Clearinghouse on Abuse and Neglect of the Elderly (CANE)|
CANE (Clearinghouse on Abuse and Neglect of the Elderly) is the nation's largest and most utilized computerized collection of elder abuse materials and resources. With over 3,000 holdings, CANE has the ability to perform customized searches of over 100 keywords producing annotated bibliographies available to the professional community and to the public.
CANE is a service of the National Center on Elder Abuse (NCEA), which is supported by the U.S. Administration on Aging.
The following articles addressing caregiving are available by request from CANE. Please be aware of each article's file number. The digits following the hyphen in the file numbers indicate the total number of photocopied pages. For example, if the file number is A78-11, then this article (number A78-11) is 11 pages in length. Articles of interest will be forwarded to you at a cost of $.20 per page.
Department of Consumer Studies
University of Delaware
Newark, DE 19716
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Janevic, M.R. & Connell, C.M.
Racial, Ethnic and Cultural Differences in the Dementia Caregiving Experience: Recent Findings
The Gerontologist; Vol. 41(3), 334-347, 2001
Keywords: Race, African-American, Chinese, Korean, Hispanic/Latino, Caregiver stress/burden, Alzheimer's/dementia
21 studies based on 18 samples were identified in this study. These caregivers were divided up racially and included the following ethnicities: African Americans, Chinese, Chinese Americans, Koreans, Korean Americans, Latinos and Whites and residents of 14 European Union countries. This research found that White caregivers were more often spouses of the elder than other groups. White caregivers also reported more depression and viewed caregiving as stressful more often than did African Americans. The research suggests that other minority groups may not have more available support than do White caregivers.
Cohen, M.A., Miller, J. & Weinrobe, M.
Patterns of Informal and Formal Caregiving among Elders with Private Long-Term Care Insurance
The Gerontologist; Vol. 41(2), 180-187, 2001
Keywords: Home care, Caregiving-other family
Data was collected from a nationally representative sample of 693 Long-Term Care (LTC) claimants who received benefits while living in a community dwelling and 424 of their informal caregivers. It was found that the LTC insurance benefits those who truly are dependent on ongoing care. A majority of the policyholders said that they were happy with their benefits, understood them and found it easy to file claims. A significant amount of disabled elders claim they are able to remain home instead of being institutionalized because of the LTC insurance. Also, the LTC insurance reduces the stress on informal caregivers.
Dyer, C., Pavlik, V., Murphy, K. and Hyman, D.
The High Prevalence of Depression and Dementia in Elder Abuse or Neglect
Journal of the American Geriatrics Society: Vol. 48(2), 205-208, 2000
Keywords: Depression, Alzheimer's/Dementia
This study describes the characteristics of patients experiencing abuse or neglect referred to an urban geriatric assessment and treatment center, and compares the prevalence of depression and dementia in these patients with that of patients referred to the geriatric program for other reasons. It was hypothesized that depression, as well as dementia, could be significant risk factors for abuse or neglect.
Pavalko, E. and Woodbury, S.
Social Roles as Process: Caregiving Careers and Women's Health
Journal of Health and Social Behavior; Vol. 41, 91-105, 2000
Keywords: Caregiver stress/burden, Employer services
This article addresses the roles of caregiving and employment, and investigates changes in women's health as they move into and out of both roles. First, health changes across different stages of involvement in the role of caring for an ill or disabled family member inside the home are explored. Additionally, it is investigated whether or not health effects of caregiving vary depending on employment. Findings indicate that psychological stress increases as women move into and continue caring for an ill or disabled person.
Seltzer, M. and Wailing, L.
The Dynamics of Caregiving: Transitions During a Three-Year Prospective Study
The Gerontologist; Vol. 40 (2), 165-178, 2000
Keywords: Caregiver-children, Caregiver-spouse/partner, Caregiver stress/burden
This study examines the role of caregiver from the perspective of wives and daughters of older persons. By categorizing the transitions of caregiver into three stages: entry, institutionalization, and bereavement, the impact of each stage on the life of the caregiver is revealed. The study proposes that daughters are more likely to enter the caregiving role than wives, and daughters are more likely to place their care recipient in an institution. Data is examined and discussed in a comparison of wives' and daughters' lives at each transition stage. The study focuses on the social involvement, family support, and the psychological well-being of the caregiver at each stage.
Ory, M.G., Hoffman III, R.R., Yee, J.L., Tennestedt, S. & Schulz, R.
Prevalence and Impact of Caregiving: A Detailed Comparison Between Dementia and Nondementia Caregivers
The Gerontologist; Vol. 39(2), 177-185, 1999
Keywords: Caregiver stress/burden, Alzheimer's/dementia
Data from 1,500 caregivers was analyzed from the 1996 National Caregiver Survey for this study. From this data, ways in which dementia care is different from other caregiving is documented. Dementia caregivers spend more hours weekly providing care than nondementia caregivers. Also reported were more employment complications, more caregiver strain, problems with mental health, a greater impact on time for leisure and other family members and more family conflict. These findings suggest that there need to be programs that tailor to the unique challenges that dementia caregivers face.
Kosloski, K., Montgomery, R.J.V. & Karner, T.X.
Differences in the Perceived Need for Assistive Services by Culturally Diverse Caregivers of Persons with Dementia
The Journal of Applied Gerontology; Vol. 18(2), 239-256, 1999
Keywords: Race, African-American, Hispanic/Latino, Use of services, Caregiver, Home care Alzheimer's/dementia
2,947 Black, Hispanic and White caregiving dyads participating in the Demonstration Grants to States program were analyzed. Hierarchical logistic regression models were estimated separately and four services were examined: adult day care, in-home respite, meal services and home health care. These were analyzed to determine whether there are culturally based differences in attitudes toward the need for services that affect their likelihood of use.
Soeda, A. & Araki, C.
