliate stigma. Each caregiver of family members with schizophrenia (n = 215), bipolar disorder (n = 85), and major depressive disorder (n = 159) completed the Affiliate Stigma Scale, Rosenberg Self-Esteem Scale, Caregiver Burden Inventory, Taiwanese Depression Questionnaire, and Beck Anxiety Inventory. After controlling for potential confounders, the hierarchical regression models showed that caregivers of a family member with schizophrenia had a higher level of affiliate stigma than those of bipolar disorder (β = -0.109; p < 0.05) and major depressive disorder (β = -0.230; p < 0.001). Self-esteem, developmental burden, and emotional burden were significant factors for affiliate stigma. The affiliate stigma of caregivers is associated with their self-esteem, caregiver burden, and by the diagnosis.

  19. Factors associated with stroke survivor behaviors as identified by family caregivers.

    PubMed

    Gonzalez, Carmanny; Bakas, Tamilyn

    2013-01-01

    Stroke survivor behaviors that caregivers identify as bothersome can lead to family caregiver stress, which can result in premature institutionalization of the survivor. The purpose of this study was to explore demographic and theory-based factors associated with survivor bothersome behaviors as identified by family caregivers. A secondary analysis of a combined sample of 96 family caregivers of stroke survivors was conducted using baseline data from two existing studies. Bothersome behaviors were measured using the Revised Memory and Behavior Problems Checklist (RMBPC). Theory-based factors were measured using well-validated scales. Male stroke survivors exhibited more bothersome behaviors (t = 3.53, p < .01). After controlling for survivor gender, 35% of the variance in bothersome behaviors was explained by caregiver depressive symptoms, task difficulty, life changes, and threat appraisal (F[5, 88] = 10.82, p < .001). These results identify potential areas for nursing interventions designed to reduce bothersome behaviors as identified by family caregivers. © 2013 Association of Rehabilitation Nurses.

  20. Family medicine residency directors' perceptions of the position of chief resident.

    PubMed

    Susman, J; Gilbert, C

    1992-03-01

    This report describes a survey that explored the selection, training, duties, skills, and evaluation of chief residents as perceived by the program directors of the 381 family medicine residencies in the United States in 1989. A response rate of 79% (300 programs) was achieved. In 70% of the programs the chief resident received no formal training, and in 41% no formal evaluation. The program directors believed the most important duties and skills of a chief resident were acting as a liaison and advocate for residents, scheduling, and leadership. The directors thought that the most exciting aspects of being a chief resident included the development of leadership skills and the ability to influence curriculum; the aspects that caused the most concern included time pressures and demands that detract from clinical learning. The authors suggest that more attention should be directed to the nurturing and development of chief residents, who are the future leaders in academic medicine.

  1. The impact of cardiac arrest on the long-term wellbeing and caregiver burden of family caregivers: a prospective cohort study.

    PubMed

    van Wijnen, Helena Gfm; Rasquin, Sascha Mc; van Heugten, Caroline M; Verbunt, Jeanine A; Moulaert, Véronique Rm

    2017-09-01

    The purpose was to gain insight in the functioning of caregivers of cardiac arrest survivors at 12 months after a cardiac arrest. Secondly, the course of the wellbeing of the caregivers during the first year was studied. Finally, factors that are associated with a higher care burden at 12 months after the cardiac arrest were investigated. A total of 195 family caregivers of cardiac arrest survivors were included. Quality of life (SF-36, EuroQol-VAS), caregiver strain (CSI) and emotional functioning (HADS, IES) were measured at two weeks, three months and one year after the cardiac arrest. Thereby, the caregiver was asked to fill out the cognitive failure questionnaire (CFQ) to evaluate their view on the cognitive status of the patient. Caregiver strain was high in 16 (15%) of the caregivers at 12 months. Anxiety was present in 33 (25%) caregivers and depression in 18 (14%) caregivers at 12 months. The repeated measures MANOVA showed that during the first year the following variables improved significantly: SF-36 domains social and mental health, role physical, role emotional and vitality, caregiver strain, HADS and IES ( P<0.001). At 12 months caregiver strain correlated significantly (explained variance 63%, P=0.03) with caregiver HADS ( P=0.01), EuroQol-VAS ( P=0.02), and the CFQ ( P<0.001), all measured at 12 months after the cardiac arrest. Overall wellbeing of the caregivers improves during the first year up to normal levels, but caregivers with emotional problems or perceived cognitive problems at 12 months are at risk for developing a higher care burden.

  2. Pain medication management processes used by oncology outpatients and family caregivers part I: health systems contexts.

    PubMed

    Schumacher, Karen L; Plano Clark, Vicki L; West, Claudia M; Dodd, Marylin J; Rabow, Michael W; Miaskowski, Christine

    2014-11-01

    Oncology patients with persistent pain treated in outpatient settings and their family caregivers have significant responsibility for managing pain medications. However, little is known about their practical day-to-day experiences with pain medication management. The aim was to describe day-to-day pain medication management from the perspectives of oncology outpatients and their family caregivers who participated in a randomized clinical trial of a psychoeducational intervention called the Pro-Self(©) Plus Pain Control Program. In this article, we focus on pain medication management by patients and family caregivers in the context of multiple complex health systems. We qualitatively analyzed audio-recorded intervention sessions that included extensive dialogue between patients, family caregivers, and nurses about pain medication management during the 10-week intervention. The health systems context for pain medication management included multiple complex systems for clinical care, reimbursement, and regulation of analgesic prescriptions. Pain medication management processes particularly relevant to this context were getting prescriptions and obtaining medications. Responsibilities that fell primarily to patients and family caregivers included facilitating communication and coordination among multiple clinicians, overcoming barriers to access, and serving as a final safety checkpoint. Significant effort was required of patients and family caregivers to insure safe and effective pain medication management. Health systems issues related to access to needed analgesics, medication safety in outpatient settings, and the effort expended by oncology patients and their family caregivers require more attention in future research and health-care reform initiatives. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  3. Mediating Effect of Family Caregivers' Hesitancy to Use Analgesics on Homecare Cancer Patients' Analgesic Adherence.

