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PubMed2000

Social support for spouse caregivers of persons with dementia.

OBJECTIVES: This study analyzes the value of simultaneously taking helper and caregiver characteristics into account when examining social support received by spouse caregivers of persons with dementia. This study questions whether sources and types of received support vary by the gender and relationship of the helper and/or by the caregiver's race and gender. METHODS: Drawing on a sample of 210 spouse caregivers of persons with dementia, the Generalized Estimating Equation (GEE) method was used to estimate a population-average logistic regression model to address cross-level helper and caregiver interactions. RESULTS: Results indicate that helper and caregiver characteristics interact in complex ways. White male caregivers are more likely to receive emotional support from adult children and to receive practical assistance from formal sources compared with other types of support and to other race-gender caregiver groups. DISCUSSION: Description of social status characteristics of caregivers as determinants of their social network may be less fruitful in understanding the benefits of social support than a focus on which helpers assist with what kinds of task for which groups of caregivers.

Activities of Daily Living↗
PubMed1981

The effects of intra-individual and inter-spouse status inconsistency on life satisfaction among older persons.

Inter-spouse status inconsistencies have been largely ignored in gerontological literature related to life satisfaction. To test a series of hypotheses linking intra- and inter-spouse status inconsistency with life satisfaction, a sample of 570 married persons over 60 years of age, drawn from the 1975 to 1978 NORC General Social Surveys data, is evaluated by regressing the measures of life satisfaction on the independent variables in hierarchical fashion. The major findings include: (a) similar to past studies, higher status in general is associated with greater life satisfaction, but not all status factors correlated with life satisfaction; (b) differences between life satisfaction scores of those with high status inconsistencies and those with low inconsistencies are noted; however these differences are not statistically significant; (c) different status factors correlate with life satisfaction depending on the older person's involvement in organizations; and, (d) the negative effects of status inconsistency are not stronger among those older persons experiencing recent traumatic events.

Aged↗
PubMed1992

Changes in grief and mental health of bereaved spouses of older suicides.

Comparisons are made of the impact of a suicide death on the surviving spouse (55 years and older) with that of a natural death on spouse survivors and a married nonbereaved control group over a bereavement period of 2 1/2 years after death. Regardless of mode of death, the loss of a loved one is a difficult psychological trauma, accompanied by depression, confusion, and pervasive feelings of emptiness. Few differences in the impact of the deaths in the early months of bereavement were reported, but changes appeared over the course of the 2 1/2-year measurement period. Compared with natural death survivors, the process of bereavement was found to be more difficult for the survivors of a suicide death, whose severe depressive feelings do not seem to lessen significantly and whose feelings of mental health do not seem to improve until after the first year. Women, in general, report greater feelings than men of anxiety, tension, and apprehension, especially within the first 6 months. By the end of the observation period, most of the differences between the two bereaved groups have disappeared, and both report functioning adequately despite continuing feelings of sadness and loss.

Aged↗
PubMed1994

A longitudinal analysis of nursing home placement for dependent elders cared for by spouses vs adult children.

Five-wave panel data from 531 informal caregivers and frail elders were analyzed using an event history framework to identify how changes in the caregiving situation are related to nursing home placement. The results indicate that the predictors of placement differ substantially for elders cared for by spouses vs those cared for by adult children. In addition, the findings suggest dramatically different descriptions of the caregiving role over time for the two groups of caregivers. There were differences not only in the conditions under which caregiving ends, but also apparent differences in when caregiving begins and how it is perceived by the caregiver. Differences in the probability of placement of elders cared for by spouses vs adult children are interpreted within the framework of these contextual differences in the caregiving role.

Adolescent↗
PubMed1994

Personality and coping among caregivers of spouses with dementia.

Personality factors and coping strategies were examined among a sample of spouse caregivers. Fifty spouse caregivers of patients diagnosed with Alzheimer's disease or a related dementia completed the NEO-FFI, a personality inventory designed to measure traits identified in the five-factor trait model, and a revised measure of the Ways of Coping Checklist. Results from a series of multivariate regressions showed that personality traits explained 60% of the variance in emotion-focused coping, 30% of variance in problem-focused coping, and 15% of variance associated with social support coping. Discussion focuses on the usefulness of including personality characteristics of the caregiver in formulating models of the caregiving coping process.

Adaptation, Psychological↗
PubMed1997

Health and well-being of spouse caregivers and the widowed.

The appropriateness of the stress-coping and life transitions models for late life experiences was assessed by examining psychosocial correlates of spouse caregiving in association with widowhood. Data were from the Health Status of Older People (HSOP) survey of 1,000 people aged 65 and over living in the community in Melbourne, Australia. Caregiving was found to be a usual precursor to widowhood and may have prepared older people for widowhood. However, these two life experiences had different consequences. While widowhood appears to be the more severe transition, caring for a spouse often seriously threatens the meaningfulness of life.

