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Part 1 of this paper explored the premise that a role predicament of caring exists within family caregiving relationships. It was argued that dysfunctional patterns of communication develop in family caregiving relationships not only in response to stereotypical expectations about older people but also in response to stereotypical expectations of both caregiver and carereceiver concerning their role in the caregiving relationship. The argument was grounded in data contained within a large comprehensive study of older people and their family caregivers. This paper builds on the earlier contention and holds that more productive and effective forms of communication and caregiving relationships can be promoted through modification of role expectations and behaviours. The Health Promoting Communication Model is introduced and proposed as an appropriate framework for guiding both prevention and intervention strategies for health promoting communication in family caregiving.

Within the context of a research program on the most relevant discourse types in chronic care medical encounters, this contribution reports on a qualitative study on the role caregivers play within the process of shared understanding occurring between health-care professionals and elderly patients. The purpose of the paper is to highlight one dimension of such complexity, by bringing to light the challenges connected to the achievement of shared understanding between health-care professionals and elderly patients when caregivers are involved in the conversation.

The paper reports on a two-step analysis of a corpus of transcripts of interactions in diabetes and hypertension settings. In the first step, caregivers’ contributions to deliberative sequences have been analyzed. In the second step, the analysis was extended to caregivers’ contributions to the whole encounter.

The results show that professionals’ ability to engage caregivers in deliberations during the encounter and, more generally, to assign a role to caregivers as legitimate participants in the consultation may favor the smooth development of the interaction and an effective process of shared understanding among all participants.

The paper further develops original research about the functions of the argumentative component in dialogues occurring in clinical settings.

Guided by a life course theoretical perspective, this study aimed to examine associations between providing caregiving for a young or adult son or daughter with special needs and multiple dimensions of physical health status among married midlife and older adults, as well as moderation of these associations by gender and marital quality (i.e., marital strain).

Regression models were estimated using data from 1,058 married adults aged 33–83 (National Survey of Midlife in the U.S. (MIDUS), 2005).

Parental caregiving for a young or adult child with special needs (in contrast to no caregiving) was linked to poorer global health and more physical symptoms among both fathers and mothers. Father caregivers reported slightly more chronic conditions than noncaregiving men, regardless of marital quality. By contrast, mother caregivers reported a much higher number of chronic conditions when they also reported a high level of marital strain, but not when they reported a low level of marital strain.

Overall, results provide evidence from a national sample that midlife and older parents providing caregiving for a child with special needs are at risk for poorer health outcomes, and further tentatively suggest that greater marital strain may exacerbate health risks, particularly among married mother caregivers.

Advanced medical technology has reduced the mortality rate among traumatic brain injury (TBI) patients. This, however, has led to an increasing number of surviving patients with a major disability. As a consequence, these patients need attentive care which becomes an important issue for the society, particularly family members. Thus, this paper aims to review some of the salient roles, challenges and needs of the family caregivers in caring or nursing for their family members diagnosed with TBI.

An inclusive search of the literature was undertaken to identify the family roles, challenges and needs in supporting and nursing TBI patients.

Previous studies have shown that the family needs to address two important aspects of taking care of TBI patients, which involve emotional and physical affairs. Hence, it is essential for the family members to have adequate information on healing treatment, nursing and care methods, financial support, support groups, managing self-care and, more importantly, emotional and social support.

This paper is not currently under consideration, in press or published elsewhere. In Malaysian culture, nursing disabled patients have always been a family responsibility. The role of nursing the patients has been done domestically and is considered a private affair. In order to execute the role, some put the patient needs as their priority and leave aside their needs and matters.

Family members provide the bulk of care to persons in later life, representing the vast majority of caregivers. However, studies confirm that men with a history of divorce are less likely than married men to view family members as potential caregivers. This chapter presents findings from a qualitative study on the experiences of 21 ex-wives who chose to provide mostly end-of-life care to their ex-husbands in mid- and late-life. We examine questions about the situational and motivating factors behind ex-wife caregivers’ decisions, and provide, as background, findings about their pre- and post-divorce relationships. Relational outcomes of the caregiving situation also are considered. Several themes emerge, including patterns of proximity and continued contact post-divorce, despite often chaotic former marital relationships; a desire to spare children from the burdens of care; and an opportunity to renew communication or connections with family through the process of caregiving. Implications of our findings include the need to acknowledge ex-spouses as potential caregivers and better understand the enduring bonds between ex-spouses.