    PubMed

    Lee, Bih-O; Liu, Yi; Wang, Yi-Hsien; Hsu, Hsin-Tien; Chen, Chien-Liang; Chou, Pi-Ling; Hsu, Wen-Chung

    2015-12-01

    Family caregivers play an increasingly critical role in cancer patients' symptom management as the number of cancer patients receiving home care grows. However, there is a lack of research measuring the impact of the family caregivers' hesitancy to use analgesics on analgesic adherence and the resulting influence on patient pain intensity. To examine whether family caregivers' hesitancy to use analgesics is a mediator that influences patient adherence and investigate how analgesic regimen adherence affects pain intensity. This study used a cross-sectional and descriptive design. One hundred seventy-six patient-family caregiver dyads (N = 352) were recruited from one local hospital in southern Taiwan. Instruments included the Short Version of the Barriers Questionnaire-Taiwan, the Morisky Medication Adherence Measure-Taiwan, the Brief Pain Inventory-Chinese, and demographic and illness questionnaires. A one-way analysis of variance and post hoc comparisons were performed to assess the influence of analgesic regimen adherence on pain intensity. Sobel tests were used to examine mediating effects. Family caregivers' hesitancy to use analgesics was a significant mediator between patient barriers to use analgesics and patient analgesic regimen adherence (P < 0.0001). Patients with low and moderate adherence levels reported significantly higher levels of pain severity (F = 3.83, P < 0.05). This study showed that family caregivers' hesitancy to use analgesics was a significant mediator associated with their hesitancy to use analgesics and the patients' analgesic adherence. It is important for health care providers to consider family caregivers' hesitancy to use analgesics when attempting to improve adherence to pain management regimens in clinical practice. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  4. Use of Zarit Burden Interview in analysis of family caregivers' perception among Taiwanese caring with hospitalized relatives.

    PubMed

    Yeh, Pi-Ming; Chang, Yuanmay

    2015-10-01

    This study was conducted to examine the relationships between family caregivers' perception of caregiving and its influencing factors among Taiwanese with hospitalized relatives. The study used a cross-sectional and descriptive correlational design. A convenience sample of 200 primary caregivers of hospitalized patients diagnosed with cancer, stroke and chronic illness was recruited in a Taiwanese Medical Center; this focus was chosen because cancer, stroke and chronic illness generally require long term care. Data were collected by structured questionnaires. Pearson product-moment correlation and stepwise multiple regression analyses were used to analyse the results of this study. Family caregivers who lacked family support and whose patients' ADL (activities of daily living) dependency was increasing experienced a greater caregiving burden. Family caregivers who had better psychological well-being, better quality of relationship and more caregiving knowledge experienced a lower caregiving burden. Quality of relationship, lack of family support and patients' ADL dependency accounted for 43% of the Zarit Burden Interview variance. The results indicated that family caregivers' perception of caregiving included sacrifice, strain, embarrassment, anger and loss of control. It is vital for nurses to understand these caregiving perceptions and their related factors to provide a holistic care plan.

  5. Determinants of hopelessness and depression among Chinese hospitalized esophageal cancer patients and their family caregivers.

    PubMed

    Han, Yanhong; Yuan, Jie; Luo, Zhiguo; Zhao, Jing; Wu, Junbo; Liu, Rongying; Lopez, Violeta

    2013-11-01

    It has been well documented that the diagnosis of cancer is psychologically devastating to both the patients and caregivers. The incidence and mortality of esophageal cancer were 20.85 and 16.24 per 100,000 persons and the sixth most commonly diagnosed cancer and the fourth main cause of cancer death in China. We surveyed patients-caregivers dyad and examined the determinants of their depression and hopelessness. The prevalence of depression among patients and caregivers was 52.8% and 47.2%, and the prevalence for hopelessness was 64.4% and 53.9%, respectively Regression models indicate that the variables measured could explain 58.9% and 51.7% of the variance in depression and 66.8% and 45.7% of the variance in hopelessness among patients and caregivers, respectively. Overall, hopelessness was a determinant of depression and vice versa to both patients and caregivers. Esophageal patients' depression and hopelessness could also affect caregivers' depression and hopelessness despite the social support that family caregivers have. Psychosocial interventions should be planned to both Chinese patients and caregivers considering the predictors found in this study. Copyright © 2013 John Wiley & Sons, Ltd.

