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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.

To conduct an exploratory mixed-methods study of attitudes toward extramarital relationships in the context of spousal Alzheimer’s disease.

We present descriptive analyses of quantitative data from the National Social, Health, and Aging Project and of qualitative comments posted online by readers of newspaper articles that focus on extramarital relationships in the context of caring for a spouse with Alzheimer’s disease.

Analyses of the quantitative data indicate the Alzheimer’s caregivers report more negative attitudes toward extramarital sex in the context of spousal Alzheimer’s disease. However, this difference is driven by non-spousal caregivers’ attitudes; spousal caregivers have substantially less negative attitudes. Analyses of public comments suggest that those who are most negative are focused on traditional religious and family values. Those who express less negative attitudes espouse a compassionate pragmatism that makes allowances for caregiver needs in the context of managing the difficulties of the spouse-caregiver role.

Quantitative data are limited by the small number of Alzheimer’s caregivers; qualitative analyses are based on a convenience sample of online comments.

Findings can inform future research, educational initiatives for professionals, the media, and people living with Alzheimer’s disease and their family members.

The number of individuals living with Alzheimer’s disease and spousal caregivers will increase as the Baby Boomer generation ages. Norms regarding extramarital relationships in the context of caring for a spouse with Alzheimer’s disease are evolving.

Little social scientific research examines attitudes toward extramarital relationships in the context of spousal Alzheimer’s disease.

Preferences of both Alzheimer patients and their spouse caregivers are related to a willingness-to-pay (WTP) measure which is used to test for the presence of mutual (rather than conventional unilateral) altruism.

Contingent valuation experiments were conducted in 2000–2002, involving 126 Alzheimer patients and their caregiving spouses living in the Zurich metropolitan area (Switzerland). WTP values for three hypothetical treatments of the demented patient were elicited. The treatment Stabilization prevents the worsening of the disease, bringing dementia to a standstill. Cure restores patient health to its original level. In No burden, dementia takes its normal course while caregiver’s burden is reduced to its level before the disease.

The three different types of therapies are reflected in different WTP values of both caregivers and patients, suggesting that moderate levels of Alzheimer’s disease still permit clear expression of preference. According to the WTP values found, patients do not rank Cure higher than No burden, implying that their preferences are entirely altruistic. Caregiving spouses rank Cure before Burden, reflecting less than perfect altruism which accounts for some 40 percent of their total WTP. Still, this constitutes evidence of mutual altruism.

The evidence suggests that WTP values reflect individuals’ preferences even in Alzheimer patients. The estimates suggest that an economically successful treatment should provide relief to caregivers, with its curative benefits being of secondary importance.

Few studies have been conducted into the contextual and relational aspects of male caregiving that include analysis by gender and family relationships. The aim was to gain understanding of the experience of older men as caregivers for an ill spouse. A narrative approach was adopted for this study. Interviews were conducted with three older men between 65 and 78 years, who had been caring for their wives for between one and 12 years. Two main categories emerged: taking on a new and unfamiliar role, and learning to live with the new role. The results also show how the men seek to maintain continuity in their relationships with the wives they are caring for. The findings can be understood in the light of a major life transition of how older men providing care for a spouse create new roles and how they cope with the changes in the marital relationship. A sense of continuity in the process of caring is important for men to help them find the strength to continue as caregivers.

The purpose of this study is to examine inter‐generational arrangements in Thailand for personal care provided to older members and provided by them as grandparents to young children.

Results are based on analysis of the 2007 Survey of Older Persons in Thailand. Consideration focuses on persons aged 60 and older.

The results document the primary role of the family, especially adult children and spouses, in providing personal care to older members. For those with only one or two adult children compared to those with four or more, spouses are considerably more likely and children less likely to be the main care provider. At the same time, older family members, as grandparents, make significant contributions to the care of young children, especially for those whose parents migrated. In most such situations, however, the grandchild's parents cover the main financial support.

Trends towards smaller family size and increased migration of adult children have already contributed to a steady decline in coresidence with adult children and increased proportions of older persons living alone or only with a spouse. How this will affect elder and grandchild care requires careful monitoring to guide social policy in relation to the roles of family, state, and voluntary sector.

The availability of representative data on the older population in Thailand provides an unusual opportunity to highlight the challenges posed by the changing demographic context of inter‐generational family care in a context of rapid population ageing in a developing country setting.