Elder Abuse by Daughters-in-Law in Japan
Journal of Elder Abuse and Neglect; Vol. 11 (1), 47-58, 1999
Keywords: Japanese, Neglect, Caregiver-children, Intergenerational abuse
The purpose of this article was to review and discuss the findings of two studies conducted in Japan in 1993 and 1997 on the issue of domestic elder abuse. These studies surveyed social workers and home aides, and found that neglect by daughters-in-law to be the most prevalent type of elder abuse occurring in Japanese homes. This phenomenon was attributed to poor relationships between daughters-in-law and their in-laws. Relevant research findings are reported.
Beigel, D. & Schulz, R.
Caregiving and Caregiver Interventions in Aging and Mental Illness
Family Relations; Vol. 48 (4), 345-354, 1999
Keywords: Mentally impaired, Caregiver stress/burden
The authors provide a review and discussion of providing care for older adults and mentally ill family members, intervention studies, and the implications for future research. The predominant approach to understanding caregiving using a stress-health process perspective is discussed as well as comparisons between the demands and the effect of caring for an older adult versus someone with a chronic, mental illness. The review of intervention studies in aging suggest that attention is needed in the systematic design of interventions to meet individual needs, adequate description of caregiving interventions, and outcome evaluations need greater specificity. The mental illness interventions studied examine efficiency issues and the authors suggest that education and psychoeducational programs have the greatest impact. The recommendations for future study include: utilization of stronger theoretical bases for intervention studies; stronger research designs; investigation of duration and intensity of interventions; a wider range of intervention modalities; a broader range of outcome measures; larger samples; and utilizing combinations of qualitative and quantitative approaches in evaluating interventions. This article is also the introductory article of a special issue in this topic for this journal.
Reinardy, J., Kane, R., Huck, S., Call, K., & Shen, C.
Beyond Burden: Two Ways of Looking at Caregiving Burden
Research on Aging; Vol. 21 (1), 106-127, 1999
Keywords: Caregiver stress/burden
The authors compare and contrast qualitative and quantitative approaches to understanding caregiver burden and satisfaction. Using a sample group who had also participated in a larger quantitative investigation (Heinz study), the researchers used interviews from the National Post Acute Care (PAC study), thus allowing comparison of the two types of data. Follow-up interviews were completed at 6 weeks, and 12 months for the PAC study but only interviews from the first set of interviews were used in the present study. The authors report a significant degree of correspondence between the quantitative and qualitative data especially for negative aspects of caregiving. There were differences noted in the subjective burden of caregiving.
Bond, J., Cuddy, R., Dixon, G., Duncan,K., and Smith, D.
The Financial Abuse of Mentally Incompetent Older Adults: A Canadian Study
Journal of Elder Abuse and Neglect: Vol. 11 (4), 23-38, 1999
Keywords: Alzheimers/Dementia, Financial abuse/fiduciary, Canada
Results of a pilot study on the financial abuse of mentally incompetent clients of the Office of Public Trustee, Manitoba, Canada are presented. The study sought to: 1)establish incidence of suspected financial abuse, 2) identify the characteristics of mentally incompetent older adults at risk, and 3) identify indictors of financial abuse. Women over the age of eighty were over-represented as victims of financial abuse. A list of financial abuse indicators is included as a potential reference for professionals and service providers.
Race and Caregiving: Patterns of Service Use by African American and White Caregivers of Persons with Alzheimer's Disease
Journal of Gerontological Social Work: Vol. 32 (2), 5-19, 1999
Keywords: Alzheimer's/dementia, Race, African-American, Use of services, Caregiver-children, Caregiver-spouse/partner
This article discusses a longitudinal study of the use of services by both White and African American caregivers of elders with Alzheimer's Disease. It was found that non-use is a pervasive problem in both groups, despite these groups expressing a need for as well as the intention to use these services and support groups. Findings suggest that support groups can have a positive impact on the well being of caregivers.
The Micropolitics of Care in Relationships Between Aging Parents and Adult Children: Individualism, Collectivism and Power
Journal of Marriage and the Family; Vol. 61 (3), 661-672, 1999
Keywords: Intergenerational issues, Caregiver-children
This article discusses the intergenerational power issues between elders and adult children in both collectivist and individualist families. It was found that elders in individualist families tend to have more power than elders in collectivist families, while elders in collectivist families tend to receive higher levels of care. Data suggests that when an elder receives care, yet does not defer to the child's power, the children will often limit the amount of care given.
The Experience of Respite: Meeting the Needs of African American and White Caregivers in a Statewide Program
Journal of Gerontological Social Work; Vol. 30 (3/4), 59-72, 1998
Keywords: Caregiver-other family, African-Americans, Race, Respite Care, Caregiver programs
This article discusses White and African American caregivers seeking respite care. Both the functioning of the caregivers and the elderly relative were assessed as well as the need for assistance. Six months after care was initially requested, the effects of the program were compared. It was found that White caregivers tended to be more anxious and depressed that the African American group, despite these two groups being comparable at the initial assessment. It was also found that the White caregivers felt less gain from the program. The needs for assistance also seemed to be different among the two groups.
Calderon, V., & Tennstedt, S.L,
Ethnic Differences in the Expression of Caregiver Burden: Results of a Qualitative Study
Journal of Gerontological Social Work; Vol. 30 (1/2), 159-178, 1998
Keywords: Caregiver stress/burden, African-Americans, Hispanic/Latino, Race
This study discusses research on ethnic differences in the caregiving experience among White caregivers, African American caregivers and Puerto Rican caregivers. It was found that White caregiving females and African American and Puerto Rican male caregivers expressed frustration and anger during difficult times in the caregiving situation. Female African Americans and Puerto Ricans tended to use bodily complaints to express frustration. Resignation, denial, respect and religious faith were ways caregivers dealt with caregiving burden. This study suggests that African American and Puerto Rican caregivers express caregiving burden differently than do their White counterparts.
Ferguson, S. and Koder, D.