  6. Coping strategies, care manager support and mental health outcome among Japanese family caregivers.

    PubMed

    Yamada, Miho; Hagihara, Akihito; Nobutomo, Koichi

    2008-07-01

    Coping and social support are regarded as major modifiers of the caregiving stress and negative mental health effects experienced by caregivers. Under Japan's Long-term Care Insurance (LTCI) system, care managers have played a major role in providing psychosocial support for family caregivers while coordinating formal and informal care resources for elderly people. However, since the launch of the LTCI system in 2000, no evaluation has examined the role care managers play in buffering the negative effects of the caregiver burden among family caregivers in Japan. This study examined the direct and buffering effects of stress-coping strategies and care manager support on caregiver burden and depression among Japanese family caregivers (n = 371) caring for community-dwelling persons aged 65 or over who were having difficulties with the activities of daily living. A self-administrated questionnaire survey was conducted between February and March 2005 in a rural suburb in south-western Japan. Hierarchical regression analyses revealed the following. (i) Coping strategies and 'social talk' by care managers had direct effects on caregiver burden and depression. (ii) 'Avoidant' coping and 'social talk' by care managers had buffering effects on the care needs-depression relationship. (iii) 'Information giving' by care managers had no significant direct effect, but it had a negative effect on the care needs-depression relationship. Overall, results concerning 'approaching' coping were in line with those of previous studies, while findings concerning 'avoidant' coping were not consistent with findings in Western countries. The type of care manager support appeared to have a variable influence on caregiver burden and depression.

  7. Acceptability of a guided self-help Internet intervention for family caregivers: mastery over dementia.

    PubMed

    Pot, Anne Margriet; Blom, Marco M; Willemse, Bernadette M

    2015-08-01

    The number of people with dementia is increasing rapidly. Providing care to a relative or friend with dementia may lead to serious mental health problems. Internet interventions may offer opportunities to improve the availability and accessibility of (cost)effective interventions to reduce family caregivers' psychological distress. This study describes the acceptability of a guided self-help Internet intervention "mastery over dementia" (MoD), aimed at reducing caregivers' psychological distress, in terms of reach, adherence and user evaluation. The sample for this study is the experimental group that participated in the (cost)effectiveness trial of MoD (N = 149). Data on characteristics of family caregivers and people with dementia, completion and user evaluation were used and analyzed with descriptive statistics, χ2and T-tests. MoD reaches a wide variety of caregivers, also those aged 75+, having a relative with a recent diagnosis of dementia or living in a care home. However, the percentage of caregivers who did not complete all eight lessons was rather high (55.7%). Among the completers (N = 66; 44.3%) were significantly more spouses, caregivers living in the same household, older caregivers, and those caring for somebody with another formal diagnosis than Alzheimer's disease. Caregivers' evaluation showed that females rated higher on the comprehensibility of the lessons and feedback and spent less time on the lessons. The guided self-help Internet intervention MoD is acceptable for a broad range of family caregivers of people with dementia. The next step is to substantiate its (cost)effectiveness.

  8. Does a family meetings intervention prevent depression and anxiety in family caregivers of dementia patients? A randomized trial.

    PubMed

    Joling, Karlijn J; van Marwijk, Harm W J; Smit, Filip; van der Horst, Henriëtte E; Scheltens, Philip; van de Ven, Peter M; Mittelman, Mary S; van Hout, Hein P J

    2012-01-01

    Family caregivers of dementia patients are at increased risk of developing depression or anxiety. A multi-component program designed to mobilize support of family networks demonstrated effectiveness in decreasing depressive symptoms in caregivers. However, the impact of an intervention consisting solely of family meetings on depression and anxiety has not yet been evaluated. This study examines the preventive effects of family meetings for primary caregivers of community-dwelling dementia patients. A randomized multicenter trial was conducted among 192 primary caregivers of community dwelling dementia patients. Caregivers did not meet the diagnostic criteria for depressive or anxiety disorder at baseline. Participants were randomized to the family meetings intervention (n = 96) or usual care (n = 96) condition. The intervention consisted of two individual sessions and four family meetings which occurred once every 2 to 3 months for a year. Outcome measures after 12 months were the incidence of a clinical depressive or anxiety disorder and change in depressive and anxiety symptoms (primary outcomes), caregiver burden and quality of life (secondary outcomes). Intention-to-treat as well as per protocol analyses were performed. A substantial number of caregivers (72/192) developed a depressive or anxiety disorder within 12 months. The intervention was not superior to usual care either in reducing the risk of disorder onset (adjusted IRR 0.98; 95% CI 0.69 to 1.38) or in reducing depressive (randomization-by-time interaction coefficient = -1.40; 95% CI -3.91 to 1.10) or anxiety symptoms (randomization-by-time interaction coefficient = -0.55; 95% CI -1.59 to 0.49). The intervention did not reduce caregiver burden or their health related quality of life. This study did not demonstrate preventive effects of family meetings on the mental health of family caregivers. Further research should determine whether this intervention might be more beneficial if

  9. Does a Family Meetings Intervention Prevent Depression and Anxiety in Family Caregivers of Dementia Patients? A Randomized Trial

    PubMed Central

    Joling, Karlijn J.; van Marwijk, Harm W. J.; Smit, Filip; van der Horst, Henriëtte E.; Scheltens, Philip; van de Ven, Peter M.; Mittelman, Mary S.; van Hout, Hein P. J.