Adaptation, Psychological↗
PubMed1987

The patient's partner: the spouse in residential care.

When an elderly patient enters residential care, tensions often arise because the patient's partner attempts to defend a threatened spousal role that is incompatible with the new setting. Patterns of patient entry into the facility also influence the interaction between the patient's spouse and nursing staff. The social worker's task is to reduce friction between the spouse and staff members by sustaining the husband or wife in an acceptable caring role.

Aged↗
PubMed1992

Caregivers of elderly relatives: spouses and adult children.

A problem in the provision of home health care for elderly people is the limited number of family members available for caregiving. Current trends in federal, state, and local policy formation suggest an increasing emphasis on the family as an appropriate caregiver. Therefore, it is necessary to examine how family relationships affect the caregivers' responses to their caregiver situation. Data are presented from 206 caregivers enrolled in a larger longitudinal study of family members caring for elderly dependent relatives. The sample is divided into four caregiver groups: (1) spouses who have children, (2) spouses who have no children, (3) adult children who have siblings, and (4) adult children who have no siblings. Measures selected for comparison were perception of burden, caregiver involvement, affective social support, mental health status, and use of community services. Differences were found among the four groups of caregivers. Implications for social work intervention are discussed.

Adult↗
PubMed1993

Effective services for bereaved spouses: a content analysis of the empirical literature.

To investigate the elements needed to serve bereaved spouses effectively, a content analysis of nine experimental studies on bereavement programs was conducted. A coding system was used to analyze the studies on five practice-related variables: characteristics of the client, the practitioner, the intervention, the research methodology, and the outcome. Comparisons between effective and ineffective programs indicated that planned brief intervention is effective in preventing or reducing symptoms of morbid grief among spouses who are at high risk or in high distress. Findings also revealed the need for practice and research on bereavement to use an ecological framework and to address issues of human diversity.

Adult↗
PubMed1980

Impact of chronic illness on the patient's spouse.

The spouse of a chronically ill person can experience a variety of undesirable reactions, such as anxiety, self-blame, or anger. Using a case example that involves Alzheimer's disease--a presenile condition--the author explains how social workers can help clients cope with and adjust to the problems created by a spouse's illness.

Alzheimer Disease↗
PubMed1979

The association of total cholesterol, triglycerides and plasma lipoprotein cholesterol levels in first degree relatives and spouse pairs.

HDL, VLDL, and LDL cholesterol as well as total cholesterol were measured in young adult offspring of Framingham Heart Study participants. Parental total cholesterol levels measured in the early 1950s were found to be significant predictors of present total cholesterol in the offspring. While both maternal and paternal cholesterol levels made an independent contribution to the prediction of the offspring's cholesterol, the mother's contribution was significantly greater than the father's for male offspring with a similar but less striking relationship for female offspring. The correlation for LDL cholesterol levels for siblings was higher than for HDL cholesterol or log VLDL choles terol. When adjustments were made for age, body weight, alcohol intake and cigarette smoking, slight reductions in the correlations were noted, but all adjusted correlations remained significantly different from zero. The spouse correlations for lipoproteins, however, did not differ from zero after adujustment. Since the significant association for lipoproteins in spouse pairs disappears on adjustment for correlates but the association for siblings does not, it is likely that the sibling lipoprotein associations result from either genetic or environmental factors shared early in life.

Adult↗
PubMed1984

Spouse concordance of smoking patterns: the Minnesota Heart Survey.

Spouse concordance of smoking patterns and other lifestyle factors was examined in data provided by 560 married couples from the Minnesota Heart Survey. Married pair concordance was measured against a standard of concordance based on the frequencies in surrogate spouse pairs. Smoking patterns are found to be significantly concordant for married pairs. More married pairs than surrogate pairs tended to both smoke or both not smoke. Among smokers, married pairs are more similar than surrogate pairs in daily number of cigarettes smoked. Among ex-smokers, married pairs are more similar than surrogate pairs in the year they quit smoking. Younger couples with the least amount of education were most concordant and showed the greatest smoking rate. Five additional lifestyle factors showed an increased level of concordance for married over surrogate pairs. Concordance in these factors was not correlated with smoking concordance. It is suggested that married couples respond similarly to a shared environment made up of daily practices, social life, and leisure activities. Further, smoking intervention directed toward the married couple should be considered.

Adult↗
PubMed1990

Marital satisfaction and distress in chronic low-back pain patients and their spouses.