Geropsychology: Some Potential Growth Areas in Psychological Research and Practice
Australian Psychologist: Vol. 33 (3), 187-192, 1998
Keywords: Alzheimer's/Dementia, Suicide, Depression, Australia, Caregiver stress/burden
This article reviews the issues of depression, suicide, and management of behavioral problems due to dementia among the elderly. The article emphasizes the role of psychologists in identifying risk factors, creating treatments, and monitoring treatment effectiveness.
Doty, P., Jackson, M.E. & Crown, W.
The Impact of Female Caregivers' Employment Status on Patterns of Formal and Informal
The Gerontologist; Vol. 38(3), 331-341, 1998
Keywords: Gender, Physically impaired, Caregiver-spouse/partner, Caregiver-children, Caregiver-paid, Employment status
Data from the 1998 National Long-Term Care Survey and the Informal Caregivers Survey is used to examine how the employment of female primary caregivers (FPCGs) affects hours of care that is received by disabled elders. It was found that when FPCGs are employed, they provide fewer hours of personal care. The care recipients tend to receive fewer hours of help from other sources. When the caregivers were working more than 17 hours per week, their care recipients receive fewer hours of care.
Institutional Respite Care: Breaking Chores or Breaking Social Bonds?
The Gerontologist; Vol. 38(5), 610-617, 1998
Keywords: Australia, Caregiver stress/burden, Respite care, Caregiver programs
This article examines the reason why respite care seems to be positively viewed by caregivers, yet is not used by those who seem to be in need of it. 144 caregivers were interviewed in Canberra and Australia. This data is the basis for examining the relationships between five appraisal dimensions and the use of respite care in the past and in the future. The data shows that respite care usage is higher when caregiving demands are high and when the relationship between caregiver and recipient is dysfunctional. When the caregiver and receiver were in a loving relationship in the past, the likelihood of future usage decreases.
Sterritt, P. and Pokorny, M.
African-American Caregiving for a Relative with Alzheimer's Disease
Geriatric Nursing; Vol. 19 (3), 127-134, May-June 1998
Keywords: Alzheimer's/dementia, African-American
This study explored the meaning of caregiving to nine African-American caregivers of family members with Alzheimer's Disease. Four major themes emerged from the study: caregiving is a traditional family value, caregiving is an act of love, social support is a mediator of the caregiver burden, and caregiving is a female role.
Rose-Rego, S., Strauss, M., & Smyth, K.
Differences in the Perceived Well-Being of Wives and Husbands Caring for Persons with Alzheimer's Disease
The Gerontologist; Vol. 38 (2), 224-230, 1998
Keywords: Alzheimer's/dementia, Caregiver-spouse/partner, Gender, Psychological abuse
This study examined differences in psychological well-being between husband and wife caregivers of persons with Alzheimer's in comparison to non-caregiver husbands and wives in similar ethnic groups. As in previous studies, caregiver wives reported more negative psychological states than did caregiver husbands.
Compton, S., Flanagan, P., and Gregg, W.
Elder Abuse in People with Dementia in Northern Ireland: Prevalence and Predictors in Cases Referred to a Psychiatry of Old Age Service
International Journal of Geriatric Psychiatry: Vol. 12(6), 632-635, 1997
Keywords: Alzheimer's/Dementia, Europe, Caregiver-children, Caregiver spouse/partner
This study examines whether or not there exists a difference in caregiver and patient characteristics between abused and non-abused populations of community-dwelling older persons patients with dementia. Conclusions do not support other research findings that caregiver characteristics such as financial dependence, criminal or psychiatric history, lifestyle changes, and/or substance abuse were associated with elder abuse. Results of this study suggest that elder abuse is associated closely with aspects of the patient/caregiver relationship.
Quayhagen, M., Quayhagen, M., Patterson, T., Irwin, M., Hauger, R., Grant, I.
Coping with Dementia: Family Caregiver Burnout and Abuse
Journal of Mental Health and Aging; Vol. 3 (3), 357-364, 1997
Keywords: Alzheimer's/dementia, Caregiver-children, Caregiver-spouse/partner, Caregiver stress/burden
Caregiver burnout and abuse both by caregivers and patients are examined and reported in this study focusing on dementia. Qualitative interview data was collected from couples in an abusive situation, non-abusive couples on a level of deterioration, and healthy control couples. Differences between the groups and situations are discussed with regard to burnout, mental health, stress, and coping strategies. Situations where the abuser is the patient are differentiated from those where the caregiver is the abuser and situational differences are discussed. Findings support the need for investigation of abuse and possible early intervention to decrease the impact of progressive deterioration.
Connell, C.M. & Gibson, G.D.
Racial, Ethnic, and Cultural Differences in Dementia Caregiving: Review and Analyzes
The Gerontology; Vol. 37(3), 355-364, 1997
Keywords: Race, Alzheimer's/dementia, Caregiver-children, African-American, Hispanic/Latino, Caregiver spouse/partner, Caregiver stress/burden
This study reviews and analyzes empirical research that examines the impact of race, culture and/or ethnicity on the experience of caregiving for an elder with dementia. Ten out of twelve of the studies reviewed examined the differences between Black and White caregivers. One of the studies compared White and Hispanic caregivers. Non-white caregivers were less likely to be a spouse and more likely to be an adult child, friend or other family member; they reported less caregiver stress, burden and depression; they held more strong beliefs about family support and the more often used prayer or faith as a coping mechanism.
Aranda, M.P. & Knight, B.G.
The Influence of Ethnicity and Culture on the Caregiver Stress and Coping Process: A Sociocultural Review and Analysis
The Gerontologist; Vol. 37(3), 342-354, 1997
Keywords: Caregiver stress burden, SES, Hispanic/Latino, Support groups
This article reviews the literature that has been written on ethnic minority caregivers. The authors suggest that culture and ethnicity play a significant role on the stress and the coping process of Latino caregivers. It was found that Latino caregivers face unique challenges when caregiving for individuals at higher risk for chronic diseases, who are disabled at earlier ages and who have more functional disabilities. The perception of stress events, use of familial support and coping behaviors were found to be influenced by ethnicity and culture. Other sources of variation in caregiver stress depended on socioeconomic class and minority group status.