    2012-01-01

    Background Family caregivers of dementia patients are at increased risk of developing depression or anxiety. A multi-component program designed to mobilize support of family networks demonstrated effectiveness in decreasing depressive symptoms in caregivers. However, the impact of an intervention consisting solely of family meetings on depression and anxiety has not yet been evaluated. This study examines the preventive effects of family meetings for primary caregivers of community-dwelling dementia patients. Methods A randomized multicenter trial was conducted among 192 primary caregivers of community dwelling dementia patients. Caregivers did not meet the diagnostic criteria for depressive or anxiety disorder at baseline. Participants were randomized to the family meetings intervention (n = 96) or usual care (n = 96) condition. The intervention consisted of two individual sessions and four family meetings which occurred once every 2 to 3 months for a year. Outcome measures after 12 months were the incidence of a clinical depressive or anxiety disorder and change in depressive and anxiety symptoms (primary outcomes), caregiver burden and quality of life (secondary outcomes). Intention-to-treat as well as per protocol analyses were performed. Results A substantial number of caregivers (72/192) developed a depressive or anxiety disorder within 12 months. The intervention was not superior to usual care either in reducing the risk of disorder onset (adjusted IRR 0.98; 95% CI 0.69 to 1.38) or in reducing depressive (randomization-by-time interaction coefficient = −1.40; 95% CI −3.91 to 1.10) or anxiety symptoms (randomization-by-time interaction coefficient = −0.55; 95% CI −1.59 to 0.49). The intervention did not reduce caregiver burden or their health related quality of life. Conclusion This study did not demonstrate preventive effects of family meetings on the mental health of family caregivers. Further research should determine whether this

  10. The Relationship between Socio-demographic Characteristics, Family Environment, and Caregiver Coping in Families of Children with Cancer

    PubMed Central

    Devine, Katie A.; Heckler, Charles E.

    2013-01-01

    The factors that influence caregiver coping mechanism preferences after a child’s diagnosis with cancer are not fully understood. This study examines the relationship between caregivers’ socio-demographic characteristics and the coping strategies they use to adapt to childhood cancer. Sixty caregivers of pediatric cancer patients completed a socio-demographic questionnaire, the Family Environment Scale, and the COPE inventory. There were no significant differences in family environment by income or education. Caregiver educational attainment was positively associated with use of planning and active coping styles, while income was not associated with caregiver coping style. Mothers were more likely than fathers to use active coping, instrumental support, religious coping, and emotional support. Men with lower education engaged in greater substance use coping and lower planning. The findings show that educational attainment and caregiver gender influence caregiver coping styles following a pediatric cancer diagnosis and suggest that educational attainment rather than financial resources drive the association between SES and coping. Programs that address educational gaps and teach caregivers planning and active coping skills may be beneficial for parents with lower educational attainment, particularly men. PMID:23670676

  11. Caregiver responsiveness to the family bereavement program: what predicts responsiveness? What does responsiveness predict?

    PubMed

    Schoenfelder, Erin N; Sandler, Irwin N; Millsap, Roger E; Wolchik, Sharlene A; Berkel, Cady; Ayers, Timothy S

    2013-12-01

    The study developed a multidimensional measure to assess participant responsiveness to a preventive intervention and applied this measure to study how participant baseline characteristics predict responsiveness and how responsiveness predicts program outcomes. The study was conducted with caregivers who participated in the parenting-focused component of the Family Bereavement Program (FBP), a prevention program for families that have experienced parental death. The sample consisted of 89 caregivers assigned to the intervention condition in the efficacy trial of the FBP. Positive parenting, caregiver depression, and child externalizing problems at baseline were found to predict caregivers' use of program skills outside the group, and more child internalizing problems predicted more positive perceptions of the group environment. Higher levels of skill use during the program predicted increased positive parenting at the 11-month follow-up, whereas positive perceptions of the group environment predicted decreased caregiver depressive symptoms at follow-up. Caregiver skill use mediated the relation between baseline positive parenting and improvements in positive parenting at 11-month follow-up, and skill use and perceived group environment mediated changes in caregiver depression from baseline to 11-month follow-up.

  12. Exploring Spirituality in Family Caregivers of Patients With Primary Malignant Brain Tumors Across the Disease Trajectory

    PubMed Central

    Newberry, Alyssa G.; Jean Choi, Chien-Wen; Donovan, Heidi S.; Schulz, Richard; Bender, Catherine; Given, Barbara; Sherwood, Paula

    2013-01-01

    Purpose/Objectives To determine whether the perceived level of spirituality in family caregivers of patients with primary malignant brain tumors (PMBTs) changes across the disease trajectory. Design Ongoing descriptive, longitudinal study. Setting Southwestern Pennsylvania. Sample 50 family caregivers of patients with PMBT. Methods Caregivers and care recipients were recruited at time of diagnosis. Participants were interviewed at two subse-quent time points, four and eight months following diagnosis. Main Research Variables Care recipients’ symptoms, neuro-psychologic status, and physical function, as well as caregiver social support. Findings Results showed no significant difference in spirituality scores reported at baseline and eight months (p = 0.8), suggesting that spirituality may be a stable trait across the disease trajectory. Conclusions Spirituality remains relatively stable along the course of the disease trajectory. Reports of caregiver depressive symptoms and anxiety were lower when paired with higher reports of spirituality. Implications for Nursing Clinicians can better identify caregivers at risk for negative outcomes by identifying those who report lower levels of spirituality. Future interventions should focus on the development and implementation of interventions that provide protective buffers such as increased social support. Knowledge Translation Spirituality is a relatively stable trait. High levels of spirituality can serve as a protective buffer from negative mental health outcomes. Caregivers with low levels of spirituality may be at risk for greater levels of burden, anxiety, and stress. PMID:23615145

  13. Positive Aspects of Family Caregiving for Dementia: Differential Item Functioning by Race

    PubMed Central

    Dilworth-Anderson, Peggye; Huang, Jin; Gross, Alden L.; Gitlin, Laura N.

