Caregiving - PowerPoint PPT Presentation

1 / 22
About This Presentation
Title:

Caregiving

Description:

Whites use more approach coping (Knight et al., 2000; Haley et al, 1996) ... and cognitive coping than rural AA or white caregivers (Wood & Parham, 1990) ... – PowerPoint PPT presentation

Number of Views:64
Avg rating:3.0/5.0
Slides: 23
Provided by: rebeccaal
Category:
Tags: caregiving

less

Transcript and Presenter's Notes

Title: Caregiving


1
Caregiving
  • Lecture 12/1/04

2
Caregiving Statistics
  • About 64 of older persons living in the
    community and in need of long-term care depend on
    informal caregivers (family and friends).
  • Caring for a person with dementia has a negative
    impact on the caregivers psychological and
    physical health, social life and career, and
    relationships with the care recipient.

3
Spousal Caregivers
  • More likely to be women than men.
  • Likely to have played traditional gender roles
    and to report taking over tasks previously
    carried out by their ill spouse.
  • Female spousal caregivers report that they
    curtail their other activities such as spending
    time with friends and family members more than
    male spousal caregivers (42.6 vs. 21).
  • Female spousal caregivers are more likely to
    report receiving no help at all and to report
    dissatisfaction with received assistance.

4
Family Assistance Provided to Spousal Caregivers
  • Assistance provided to spousal caregivers by
    adult children depends on whether the mother or
    father is the spousal caregiver, with more
    assistance provided to fathers caring for ill
    mothers.
  • More male spousal caregivers receive help from
    siblings than do female spousal caregivers.

5
Paid Assistance Provided to Spousal Caregivers
  • No gender difference in use of formal support
  • Male spousal caregivers report the CR receives
    enough support from family and friends
  • Female spousal caregivers report the CR does not
    need additional help
  • Male spousal caregivers are more likely than
    female spousal caregivers to pay others to cook
    or perform housekeeping tasks.

6
Caregiving Gender and Mental Health
  • In comparison with male spousal caregivers,
    female spousal caregivers report
  • Greater dissatisfaction with received social
    support
  • More feelings of isolation
  • Lack of sleep and privacy
  • More feelings of embarrassment and rejection by
    their ill spouse

7
Adult Child Caregivers
  • Due to the developmental stage / social roles of
    adult children, caregiving can have a greater
    impact on their lifestyle than on that of spousal
    caregivers.
  • More likely to be employed
  • More likely to be caring for children
  • Adult-child caregivers are more likely than
    spousal caregivers to report role captivity in
    caregiving.
  • Adult-child caregivers may also be long-distance
    caregivers.

8
Statistics RE Aging and Ethnicity
  • US Census Data 2000 reports that the US elderly
    population increased from 5 in 1930 to 13 in
    1990, with projected increase to 20 of the total
    US population by 2050.
  • The percentage of racial and ethnic minority
    elders will increase at a much higher rate than
    that of non-Hispanic white elders over the next
    50 years.
  • The prevalence of severe functional impairments
    among minority elderly is higher than among their
    white counterparts (SES, access, life-context
    issues).

9
Race and Caregiving1980 through 2000
  • Not limited to dementia, though dementia
    predominates caregiving research.
  • Parameters of inclusion (N 59 studies)
  • Published in refereed professional journals
  • Focus on informal caregiving of dependent elderly
    people with race, ethnicity or culture as a
    primary focus
  • Parameters of exclusion
  • Race used only as a control variable
  • Caregiving of institutionalized elderly
  • Only care recipient views were reported
  • Most data available for white and AA caregivers.

10
Race and Caregiving1980 through 2000 Part II
  • Four domains of research with at least 10
    published articles regarding the topic
  • Social support study n 32
  • Negative effects of caregiving study n 29
  • Coping with caregiving stress study n 13
  • Cultural effects on caregiving study n 20

11
Race and Caregiving1980 through 2000 Part III
  • Social support study n 32
  • 14 theoretical 18 atheoretical studies
  • Stress and coping models predominate
  • 11 comparisons of AA and white
  • Ethnic minority elders have more diverse informal
    support networks
  • Ethnic minority elders use informal support
    networks similarly in comparison with whites
  • Ethnic minority elders use formal services less
    than nonminority caregivers

12
Race and Caregiving1980 through 2000 Part IV
  • Negative effects of caregiving study n 29
  • In the rare cases where theory-driven research
    was conducted, stress process models predominate
  • Regarding depression, 6 studies report no
    difference between AA and white caregivers
    (mostly small samples) 4 studies report that
    white caregivers are significantly more depressed
    than AA.