The purpose of this paper is to describe family caregivers’ experiences of providing care for older people with a tracheostomy during hospitalization.

A descriptive phenomenological approach was used in this study. A total of 40 family caregivers were interviewed face-to-face in medical-surgical wards. Data was analyzed using Giorgi’s phenomenological method.

Family caregivers described meanings of providing care, learning how to provide care, caring activities, impacts of caregiving, support needs and qualities of being a caregiver. Meanings included filial responsibility, spousal attachment and end of life care. Caring activities were varied. Impacts experienced were reported as physical, psychological, social and financial. Caregivers expressed the need for information from the nursing team and assistance from their relatives. Positive caregiver qualities that were described included loving to provide care for older people and confidence and sincerity in caregiving.

Although caring for older people with a tracheostomy was difficult and came with challenging impacts, family caregivers were willing to support their loved ones due to feelings of family responsibility.

The paper addresses family participation in providing care for people with a tracheostomy. They experience physical, psychological, social and financial consequences of caregiving. Therefore, health-care professionals should support family caregivers with education, training and awareness of supports and resources for dealing with problematic impacts and other expressed needs.

This study examined factors associated with depression in 125 informal caregivers to adults living with HIV/AIDS in Lomé, Togo.

Each caregiver completed a questionnaire that assessed primary and secondary stressors, social support and depression. Most of the participants were women (78 per cent), married (53 per cent), and had been giving care to nuclear family members (63 per cent) for about 11 months. OLS regression was used to examine the association of primary and secondary stressors with self‐reported depression.

The analysis showed that caregiving demand, role captivity, and job conflict were positively associated with self‐reported depression. This suggests that work‐related strains and role strains were associated with depression levels among caregivers in our sample.

The study is based on a small convenience sample of volunteers and this may limit the generalisability of the results.

This knowledge can benefit HIV/AIDS service providers in counselling caregivers who need to maintain a healthy quality of life and well‐being for their difficult and challenging task.

This paper contributes to knowledge on caregiving role to people with chronic illnesses by incorporating an understudied population into the knowledge base.

The purpose of this paper is to explore the linkage between nurses' levels of optimism and performance outcomes.

The study sample consisted of 78 nurses in all areas of a large healthcare facility (hospital) in the Midwestern United States. The participants completed surveys to determine their current state of optimism. Supervisory performance appraisal data were gathered in order to measure performance outcomes. Spearman correlations and a one‐way ANOVA were used to analyze the data.

The results indicated a highly significant positive relationship between the nurses' measured state of optimism and their supervisors' ratings of their commitment to the mission of the hospital, a measure of contribution to increasing customer satisfaction, and an overall measure of work performance.

This was an exploratory study. Larger sample sizes and longitudinal data would be beneficial because it is probable that state optimism levels will vary and that it might be more accurate to measure state optimism at several points over time in order to better predict performance outcomes. Finally, the study design does not imply causation.

Suggestions for effectively developing and managing nurses' optimism to positively impact their performance are provided.

To date, there has been very little empirical evidence assessing the impact that positive psychological capacities such as optimism of key healthcare professionals may have on performance. This paper was designed to help begin to fill this void by examining the relationship between nurses' self‐reported optimism and their supervisors' evaluations of their performance.

The purpose of this study is to gain a deeper understanding of female spouses’ lived experiences of changes in everyday life while living with a husband with dementia.

Nine individual interviews of female spouses were conducted in 2017. A phenomenological narrative approach was applied during data collection, and the analysis was inspired by Amedeo Giorgi’s analytic steps.

Female spouses experienced changes in their marital relationships, and found ways of managing these changes, although they realized life was marked by loneliness and distress. The identified themes reveal how female spouses experienced changes in everyday life as the disease progressed. Everyday routines gradually changed and they actively sought ways to uphold everyday life and a marital relationship.

Research should focus on developing supportive interventions, where the people with the lived experiences in relation to dementia are involved in the research process, to better target the needs for support, when developing interventions.

Insight into everyday life can help health-care service providers to better the support to female spouses and contribute with more individualized support, which may contribute to the quality of care.

In this study, the authors disclose the invisible and silent work that takes place in an everyday life, when living with a husband with dementia during the time span of caregiving. Spouses’ experiences are important to include, when developing intervention to support spouses to better tailor the interventions.

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.