    2015-01-01

    Objectives. Due to increasing interest in the positive experiences associated with family caregiving, potential demographic group differences were examined on the Positive Aspects of Caregiving (PAC) scale at both the item and scale levels. Method. Family caregivers (N = 642) completed the PAC as part of their participation in the Resources for Enhancing Alzheimer’s Caregiver Health (REACH II) clinical trial. Multiple indicators, multiple causes models were used to examine potential differential item functioning (DIF) across demographic subgroups. Results. Overall PAC scale scores indicated that both Hispanics and African Americans experienced more PAC than Whites. Two items with statistically significant (p < .004) and practically meaningful (odds ratio > 2.0) DIF were found for African American caregivers. After controlling for the underlying unidimensional construct, African Americans reported that caregiving gave them “a more positive attitude toward life” and enabled them to “appreciate life more” than either Whites or Hispanics. No instances of meaningful DIF were found between Hispanics and Whites, women and men, or spouses and nonspouses. Discussion. PAC scores differ significantly by race. In addition, 2 items with meaningful race DIF identify content areas that are particularly relevant to the cultural experiences of African American caregivers. PMID:26033356

  14. Impaired autonomic nervous system activity during sleep in family caregivers of ambulatory dementia patients in Japan.

    PubMed

    Sakurai, Shihomi; Onishi, Joji; Hirai, Makoto

    2015-01-01

    The number of dementia patients requiring care is rapidly increasing in Japan. Consequently, a large percentage of family members, including spouses and children of those with dementia, are assuming the role of primary caregiver. Many caregivers develop health problems including sleep disorders. Some report poor quality of sleep even when sleep duration is normal. In the present study, we used actigraphy and heart rate variability spectral analysis to assess autonomic nervous system activity and quality of sleep in family caregivers of people with ambulatory dementia. The 20 caregivers who participated in our study exhibited significantly higher levels of sympathetic nervous system activity during sleep than noncaregivers. This abnormal activity was most prominent during the first half of the sleep period and was not related to overall sleep duration. We propose that relaxation is inhibited during the first half of the sleep period in this caregiver population. This may be due to increased stress, as caregivers of people with ambulatory dementia may worry about their patients waking and wandering at night, potentially injuring themselves. Our findings indicate a need for increased support for caregivers of people with dementia, including the assessment and treatment of sleep disorders. © The Author(s) 2014.

  15. Educational needs of employed family caregivers of older adults: Evaluation of a workplace project.

    PubMed

    Curry, Linda Cox; Walker, Charles; Hogstel, Mildred O

    2006-01-01

    Family members provide 80% of care for older adults in the United States. Many family caregivers are employed either full or part time. For employed caregivers, personal health, job performance, and the ability to advance their career are affected by the weight of their caregiving responsibilities. Some find it necessary to quit their jobs. Employed caregivers report a need for caregiving information; however, they seldom think of their workplace as a valuable resource. Results of the second of a 3-phase research and service project are discussed. Based on a needs assessment completed by employees of a large institution, educational sessions were offered during 3 consecutive months. Thirty-five employees attended 1 or more sessions. The sessions were evaluated highly on a 5-point Likert-type scale for usefulness of information, quality of presentation, and value of session. Sharing project results with the employing institution's human resources department yielded commitment to integrate caregiver education and referral into a newly organized work-life program. When properly managed, such workplace programs can provide needed assistance to employed caregivers. A nurse working with older adults is an ideal provider to initiate and manage this kind of program.

  16. Family response to end-of-life education: differences by ethnicity and stage of caregiving.

    PubMed

    Braun, Kathryn L; Karel, Harumi; Zir, Ana

    2006-01-01

    The authors developed and tested 5 educational booklets to improve end-of-life knowledge, attitudes, intention, and practices in a multiethnic sample of family caregivers of well, homebound, and institutionalized elders. Of 570 participants, 424 (74%) read at least 1 booklet and completed pretests and posttests. At 3-month follow-up, small improvements were seen in completion of advance directives, and significant increases were seen in proportions of caregivers with funeral or burial plans and willingness to consider hospice. The booklets had wide appeal, but end-of-life measures varied by care-giver stage and ethnicity, suggesting that these factors need to be considered in developing education interventions for family caregivers.

  17. Ethnie Differences in Beliefs Regarding Alzheimer Disease Among Dementia Family Caregivers

    PubMed Central

    Gray, Heather L.; Jimenez, Daniel E.; Cucciare, Michael A.; Tong, Hui-Qi; Gallagher-Thompson, Dolores

    2014-01-01

    Objective The purpose of this study was to examine ethnic differences in female dementia family caregivers’ knowledge, attitudes, and beliefs about Alzheimer disease (AD). Methods Baseline data were collected from 215 female caregivers before their participation in various psychoeducational intervention programs. Caregivers were questioned about the epidemiology, etiology, and treatment of AD. Logistic regressions and one-way analysis of variance were conducted to assess ethnic differences. Results Hispanic and Chinese caregivers were more likely to believe that AD is a normal part of aging and that AD can be diagnosed by a blood test than the white group. These beliefs about AD may delay help-seeking activities for these patients and their family caregivers. Conclusion Increased public education about AD is needed in these communities. Results are discussed in terms of barriers to accessing information about AD and ways to improve public informational outreach activities, so that the intended audiences are reached more effectively. PMID:20104051

  18. Post-traumatic stress disorder symptoms in family caregivers of adult patients with acute leukemia from a dyadic perspective.