Lee. Y., Sung, K.
Cultural Differences in Caregiving Motivations for Demented Parents: Korean Caregivers vs. American Caregivers
Aging and Human Development; Vol. 44 (2), 115-127, 1997
Keywords: Alzheimer's/dementia, Caregiver-children, Korean, Race
The background of caregivers in Asian nations is generally constant. The burden is given to the children. In American culture the caregiver is usually in a more formal setting. The complexity of dementia leads both groups to respond more and take more responsibility. This study examined the differences in motivation for parent care of Korean caregivers and Caucasian-American caregivers.
Clark, M. and Standard, P.
Caregiver Burden and the Structural Family Model
Family & Community Health; Vol. 18 (4), 58-66, 1996
Keywords: Caregiver stress/burden, Support groups
The burdens of giving care to a chronically ill or dependent family member can be overwhelming. While support groups and individual counseling assist the caregiver in coping with these burdens, recognition of the individual family structure is useful when developing successful clinical interventions. Minuchin's structural family model highlights an individual's need of group support for survival, socialization, and emotional stability. Using this framework with a family case study involving 3-generational family interventions to decrease the family's caregiving burden are examined.
Motivations to Care: Daughters and Son-in-law Caring for Relatives with Alzheimer's Disease
Family Relations; Vol. 45, 37-45, 1996
Keywords: Caregiver-children, Alzheimer's/dementia
In an exploratory, qualitative study of 16 daughters and sons-in-law and their 16 spouses, 4 patterns emerged that highlighted the differences in their motivation for involvement in caregiving. Differences related to notions of obligation, reactive versus pro-active involvement, managerial roles in the family, and the differences in the impact of involvement for daughters and sons-in law.
Ingersoll-Dayton, B., Starrels, M.E., and Dowler, D.
Caregiving for Parents and Parents-in-law: Is Gender Important?
The Gerontologist; Vol. 36 (4), 483-491, 1996
Keywords: Gender, Caregiver-children, Caregiver-family
This article analyzes cross-sectional data collected from 1,585 employed caregivers of parents and parents-in-law. Hierarchical regression models were used to examine the additive and multiplitive effects of relationship status (parent or parent-in-law) and gender on caregiving activities, resources, and costs. Findings indicate that both the caregiver's gender and the elder's gender are associated with care provided to and from parents and parents-in-law. Results also show that daughters-in-law are especially vulnerable because they receive few resources from elders. Practice implications and directions for future research are discussed.
For Better or Worse: Spouse Abuse Grown Old
Journal of Elder Abuse and Neglect; Vol. 8 (1), 1-33, 1996
Keywords: Physical abuse, Caregiver-spouse/partner, Risk assessment, Socio-economic status
Spouse abuse is one of the more common forms of elder abuse but little is known about its causes and consequences. This study focuses on older couples to determine the prevalence of risk factors previously identified for spouse abuse in studies of younger couples. Results from the study indicate that although the incidence of spouse abuse in older couples is significantly less than that of younger couples, many of the risk factors present in abusive couple relationships are the same.
Network Effects in Caregiver to Care-recipient Violence: A Study of Caregivers to Those Diagnosed with Alzheimer's Disease
Journal of Elder Abuse and Neglect; Vol. 8 (1), 69-80, 1996
Keywords: Alzheimers/Dementia, Caregiver stress/burden
This article explores the relationship between caregiver support networks and violent feelings toward the care recipient. Data from studies conducted by Pillemer and Suitor of caregivers to family members with Alzheimer's disease were reanalyzed, and this article further investigates whether the structure of caregivers' social networks helps explain which caregivers are more likely to fear becoming violent toward their elderly care recipients.
Jakubiak, C., and Callahan, J.
Treatment of Mental Disorders Among Nursing Home Residents: Will The Market Provide?
Generations; Winter 1995-1996
Keywords: Health Care, Alzheimer's/dementia, Institutional care-abuse/neglect
Mental disorders are common among nursing home residents with more than two-thirds having one or more psychiatric symptoms. Nursing homes have replaced state mental hospitals as the center of institutional care for older mentally ill and demented people. In the U.S., ninety-four percent of all institutionalized elderly people with a mental disorder receive their care in a nursing facility, though very little treatment was being provided. This study concluded that the prevalence of mental disorders is higher in independent for-profit and public facilities than in facilities that are part of a chain.
Reis, M. & Nahmiash, D.
Validation of the Caregiver Abuse Screen (CASE)
Canadian Journal on Aging; Vol. 14(2), 45-60, 1995
Keywords: Caregiver-other family, Risk assessment
This article studies the Caregiver Abuse Screen (CASE). CASE is a measure of abuse and neglect of seniors. A sample of abusive caregivers was compared with two groups of non-abusive caregivers. The CASE did differentiate between the abusive and non-abusive groups, but not between the two non-abusive groups. High CASE scores correlated with high abuse and aggression scores from other screens. High scores also correlated with caregiver personality traits, poor caregiver/care recipient relationships, more care recipient behavioral problems, poor caregiver health and depression and with less social support. The findings support the validity of the CASE as an initial abuse screen tool.
Fuller-Jonap, F. and Haley, W.
Mental and Physical Health of Male Caregivers of a Spouse with Alzheimer's Disease
Journal of Aging and Health; Vol. 7 (1), 99-118, February 1995
Keywords: Caregiver-spouse, Alzheimer's/dementia, Caregiver stress/burden
This is a report on the assessment of mental and physical health of 52 male spouse caregivers of patients with Alzheimer's Disease and 53 demographically equated controls. Results indicate that compared with non-caregiving men, male spouse caregivers have poorer mental and physical health. The importance of focusing on understudied specific subgroups of caregivers is emphasized.
Barber, C.E. & Pasley, B.K.