13
Race and Caregiving1980 through 2000 Part IV
(cont)
  • More on race and caregiver depression
  • In one study, the relationships among depression,
    positive reappraisal, and heart rate reactivity
    were found to operate differently for AA and
    white caregivers (Knight McCallum, 1998)
  • Positive reappraisal may increase stress among
    whites while decreasing stress among AAs.
  • The relationship between race and depression may
    be mediated by stress and coping appraisals
    (Haley et al 1996)

14
Race and Caregiving1980 through 2000 Part IV
(cont)
  • Race and caregiver burden
  • Five studies found white caregivers reported
    significantly higher burden than AAs 4 studies
    found no difference
  • Lack of consideration of the relationship of
    culture and caregiver burden (personal and family
    hx, sociopolitical factors)

15
Race and Caregiving1980 through 2000 Part IV
(cont)
  • Race and caregiver role strain (4 studies)
  • Hispanic caregivers reported higher role strain
    and personal strain than AA caregivers (Cox
    Monk, 1996).
  • Best predictors of role strain include being
    white, having greater behavioral bother and task
    distress, and higher CR (spouse) ADL need (Farran
    et al 1997 ).
  • Lower levels of provisional and ultimate meaning
    for white vs AA caregivers provisional meaning
    decreases depression and role strain (Farran et
    al 1997).
  • As caregiving mastery decreases, role strain
    increases (Miller et al., 1995).
  • Role conflict, respite, and care relationship
    effects differ between white and AA caregivers
    (Mui, 1992).

16
Race and Caregiving1980 through 2000 Part IV
(cont)
  • Race and caregiver relationship strain (1 study)
  • No differences between white and AA caregivers,
    but levels are high (Cox, 1993).

17
Race and Caregiving1980 through 2000 Part IV
(cont)
  • Race and caregiver psychological distress (3
    studies)
  • Distressed AA caregivers reported being less
    satisfied with SS, greater role strain, poorer
    health, and less mastery (Dilworth-Anderson et
    al., 1999).
  • AA caregivers report lower distress and appraised
    caregiving more favorably than whites (Farran et
    al., 1997).

18
Race and Caregiving1980 through 2000 Part V
  • Coping with caregiving stress study n 13
  • Primarily theoretical with predominance of the
    stress and coping model.
  • AA caregivers using more emotion-focused coping
    (including Escape-Avoidance) than whites. Whites
    use more approach coping (Knight et al., 2000
    Haley et al, 1996).
  • Quality of SS may predict confrontive coping,
    appraisals of perceived rewards may predict
    palliative coping, and appraisals of perceived
    costs may predict emotive coping (Picot, 1995).
  • Urban AA caregivers use more behavioral and
    cognitive coping than rural AA or white
    caregivers (Wood Parham, 1990).

19
Race and Caregiving1980 through 2000 Part V
(cont)
  • Coping with caregiving stress study n 13
  • AA caregivers cope with difficulties of
    caregiving with prayer, faith in God, and
    religion.

20
Race and Caregiving1980 through 2000 Part VI
  • Cultural effects on caregiving study n 20
  • Little attention given to defining culture from a
    sociohistorical perspective.
  • Most researchers found cultural groups have
    values about reciprocity, filial obligation, and
    a sense of responsibility for caring for older
    family members.
  • Cultural perceptions about illness and disease
    shape the meanings groups assign to a dependent
    OAs illness.

21
Race and Caregiving Research Needs
  • Need to measure culture directly and not rely on
    race as a proxy measure.
  • Need more studies on additional ethnic minorities
    and to break whites down into ethnic groups.
  • Need to make stress process models more
    culturally relevant.

22
General Caregiving Research Needs
  • Need to incorporate noncaregiving comparison
    groups.
  • Need to use similar measures in probability
    samples and make multivariate not bivariate
    comparisons.
  • Need for mixed method studies.
  • Need to investigate positive caregiving outcomes.
  • Need to investigate gender.
Write a Comment
User Comments (0)
About PowerShow.com