Gerontology September 26 2012 Family Caregiving Who becomes a family caregiver Son 6 Daughters 29 Husbands 18 Wives 30 Other 17 Profile of Caregiving Spouses are often the primary caregivers Next adult offspring specifically women over 75 Parents prefer same sex caregivers For every person in a nursing home 2 or more elderly cared for by family Caregiving last 5 7 years or more Spring 6 10 hours or as much as 35 hours week Informal Caregiving Providing help and assistance to relatives or friends who are unable to provide for themselves Characteristics of Caregivers Two thirds of caregivers are married Age distribution of caregivers Under 35 years 36 49 years 50 64 years 28 29 26 Employed Full Time 50 Spouses Transition to Caregiving Most stressful when one spouse has Alzheimer s Areas of Change Marital intimacy changes does not disappear Psychological well being Participation in household tasks husbands Social integration Transition to Caring for a Parent Reverberates across family relationships Adult Children experience stress when Parent is demanding critical and unappreciative Lack support from other family members Gender Differences in Caregiving Daughter provides more hours of care than sons Daughters sons perform different tasks Daughters hands on care No differences in feelings of obligation Sons household chores transportation finances etc Then why do women provide more care Caregiving as part of gendered division of labor Related to earning potential Work and Caregiving 1 3 employed full time or part time What is the effect of employment on Caregiving Often continue to work full time just add caregiving Greater stress more work family conflicts BUT greater stress when NOT employed outside the house WHY Work offers respite from caregiving responsibilities Alzheimer s Disease Most common cause of dementia Gradual steady deterioration Early Impairment in memory and new learning Later Lose ability to perform tasks of daily life Personality changes Apathy dependency anger aggressiveness sometimes inappropriate sexual behavior Family Stress and Adaptation Caregiving is stressful Chronic stress Negative effects on health well being Costs of caregiving Exhaustion loss of time for oneself feeling overwhelmed role overload financial worry changes in relationships etc Benefits of caregiving Being appreciated a new perspective on the relationship increased closeness to the care recipient Caregiving Stressors Primary Problems related to the disease disability Ex Behavior problems loss of relationships Secondary Impact of primary stressors on caregiver s life Ex Missed work marital strain What is stressful to one caregiver may not be stressful to another caregiver Behavior and Psychological Symptoms in Dementia BPSD Most challenging stressors for caregivers Most common behaviors are Mood disturbances depression Agitation and restlessness Disruptive behaviors sleep disturbances and ADL behaviors Disease Behavior Problems Advice for Caregivers Gain information about the illness and treatment Reduces misunderstanding and misinterpretation of behaviors Avoid reorientating patient to reality Useful strategies for managing problem behaviors Problem Solving Used to manage problem behaviors Information about problems Brainstorm solutions 1 Activity 2 Prevent maps 3 Reassurance comfort 4 Food 5 Reduce noise 6 Treat illness or source of pain 7 Medications Caregiving Burden Degree of stress depends on Coping skills How well do you cope with stress Availability of social support family and friends Role of other family Strain on marital relationship but source of support Siblings described as great source of caregiving stress Sharing the burden feeling unappreciated decisions But some report increased closeness Reducing Caregiving Burden Respite Time away from caregiving responsibilities Community support could reduce postpone institutionalization Flexible work schedule leave provisions Use of Support Services What might be the barriers to seeking support 1 Existence of resources 2 Time demands other responsibilities 3 Lack of information 4 Stigma guilt anxiety etc In summary Spouse and daughters most likely caregivers Different types of caregiving stressors Importance of understanding disease like Alzheimer s Managing problems and offer support respite to help caregivers cope with stressors of caregiving
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