Family Care of Alzheimer's Patients: The Role of Gender and Generational Relationship on Caregiver Outcomes
The Journal of Applied Gerontology; Vol. 14 (2), 172-192, June 1995
Keywords: Alzheimer's/dementia, Caregiver-children, Caregiver-spouse
This article discusses a study of 262 caregivers of people with Alzheimer's disease with regard to the caregiver's gender and the generational relationship between caregiver and care recipient. Negative impacts on the different kinds of caregivers are discussed.
Burton, L., Kasper, J., Shore, A., Cagney, K., Laveist, T., Cubbin, C. and German, P.
The Structure of Informal Care: Are there Differences by Race?
The Gerontologist; Vol. 35 (6), 1995
Keywords: Race, Caregiver-family, Physically impaired
This study investigated whether there are race differences in the structure of informal caregiving networks. Data on 3,793 functionally impaired persons age 65 and over from the 1989 National Long-Term Care Survey were analyzed. The size of the total caregiver network and the unpaid network did not differ by race, but the likelihood of there being a non-immediate family member among unpaid caregivers was higher among disabled older blacks. These findings raise questions about whether race differences in nursing home utilization and paid long-term care services, documented in other studies, can be explained by differences in caregiving arrangements.
Mittelman, M., Ferris, S., Shulman, E., et al
A Comprehensive Support Program: Effect on Depression in Spouse-Caregivers of AD Patients
The Gerontologist; Vol. 35 (6), 792-802, 1995
Keywords: Caregiver-stress/burden, Alzheimer's/dementia
Caregivers of Alzheimer's Disease patients often suffer from depression. Using a longitudinal treatment/control study, the effects of a comprehensive support program on depression in spouse-caregivers was studied. This psychosocial intervention program treats the primary caregiver and family members over the entire course of the disease through individual and family counseling, the continuous availability of ad hoc counseling, and support group participation. Results of the study suggest that enhancing long-term social support can have a significant impact on depression in caregivers.
Montgomery, R.J.V. & Kosloski, K.
A Longitudinal Analysis of Nursing Home Placement for Dependent Elders Cared for by Spouses vs Adult Children
Journal of Gerontology: SOCIAL SCIENCES; Vol. 49(2), S62-S74, 1994
Keywords: Caregiver spouse/partner, Caregiver-children, Nursing homes
In this study, 531 informal caregivers and frail elders were analyzed using an event history framework. This framework was used to identify how changes in caregiving situations are related to nursing home placement. The results from this data indicate that the predictors of placement differ depending on if a spouse as opposed to their adult children cares for the elder. Also, it was found that there are different descriptions of the caregiving role over time for the two caregiving groups. Differences also appeared when the caregiving role begins and how the role is perceived by the caregiver.
Reese, D., Gross, A., Smalley, D., et al
Caregivers of Alzheimer's Disease and Stroke Patients: Immunological and Psychological Considerations
The Gerontologist; Vol. 34 (4), 534-540, 1994
Demands of caregiving for Alzheimer's Disease patients have been reported to affect psychological and immunological health of the caregivers. The question of whether the observed psychological and immunological changes were unique to AD caregivers was addressed in this study. The subjects were 25 caregivers of AD patients, 25 caregivers of stroke patients, and 25 noncaregiving individuals. Comparisons of all subjects made on several psychological and immunological indices indicated that the AD caregiving group was more psychologically distressed than a control group. With respect to immunological function, there were no differences among the three groups. Implications of the findings are discussed.
Dwyer, J., Lee, G., & Jankowski, T.
Reciprocity, Elder Satisfaction, and Caregiver Stress and Burden: The Exchange of Aid in the Family Caregiving Relationship
Journal of Marriage and Family; Vol. 56, 35-43, February 1994
Keywords: Caregiver-children, Caregiver stress/burden, Gender, Physically impaired, Home care
This study examines the levels of stress and burden of daughter caregivers when caring for their impaired aged mothers. The impact of reciprocation for care received as well as satisfaction of the elder was also examined. Data was collected from 135 mother-daughter dyads. The study found no role of reciprocation of the mothers' satisfaction. Stress and burden increased for the caregivers as reciprocal tasks performed by the elder decreased.
Intrieri, R. & Rapp, S.
Self-Control Skillfulness and Caregiver Burden Among Help-Seeking Elders
Journal of Gerontology; Vol. 49 (1), 19-23, 1994
Keywords: Gender, Caregiver-spouse/partner, Caregiver-stress/burden
The purpose of this study was to examine the relationship between the dispositional use of self-control skills and caregiver burden in a sample of help-seeking spouse caregivers. 44 primary care providers to spouses with non-trauma induced cognitive impairment were surveyed. Higher self-control was associated with less psychiatric problems and caregiver burden. The more memory and behavioral problems the recipient had the greater the caregiver's sense of burden. The level of education had no impact on skillfulness although the younger caregivers were more skillful.
Kosloski, K. & Montgomery, R.J.V.
The Effects of Respite on Caregivers of Alzheimer's Patients: One-Year Evaluation of the Michigan Model Respite Programs
Journal of Applied Gerontology; Vol. 12(1), 4-17, 1993
Keywords: Caregiver stress/burden, Respite care, Alzheimer's/dementia
In this study, the impact of respite care on informal caregivers for participants in the Michigan Model Respite Programs was evaluated. Caregivers were evaluated based on three dimensions: subjective (felt) burden, objective burden and morale. It was found that caregivers who used respite had a lower level of subjective burden and higher morale as compared to the control groups. There seems to be no differences between the groups in regard to objective burden.
Coyne, A.C., Reichman, W.E., and Berbig, L.J.