    PubMed

    Jia, Mutian; Li, Jie; Chen, Chunyan; Cao, Fenglin

    2015-12-01

    Acute leukemia is a fatal disease in adults that not only affects the patients who suffer from it but also their family caregivers. No studies have investigated post-traumatic stress disorder symptoms (PTSS) in family caregivers of adult patients with acute leukemia using a matched sample. The current study examined PTSS in adult patients with acute leukemia and their family caregivers and investigated the factors associated with caregivers' PTSS. A total of 163 patient-caregiver dyads completed questionnaires assessing their PTSS, psychological resilience, and perceived social support. Hierarchical linear regression was used to explore the related factors of caregivers' PTSS. More caregivers than patients met caseness criteria for PTSS (36.8% vs. 18.4%, p < 0.001). Among caregivers, being more closely related to the patients (e.g., spouses and parents), having patients with higher PTSS and having lower psychological resilience were independently associated with more severe PTSS. Caregivers of acute leukemia patients had significantly more severe PTSS than did their patients. This study is the first to investigate PTSS among family caregivers of adult patients with acute leukemia and its related factors in a matched sample. More attention should be paid to the caregivers of patients with acute leukemia to minimize their PTSS and thus improve mental health of caregivers and reduce potential negative consequences for the patients themselves. Copyright © 2015 John Wiley & Sons, Ltd.

  19. Benefits of a poetry writing intervention for family caregivers of elders with dementia.

    PubMed

    Kidd, Lori I; Zauszniewski, Jaclene A; Morris, Diana L

    2011-01-01

    This pilot clinical trial tested effectiveness of a poetry writing intervention for family caregivers of elders with dementia. This paper presents findings from a larger study using mixed methods to examine outcome variables of self-transcendence, resilience, depressive symptoms, and subjective caregiver burden. Findings reported here focus on qualitative analysis of in-depth interviews conducted with participants following their poetry writing experience. A grounded theory approach was used. Themes that arose from the data support a mid-range theory of self-affirmation in caregivers with subthemes of achievement, catharsis, greater acceptance, empathy, self-awareness, reflection, creative and fun, positive challenge, and helping others.

  20. Can family caregivers of terminally ill patients be a reliable source of information about the severity of patient symptoms?

    PubMed

    Resnizky, Shirli; Bentur, Netta

    This study examines the reliability of family caregivers' assessments of a terminally ill patient's symptoms and identifies patient and caregiver characteristics that affect the reliability of caregiver reports. It compares the reports of 143 patients in home hospice units with those of their family caregiver about patient symptoms during the 3 days preceding the interview (Edmonton scale). Correlation coefficients between the patients' and proxies' reports were 0.5 to 0.8, indicating moderate-to-high agreement. Characteristics that had an independent effect on identical reporting were the patient being fully disabled, the care-giver being a woman in good health, the caregiver living with the patient, and the caregiver providing assistance with activities of daily living and medical care. These results suggest that primary caregivers can be a good source of information about a patient's symptoms, although their reports should be used with caution.

  1. Seeking harmony in the provision of care to the stroke-impaired: views of Chinese family caregivers.

    PubMed

    Lee, Regina L T; Mok, Esther S B

    2011-05-01

    To explore the coping strategies of Chinese family caregivers of stroke-impaired older relatives. Many stroke-impaired patients rely heavily on support from their families, and the daily lives of such family caregivers are severely impacted. However, services and support for family caregivers of stroke-impaired relatives in the home setting have received little attention. Appropriate and relevant information and support to family caregivers are important in facilitating the care-giving task. It is, therefore, necessary to understand the nature and demands of care-giving before planning specific educational and support programmes. Grounded theory. Fifteen Chinese family caregivers of stroke-impaired older relatives were recruited and interviewed in 2003 and 2004. Theoretical sampling and constant comparative analysis were used to recruit the sample and perform data analysis. Seeking harmony to provide care for the stroke-impaired was the core category for describing and guiding the family care-giving process, with five main stages: (1) living with ambiguity, (2) monitoring the recovery progress, (3) accepting the downfalls, (4) meeting family obligations and (5) reconciling with harmony. These issues were seldom discussed openly with health professionals. The findings indicated that Chinese family caregivers determine their own needs by seeking harmony to continue to provide care without thinking about getting help from others or their own health problems. These findings help to define some of the complex dynamics that have an impact on the development of partnership care and might challenge nurses practising in the community. Community nurses should assess and understand the coping strategies of family caregivers and assist them to engage in stress-reducing practices. This is an important partnership to be formed in stroke care for family caregivers in the community. The study findings will guide further development of family care-giving aspects in nursing practice

  2. The crisis of stroke: experiences of patients and their family caregivers.

    PubMed

    Lutz, Barbara J; Young, Mary Ellen; Cox, Kim J; Martz, Crystal; Creasy, Kerry Rae