This study aims to examine how health-care managers in acute care and post-acute care facilities support and plan to improve transitional care for cardiac patients and their family caregivers, to better manage care in the home.

A qualitative descriptive approach, guided by appreciative inquiry was used in this study. A purposive sample of 16 participants were engaged in the study. Participants completed a demographic questionnaire, the caregiver policy lens questionnaire and participated in one of four focus group interviews. The semi-structured focus group interviews were audio-recorded and analyzed using thematic analysis.

Using Donabedian’s framework, six major themes contributed to how health-care managers can improve transitional care: structure included supporting personnel and continuing education; process included enacting approaches of care, coordinating care among the health-care team and calling to work upstream; and outcomes included needing to clarify expectations of home care services and witnessing the impact of the caregiver role.

These findings demonstrate the importance of Donabedian’s core dimensions of structure and processes in influencing caregiver outcomes. These results emphasize the central role of the manager in influencing system change to improve transitional care.

This study aims to examine the psycho-emotional and social experiences of caregivers of children with autism spectrum disorder. Various facets of the caregiving experience are explored, including the feelings and thoughts of the parents/caregivers, such as the resilience experienced in their journey, how they coped with the challenges and also their positive experiences.

In this study, these aspects of the caregiving experience are broadly probed using semi-structured interviews subjected to narrative analysis. Lastly, there is a focus on the role of therapist-led intervention, specifically, the Eye to I^© intervention model and its contributions to the parent/caregiver experience.

Findings from this study indicate that parents benefit from interventions that bridge gaps in skills and interpersonal communication which parents/caregivers feel they encounter in their day-to-day activities. Additionally, support groups for parents and caregivers could further address these issues.

This exploration reveals insights about the roles of societal structures and the caregiving journey.

This paper contends that dysfunctional patterns of communication can develop in family aged care dyads in response to stereotypical role expectations in the caregiving‐carereceiving relationship, thus giving rise to a role predicament of caring. If this argument holds it follows that more productive and effective forms of communication and relationship are dependent upon both members of the aged care dyad understanding the expectations of their role and if necessary reconstructing them. Part 1 of this two part conceptual paper develops the Communication Predicament of Ageing Model to include role expectations. The conceptions are grounded in important conclusions drawn from data contained in a large comprehensive study of older people and their family caregivers. Part 2 of the paper (to be published in the next issue of Quality in Ageing) introduces the health promoting communication model which was developed as a framework for guiding both prevention and intervention strategies to prevent or transform a role predicament of caring.

Dementia is characterized by the progressive decline in cognitive and daily functioning. Although the decline is often the defining characteristic of dementia in biomedical models, several scholars highlight the preserved skills of persons with dementia. Identity, or a sense of self, is among the areas relatively preserved in the later stages of dementia. It is the window through which caregivers understand the subjective experiences of persons with dementia.

This qualitative exploratory study highlights the value of social relationships, particularly the role of the Filipino family in recognizing personhood and maintaining identity in dementia care. Preserving identity entails understanding the person’s unique characteristics that reflect one’s sense of self. In a highly collectivistic culture, such as the Philippines, the family is crucial to preserving identity and overall well-being in dementia. This study explores the perspectives of 15 Filipino caregivers as regards caring for a family member with dementia. Participants discuss changes in family structure and the challenges in dementia care. More importantly, they delve into strategies used to preserve identity and encourage life participation in their loved one with dementia. Essential Filipino cultural values in dementia care, such as collectivism, religion, and the values of filial piety and utang na loob (or debt of gratitude) are further discussed.

The population is aging. The desire to remain in one’s own home through the aging process appears universal. Home health caregivers provide a vital role in allowing people to age in place. Women, and in particular immigrant women, have become the face of home health caregivers. Caregiving is generational. Paid caregiving is viewed as a natural extension of a skill set women have used most of their adult life. Home health caregivers view their work as a continuation of their roles in the family and they often frame their work as providing services that family members cannot, or will not perform. Reimbursement for these services is problematic. Assigning a monetary value to caregiving seems callous, and as a result caregivers are underpaid and undervalued. Global push–pull factors and the creation of a gray economy also contribute to a devaluation of these jobs. Caregivers themselves are poor advocates for better pay and working conditions because they believe it commodifies a kinship like experience. The future of caregiving is problematic. Poor countries will suffer greatly exporting their women; rich countries will need a tremendous number of caregivers to match their demographics and women will be overwhelmed providing care for others and themselves.