The Relationship Between Dementia and Elder Abuse
American Journal of Psychiatry; Vol. 150 (4), 643-646, April 1993
Keywords: Alzheimer's/dementia, Caregiver-family, Physical abuse, Abuse profile
Alzheimer's Disease and other dementias may be associated with greater risk for physical abuse than other illnesses of the elderly. This study shows that caregivers who had been abused by patients, in comparison to those who had not, were more likely to direct abusive behavior back toward the patient in their care. Also, the abusive caregivers had been in the caregiving role for more years, were providing care for more hours per day, and were caring for more functionally impaired patients. These results support the hypothesis that abuse involving cognitively impaired older adults and their caregivers may be associated with the relatively high psychological and physical demands placed on family members who care for relatives with dementia.
The Nurse, the Elderly Caregiver and Stress
Caring; Vol. X11 (1), 14-17, January 1993
Keywords: Home care, Intervention, Caregiver-spouse/partner, Nurses, Caregiver stress/burden, Socio-economic status
This article is about identification of the major factors causing stress in home caregivers. The role of the home care nurse is to reduce the level of stress of the caregiver, to help avoid stress related consequences and to provide assistance to the caretaker. Providing respite care is suggested as an intervention method when signs of stress emerge.
Cairl, R.E. & Kosberg, J.I.
The Interface of Burden and Level of Task Performance of Caregivers of Alzheimer's Disease Patients�cClinical Profiles
Journal of Gerontological Social Work; Vol. 19 (3/4), 133-151, 1993
Keywords: Caregiver-spouse/partner, Caregiver-children, Alzheimer's/dementia, Home care
The caregivers of Alzheimer's Disease patients are studied and classified into four subgroups: the intolerant subgroup, the ideal subgroup, the clinically challenging subgroup, and the paradoxical subgroup. Individual caregivers were placed in their groups based on their background, caregiver status, and the patients' status. Results of the study are evaluated concerning future policy/program issues and research issues.
Lusis, S., Hydo, B., and Clark, L.
Nursing Assessment of Mental Status in the Elderly
Geriatric Nursing; Vol. 14 (5), 255-259, 1993
Keywords: Health care
The purpose of this study was to identify common characteristics in patients who become acutely confused after admission to medical nursing units. Those who become delirious may have a longer length of stay, a higher mortality rate, and an increased risk of institutionalization. Delirium in an older person is often associated with an acute medical illness or drug reaction. Recent studies have underlying cognitive impairment. This study suggests that at this particular institution, the �gyoung�h older patient who is cognitively intact on admission is not likely to become confused while hospitalized for medical illness.
Weinberger, M., Gold, D., Divine, G., et al
Expenditures in Caring for Patients with Dementia Who Live At Home
American Journal of Public Health; Vol. 83 (3), 338-341, 1993
This study compared the expenditures of caring for patients with dementia who live at home with those who reside in nursing homes. 141 primary caregivers of dementia patients who had been referred to a university-based memory disorders clinic were interviewed by clinic social workers. During follow-up interviews, caregivers spent on average 105 hours a week in caregiving activities. The average total expenditures were high and did not include opportunity costs. Nearly $1500 more per patient was expended annually for home-based care.
Clipp, E.C., & George, L.K.
Dementia and Cancer: A Comparison of Spouse Caregivers
The Gerontologist; Vol. 33 (4), 534-541, 1993
Keywords: Caregiver-spouse/partner, Alzheimer's/dementia, Physically impaired
The purpose of this study was to compare well-being of spouse caregivers of dementia suffers to spouse caregivers of individuals with cancer. The results indicated that dementia caregivers were more adversely affected by their role than were cancer caregivers. Age was also a factor and indicated that younger caregivers were more compromised than were older caregivers.
Walker, A. Pratt, C. & Oppy, N.
Perceived Reciprocity in Family Caregiving
Family Relations; Vol. 41 (1), 82-85, January 1992
Keywords: Caregiver-children, Gender
This study explored the perceptions of the aid received by 174 caregiving daughters from their care-receiving mothers. Most of the teams perceived that the mothers gave aid to the daughters in return for the daughter's help. 90% of the respondents cited the type of aid most commonly perceived was love given from the mother to the daughter. 75% reported that the mothers gave information and over 50% of the mothers gave both advice and money. This study suggests that care-receiving mothers are actually engaged in relational exchanges with their caregiving daughters.
Paveza, G., Cohen, D. Eisdorfer, C., et al
Severe Family Violence and Alzheimer's Disease: Prevalence and Risk Factors
The Gerontologist; Vol. 32 (4), 493-497, 1992
Keywords: Alzheimers/dementia, Caregiver-family
This study describes the prevalence of violence and the risk factors for violence in 184 Alzheimer patients and their primary caregivers living in the community.
Caregiver Strain Among Black and White Daughter Caregivers: A Role Theory Perspective
The Gerontologist; Vol. 32 (2), 203-212, April 1992
Keywords: Caregiver-children, African-Americans, Race, Caregiver stress/burden, Gender
This study addresses the issue of racial differences in family caregiving and examined the emotional strain experienced by black and white daughter caregivers. It was found that black and white daughter caregivers perceive and react differently to caregiving responsibilities. Overall, black daughters reported less strain. Predictors of strain for this group included poor health, lack of respite support and conflict in life. For white daughters predictors of strain included poor parent-daughter relationships and work conflict. A common predictor of strain for the two groups was conflict between duties and the daughters' personal and social lives.
Risk Factors of Elder Abuse in Caregiving to the Elderly in African-American Families
Presented at Family Conflict and Elder Abuse Workshop; May 23, 1991
Keywords: African-American, Caregiver-other family, Gender, Dependence
The purpose of this paper is to identify risk factors for elder abuse in black families using a contextual approach as the conceptual focus. Black families providing care to the elderly will serve as the vehicle through which elder abuse is discussed. Emphasis is placed on family caregiving arrangements because it is through caregiving that many situational risk factors associated with violent and abusive family behavior are evident.
Smith, G.C., Smith, M.F., and Toseland, R.W.