    2011-01-01

    Approximately 4.8 million stroke survivors are living in the community with some level of disability requiring the assistance of family caregivers. Stroke family caregivers are often unprepared for the demands required of them. The purpose of this grounded theory study was to explore the needs of stroke patients and their family caregivers as they transitioned through the stroke care continuum from acute care to inpatient rehabilitation to home. Thirty-eight participants, 19 recovering stroke patients (11 male, 8 female), 15 primary family caregivers (14 spouses, 1 mother), and 4 adult children were interviewed during their stay at a rehabilitation facility and within 6 months of discharge. Interview questions were loosely structured and focused on the stroke experience and how patients and caregivers were managing postdischarge. Data were analyzed using dimensional and comparative analysis. Findings were organized in a conceptual framework illustrating the trajectory of the crisis of stroke. Stroke survivors and their caregivers faced enormous challenges as they moved through 3 phases of the trajectory: the stroke crisis, expectations for recovery, and the crisis of discharge. Findings from this study suggest that as caregivers move through the phases of the trajectory, they do not have a good understanding of the role to which they are committing, and they are often underprepared to take on even the basic tasks to meet the patients' needs on discharge. Stroke survivors and their caregivers do not have adequate time to deal with the shock and crisis of the stroke event, let al.one the crisis of discharge and all of the new responsibilities with which they must deal.

  3. The Crisis of Stroke: Experiences of Patients and Their Family Caregivers

    PubMed Central

    Lutz, Barbara J.; Young, Mary Ellen; Cox, Kim J.; Martz, Crystal; Creasy, Kerry Rae

    2013-01-01

    Purpose Approximately 4.8 million stroke survivors are living in the community with some level of disability requiring the assistance of family caregivers. Stroke family caregivers are often unprepared for the demands required of them. The purpose of this grounded theory study was to explore the needs of stroke patients and their family caregivers as they transitioned through the stroke care continuum from acute care to inpatient rehabilitation to home. Methods Thirty-eight participants, 19 recovering stroke patients (11 male, 8 female), 15 primary family caregivers (14 spouses, 1 mother), and 4 adult children were interviewed during their stay at a rehabilitation facility and within 6 months of discharge. Interview questions were loosely structured and focused on the stroke experience and how patients and caregivers were managing postdischarge. Data were analyzed using dimensional and comparative analysis. Results Findings were organized in a conceptual framework illustrating the trajectory of the crisis of stroke. Stroke survivors and their caregivers faced enormous challenges as they moved through 3 phases of the trajectory: the stroke crisis, expectations for recovery, and the crisis of discharge. Findings from this study suggest that as caregivers move through the phases of the trajectory, they do not have a good understanding of the role to which they are committing, and they are often underprepared to take on even the basic tasks to meet the patients’ needs on discharge. Conclusion Stroke survivors and their caregivers do not have adequate time to deal with the shock and crisis of the stroke event, let alone the crisis of discharge and all of the new responsibilities with which they must deal. PMID:22436315

  4. Effectiveness of family meetings for family caregivers on delaying time to nursing home placement of dementia patients: a randomized trial.

    PubMed

    Joling, Karlijn J; van Marwijk, Harm W J; van der Horst, Henriëtte E; Scheltens, Philip; van de Ven, Peter M; Appels, Bregje A; van Hout, Hein P J

    2012-01-01

    Interventions relieving the burden of caregiving may postpone or prevent patient institutionalization. The objective of this study was to determine whether a family meetings intervention was superior to usual care in postponing nursing home placement of patients with dementia. A randomized multicenter trial was conducted among 192 patients with a clinical diagnosis of dementia living at home at enrolment and their primary family caregiver. Dyads of caregivers and patients were randomized to the family meetings intervention (n = 96) or usual care (n = 96) condition. The intervention consisted of two individual sessions with the primary caregiver and four family counseling sessions that included family members and friends. The primary outcome measure was the time until institutionalization of the patient. Intention-to-treat as well as per protocol analyses were performed. Survival analyses were carried out to evaluate the effectiveness of the intervention. During 18 months follow-up 23 of 96 relatives with dementia of caregivers in the intervention group and 18 of 96 relatives with dementia of caregivers in the usual care group were institutionalized. No significant difference between the intervention and the usual care group was found in time until institutionalization (adjusted hazard ratio (HR) 1.46, 95% confidence interval (CI) 0.78 to 2.74). The per-protocol analysis revealed no significant effect either (adjusted HR 0.57, 95% CI 0.21 to 1.57), although the number of placements among the adherers was relatively low (9.4%). A subgroup effect was found for patients' age, with a significantly higher risk of institutionalization for 'younger' patients in the intervention group compared with the usual care group (adjusted HR = 4.94, 95% CI 1.10 to 22.13). This family meetings intervention for primary caregivers of patients with dementia did not postpone patient institutionalization more than usual care. CONTROLLED-TRIALS.COM ISRCTN90163486.

  5. Effectiveness of Family Meetings for Family Caregivers on Delaying Time to Nursing Home Placement of Dementia Patients: A Randomized Trial

    PubMed Central

    Joling, Karlijn J.; van Marwijk, Harm W. J.; van der Horst, Henriëtte E.; Scheltens, Philip; van de Ven, Peter M.; Appels, Bregje A.; van Hout, Hein P. J.