This study examined the relation between marital satisfaction, psychological distress, self-reported pain, disability, and clinical findings in 63 chronic low-back pain (CLBP) patients from primary health care centers. The relation between marital satisfaction and psychological distress in their spouses was also studied. Marital dissatisfaction in female CLBP patients was significantly associated with psychological distress, as well as with patient self-reported pain and disability. Marital dissatisfaction in their male spouses was also strongly related to psychological distress. In male CLBP patient couples, marital dissatisfaction and psychological distress were much less significantly related. This gender difference should be taken into account in the treatment of CLBP couples.

Adult↗
PubMed1990

Assessing the coping status of spouses of critically ill cardiac patients: a theoretically based approach.

Acute cardiovascular disease is an emotionally traumatic event for the patient and family alike. As nurses are concerned with optimizing the health and well-being of patients and families, the nurse's role in assessing coping responses of the spouses is critical for the formulation of appropriate nursing diagnoses and the development of effective interventions. This article describes the spousal coping instrument, which is based on a conceptual model of nursing and is designed to comprehensively assess the coping responses, factors that influence coping, and outcomes of spouses whose partners have suffered an acute cardiac event.

Adaptation, Psychological↗
PubMedDate not supplied

The communication of affection between cancer patients and their spouses.

Thirty-eight patients receiving chemotherapy for advanced cancer and 37 of their spouses were studied to assess changes since illness in the desire for affection (sexual, physical, and verbal) and changes in actual affectional behavior. Each participant in the study was interviewed and then completed the Beck Depression Inventory and an Affectional Needs and Behavior Scale. Results indicated that patients and spouses of both sexes experienced simultaneously an increase in the desire for physical closeness and a decrease in the desire for sexual intercourse. Women patients and their husbands were in greater agreement regarding the changes assessed than were men patients and their wives. In addition, women patients reported the highest level of depression, but were more likely than the other groups to have their affectional needs met. Interpretations of these findings and implications for the management of patients in advanced stages of life-threatening illness are discussed.

Depression↗
PubMedDate not supplied

Similarities within young and middle-aged spouse pairs in behavioral and cardiovascular response to two experimental stressors.

The similarities of 30 young (X = 26 years) and 30 middle-aged (X = 52 years) spouse pairs in behavioral and cardiovascular response to two experimental stressors were compared to assess the importance of shared home experiences in determining cardiovascular responsivity to stress. Familial environmental influences on reactivity should produce increasing similarity among family members with number of years lived together. Although pair members exhibited a number of behavioral similarities, some of which appeared to increase with number of years lived together, there were few similarities in heart rate and blood pressure response to stress. However, both young and middle-aged pairs exhibited significant similarities in systolic blood pressure response to isometric handgrip. The fact that similarities were observed in young as well as middle-aged spouse pairs suggests that assortative mating in regards to cardiovascular reactivity to stress may occur in some instances. As a result, some previous estimates of the heritability of cardiovascular reactivity to environmental stress may have been artificially low.

Adult↗
PubMed1992

Use of formal community resources by spouse caregivers of chronically ill adults.

This descriptive correlational study examined the use of formal community resources of spouse caregivers of progressively chronically ill individuals. The convenience sample was 61 individuals with a definitive diagnosis of multiple sclerosis and their spouse caregivers. Results indicated that 34.4% of the sample used community resources. Relationships among caregiver demographics, extent of caregiving tasks, subjective burden, perceived uncertainty of the caregiver, functional incapacity of the chronically ill individual, level of social support, and the use of formal community resources were analyzed. Positively correlated (P less than 0.05) with the criterion variable of use of formal community resources were the variables of caregiver age (rpb = 0.342), number of caregiving tasks (rpb = 0.424), caregiver employment level (chi 2 = 8.25), and functional incapacity of the care receiver (rpb = 0.565). Results of discriminate function analysis indicated that three variables, functional incapacity, caregiver age, and number of caregiving tasks, correctly classified users versus nonusers of community resources 83.6% of the time.

Adult↗
PubMed1989

Caregiving spouses. Physical and mental health in perspective.

The self-reported physical and mental health of 315 persons caring for a spouse who had been diagnosed with Alzheimer's disease or a related disorder was compared with general population norms for existing data bases controlling for age and gender. Results suggest that across all indicators of mental health, spouse caregivers are more depressed, express higher levels of negative affect, are more likely to use psychotropic drugs, and have more symptoms of psychological distress than the general population. In terms of physical health, caregivers report higher than expected rates of diabetes, arthritis, ulcers, and anemia, yet they use medical services at rates which are similar or lower than those reported by the general population. Since no simultaneous control group was studied, these results suggest, but do not prove, the presence of differences between caregivers and non-caregivers.

Aged↗