Problems Identified by Family Caregivers in Counseling
The Gerontologist; Vol. 31 (1), 15-22, February 1991
Keywords: Caregiver-family, Evaluation, Counseling programs, Gender
This article discusses seven categories of problems that caregiving daughters and daughters-in-law were willing to work on in counseling. These categories include improving coping skills, meeting elder's care needs, responding to family issues, concern over the caregiver-recipient relationship, eliciting formal and informal supports, feelings of inadequacy and guilt, and planning for elder's future. Included are case examples and practice implications.
The Relationship of Intergenerational Reciprocity of Aid to the Morale of Older Parents: Equity and Exchange Theory Comparisons
Journal of Gerontology; Vol. 45 (4), 150-155, 1990
Keywords: Caregiver-children, Theories
Intergenerational reciprocity was investigated using two competing theoretical perspectives, social exchange and equity propositions. The results provide support for earlier studies that conclude the amount of help exchanged within families does not affect the well being of older family members.
Reed, B., Stone, A., and Neale, J.
Effects of Caring for a Demented Relative on Elder's Life Events and Appraisals
The Gerontologist; Vol. 30 (20), 200-205, 1990
Keywords: Caregiver-family, Caregiver-stress/burden
This study examined the potential sources of distress for a caregiver when caring for a demented relative. It focused on two aspects of the caregiver's experience to identify if the responsibility of giving alters the rate of quality of non-giving activities and to see how caregiving changes events and thoughts. The caregivers reported more negative events and appraisals and rated these as more undesirable than did the control subjects, but did not differ on any positive events or appraisals.
Hamel, M., Gold, D., Andres, D., et al
Predictors and Consequences of Aggressive Behavior By Community-Based Dementia Patients
The Gerontologist; Vol. 30 (2), 206-211, 1990
Keywords: Caregiver-stress/burden, Alzheimer's/dementia
This study examined patient aggression from a sample of 213 community-based dementia patients, the caregivers' reaction to patient behavior, and the association between aggression and cognitive functioning in demented individuals. 57% of the patients were reported to be occasionally aggressive of which most aggression was cited as verbal. Higher levels of premorbid patient aggression and troubled premorbid relationships between the care-receiver and caregiver are predictors of patient aggression. Patient aggression predicted the decision to discontinue home care.
Using a Family Systems Approach: Prevent Elder Abuse
Journal of Gerontological Nursing; Vol. 15 (3), 21-26, 1989
Keywords: Health care, Needs assessment, Caregiver-children, Home care, Socio-economic status
This article uses a family system approach as a foundation for understanding and assessing the risk of elder abuse in the home. In addition, a validated assessment instrument is presented that evaluates the risk of elder abuse in the home (REAH). Using this instrument, professionals can construct two profiles: 1) the older person, including personal data and dependency needs and 2) the caregiver, including personal data and family dynamics. Holistic care can then be identified and implemented.
Dependency Stress and Elders' Abusive Behavior Toward Family Caregivers
Presented at International Congress of Gerontology; June 19-23, 1989
Keywords: Abuser profile, Victim profile, Caregiver-other family, Caregiver-children
This study examines the impact of dependencies in those cases in which family caregivers perceive that they are the victims of abuse perpetrated by elder kin. Dependency stress measures included financial stress, physical stress, emotional stress, stress associated with caregivers having to help groom the elder and stress associated with caregivers having to aid the elder in household management. Elder behaviors hypothesized to cause stress included using different ploys to gain control: emotional, physical, disability, refusal, embarrassment, and interference. Results indicate that some elder's behavior cause stress for caregivers, which in turn may lead to elder abuse.
Scogin, F., Beall C., Bynum, J. Et. Al.
Training for Abusive Caregivers: An Unconventional Approach to an Intervention Dilemma
Journal of Elder Abuse and Neglect; Vol. 1 (4), 73-85, 1989
Keywords: Intervention, Caregiver-children, Caregiver-family, Education/training
This article proposes a model for elder abuse intervention based on a recently implemented caregiver training program. Caregivers at risk for abuse were offered training through mental health centers on biopsychosocial issues in aging, problem-solving, stress and anger management, and utilization of community resources. Participants were compared with similar caregivers on measures of psychosocial well-being to examine the efficacy of training. Participants experienced some reduction in symptoms of psychological distress and caregiving burden over time while symptoms worsened or remained unchanged for non-participants. Suggestions are made for utilizing this approach in cases of founded abuse.
Parsons, R.J., Cox, E.O. and Kimboko, P.J.
Satisfaction, Communication and Affection in Caregiving: A View from the Elder's Perspective
Journal of Gerontological Social Work; Vol. 13 (3/4), 9-19, 1989
Keywords: Caregiver-other family, Caregiver stress/burden, Intergenerational abuse, Home care
Multigenerational caregiving is becoming a prevalent means of caring for moderately to severely impaired elders. Handling stress created in these arrangements may depend on the relationship between the elder and the caregiver. This study examines components of such relationships and highlights caregiving as experienced by the elder receiving care. Findings indicate that improved quality of relationship between elder and caregiver is related to a high degree of elder's satisfaction. However, findings also suggest that elders fear being a burden, hide their troubles and feelings and generally feel no sense of contribution to the household.
Fruehwirth, S. and Smith E.
An Application of Johnson's Behavioral Model: A Case Study
Journal of Community Health Nursing; Vol. 6 (2), 61-71, 1989
Keywords: Alzheimer's/dementia, Physically impaired, Caregiver-children, Home care
This is a case study of caregivers of Alzheimer's Disease patients. The purpose was to apply Johnson's model in the assessment of and interventions with this group (n=6). An overview of Johnson's model is presented. Alzheimer's Disease and the problems associated with caregiving are discussed. An assessment of the caregivers in the group applying Johnson's model is also presented as is nursing diagnoses, client goals, interventions and client outcome.
Kinney, J.M. and Parris-Stephens, M.A.