    2012-01-01

    Background Interventions relieving the burden of caregiving may postpone or prevent patient institutionalization. The objective of this study was to determine whether a family meetings intervention was superior to usual care in postponing nursing home placement of patients with dementia. Methods A randomized multicenter trial was conducted among 192 patients with a clinical diagnosis of dementia living at home at enrolment and their primary family caregiver. Dyads of caregivers and patients were randomized to the family meetings intervention (n = 96) or usual care (n = 96) condition. The intervention consisted of two individual sessions with the primary caregiver and four family counseling sessions that included family members and friends. The primary outcome measure was the time until institutionalization of the patient. Intention-to-treat as well as per protocol analyses were performed. Survival analyses were carried out to evaluate the effectiveness of the intervention. Results During 18 months follow-up 23 of 96 relatives with dementia of caregivers in the intervention group and 18 of 96 relatives with dementia of caregivers in the usual care group were institutionalized. No significant difference between the intervention and the usual care group was found in time until institutionalization (adjusted hazard ratio (HR) 1.46, 95% confidence interval (CI) 0.78 to 2.74). The per-protocol analysis revealed no significant effect either (adjusted HR 0.57, 95% CI 0.21 to 1.57), although the number of placements among the adherers was relatively low (9.4%). A subgroup effect was found for patients’ age, with a significantly higher risk of institutionalization for ‘younger’ patients in the intervention group compared with the usual care group (adjusted HR = 4.94, 95% CI 1.10 to 22.13). Conclusion This family meetings intervention for primary caregivers of patients with dementia did not postpone patient institutionalization more than usual care. Trial

  6. Educating the next generation of family caregivers through the use of dynamic case studies.

    PubMed

    Jenkins, Carol L; Schwartz, Abby J

    2017-04-17

    Between 2008 and 2016, students in an Introduction to Gerontology course were required to complete a dynamic case study project simulating caregiving arrangement decision making. Students were divided into groups representing typical multigenerational families and were required to determine how to develop caregiving arrangements to respond to an older family member' s changing levels of need. The assignment concluded with students writing a final paper summarizing what they learned. This study examined the themes emerging from student group case study papers to gain an understanding of the challenges students face in understanding the dynamics of making family-based caregiving decisions. This is of particular importance as many students were seeking careers in human services and would be assisting clients in such decision-making processes, as well as involvement in decision making for their own family members. Themes that emerged from group papers and the implications related to gerontology education and policy are discussed.

  7. Educational needs of family caregivers of persons living with HIV/AIDS in Thailand.

    PubMed

    Maneesriwongul, Wantana; Panutat, Suntharee; Putwatana, Panwadee; Srirapo-ngam, Yupapin; Ounprasertpong, Ladawan; Williams, Ann B

    2004-01-01

    As the AIDS epidemic continues to overwhelm the acute care hospital system in Thailand, an increasing number of family members are required to provide care for persons living with AIDS (PLWA) in their homes. In response to the increasing demand for home care, a qualitative study using focus group methodology was conducted to learn more about the need for education and support for family caregivers of PLWA in Thailand. Eighteen family caregivers and 18 nurses caring for PLWA participated in four focus group discussions. The major themes identified were fear, stigma, sorrow, empathy, hopelessness, and hope. In addition, participants voiced a need for education to improve the knowledge and skills related to care of PLWA. These findings will be used to guide the development of a training program for family caregivers.

  8. Workplace characteristics and work-to-family conflict: does caregiving frequency matter?

    PubMed

    Brown, Melissa; Pitt-Catsouphes, Marcie

    2013-01-01

    Many workers can expect to provide care to an elder relative at some point during their tenure in the workforce. This study extends previous research by exploring whether caregiving frequency (providing care on a regular, weekly basis vs. intermittently) moderates the relationship between certain workplace characteristics and work-to-family conflict. Utilizing a sample of 465 respondents from the National Study of the Changing Workforce (Families and Work Institute, 2008), results indicate that access to workplace flexibility has a stronger effect on reducing work-to-family conflict among intermittent caregivers than among those who provide care regularly.

  9. Exploring the experience of residents during the first six months of family medicine residency training

    PubMed Central

    Martin, Dawn; Nasmith, Louise; Takahashi, Susan Glover; Harvey, Bart J.

    2017-01-01

    Background The shift from undergraduate to postgraduate education signals a new phase in a doctor’s training. This study explored the resident’s perspective of how the transition from undergraduate to postgraduate (PGME) training is experienced in a Family Medicine program as they first meet the reality of feeling and having the responsibility as a doctor. Methods Qualitative methods explored resident experiences using interpretative inquiry through monthly, individual in-depth interviews with five incoming residents during the first six months of training. Focus groups were also held with residents at various stages of training to gather their reflection about their experience of the first six months. Residents were asked to describe their initial concerns, changes that occurred and the influences they attributed to those changes. Results Residents do not begin a Family Medicine PGME program knowing what it means to be a Family Physician, but learn what it means to fulfill this role. This process involves adjusting to significant shifts in responsibility in the areas of Knowledge, Practice Management, and Relationships as they become more responsible for care outcomes. Conclusion This study illuminated the resident perspective of how the transition is experienced. This will assist medical educators to better understand the early training experiences of residents, how these experiences contribute to consolidating their new professional identity, and how to better align teaching strategies with resident learning needs. PMID:28344713