Caregiving Hassles Scale: Assessing the Daily Hassles of Caring for a Family Member with Dementia
The Gerontologist; Vol. 29 (3), 328-332, 1989
Keywords: Alzheimer's/dementia, Caregiver-other family, Caregiver stress/burden, Dependence
The caregiving hassles scale was designed to assess the daily hassles of caring for a family member with Alzheimer's Disease. Primary caregivers of Alzheimer's Disease patients (n=60) completed the caregiving hassles scale on two occasions to report on their well-being. The 42-item scale provides a reliable and psychometrically sound instrument for assessing hassles associated with assistance in basic activities of daily living, assistance in instrumental activities of daily living, care-recipients' cognitive status, care-recipients' behavior and caregivers' social network.
Brody, E., Saperstein, A., and Lawton, M.
A Multi-Service Respite Program for Caregivers of Alzheimer's Patients
Journal of Gerontological Social Work; Vol. 14 (1/2), 41-73, 1989
This paper describes the services and procedures of the Philadelphia Geriatric Center's multi-service respite service demonstration project for 305 caregivers of elderly Alzheimer's patients. Of all caregivers who were offered respite, 52% actually took advantage of the services; of those, two-thirds chose in-home services with smaller proportions using daycare and institutional respite. Advantages and disadvantages of several types of respite care were covered.
Moritz, D., Kasl, S., and Berkman, L.
The Health Impact of Living With a Cognitively Impaired Elderly Spouse: Depressive Symptoms and Social Functioning
Journal of Gerontology; Vol. 44 (1), 17-27, 1989
Keywords: Caregiver-spouse/partner, Depression
The purpose of this study was to identify the social and psychological consequences of living with a cognitively impaired spouse among community-dwelling elderly individuals. It examines the relationship between level of cognitive functioning in one spouse and indicators of depressive symptomatology and social functioning in their partners.
Suitor, J. & Pillemer, K.
Explaining Intergenerational Conflict When Adult Children and Elderly Parents Live Together
Journal of Marriage and the Family; Vol. 50 (4), 1037-1047, November 1988
Keywords: Intergenerational abuse, Dependence, Caregiver-children, Incidence
In a stratified random sample of 372 elderly parents living with adult children, low levels of intergenerational conflict were reported. Conflict was lower when the adult child was older and in a similar marital status as the parent. Conflict was not related to the parent's health or dependency upon the adult child. Thus, social structural characteristics were most important in predicting intergenerational conflict.
Sweer, L., Martin, D., Ladd, R., et al
The Medical Evaluation of Elderly Patients with Major Depression
Journal of Gerontology: Medical Sciences; Vol. 43 (3), 53-58, 1988
This article describes a study which determines the frequencies of abnormal findings on screening examinations in an elderly population hospitalized for major depression, the incidence of newly discovered medical problems, and the impact of those evaluations on diagnosis and treatment. Results show that elderly patients with major depression experience a great deal of morbidity due to unrecognized medical illnesses.
Family Responsibilities and Caregiving in the Qualitative Analysis of the Alzheimers Disease Experience
Journal of Marriage and the Family; Vol. 50, 197-207, 1988
Following the trend of research on the caregiving side of Alzheimer's disease experience, field data are presented in illustration of the interpretive dynamics of the family responsibility. Four features are addressed: social comparison, issue contingency, family history and kinship priority. It is argued that qualitative analysis offers empirical lessons about family responsibility that remain untaught by other methods.
The Need to Assess Dementia
Journal of Gerontological Nursing; Vol. 14 (1), 35-39, 1988
This paper presents a model based upon a series of state-level initiatives in the Commonwealth of Pennsylvania for improving coordination between the aging and mental health systems to better serve elderly persons with mental health problems.
Families Caring for Frail and Demented Elderly: A Review of Selected Findings
Family Systems Medicine; Vol. 5 (3), 344-356, 1987
Keywords: Caregiver-spouse/partner, Caregiver-children, Depression, Alzheimer's/dementia, Frail elderly
This article focuses on the characteristics and burdens of the caregivers for the frail and demented elderly. The two types of caregivers are compared and contrasted with respect to intervention, and supportive programs for each type are discussed.
Lund, D.A., Pett, M.A., and Caserta, M.S.
Institutionalized Dementia Victims: Some Caregiver Considerations
Journal of Gerontological Social Work; Vol. 11 (1/2), 119-135, 1987
Keywords: Nursing homes, Alzheimer's/dementia
The purpose of this study was to identify factors associated with caregivers' perceived likelihood of institutionalizing dementia victims. Forty-five primary caregivers of non-institutionalized victims completed questionnaires dealing with socio-demographic characteristics of the victim and caregiving situation. Results are discussed.
Morycz, R.K., Malloy, J., Bozich, M. et al
Racial Differences in Family Burden: Clinical Implications for Social Work
Keywords: African-American, Race, Caregiver stress/burden, Caregiver-family, Alzheimer's/dementia
This article examines the clinical implications for social work practice of the differential impact of caregiving strain according to race. Data for this report is drawn from a study of 810 patients in the community-based geriatric assessment center. Although this research found no essential difference, based on race, in the experience of family burden as a social problem, there was a difference within the interaction of race and the care for an elderly person with Alzheimer's Disease.
Thompson, J., Pender, K., and Hoffman-Schmitt, J.
Retaining Rights of Impaired Elderly
Journal of Gerontological Nursing; Vol. 13 (3), 20-25, 1987
Keywords: Health care, Alzheimer's/dementia
Complex ethnological issues face nurses today, especially when dealing with the cognitively impaired person. This article reviews residents' rights in the long-term care setting, discusses issues of competency and decision making as they affect the nurse's role in health care planning and identifies an approach to solving these problem issues.
Phillips, L.R. and Rempusheski, V.F.
Caring for the Frail Elderly at Home: Toward a Theoretical Explanation of the Dynamics of Poor Quality Family Caregiving
Advances in Nursing Science; Vol. 8 (4), 62-84, 1986
Keywords: Caregiver-family, Health care, Evaluation, Intervention, Home care, Theories
This article describes a theoretical sampling of 39 family caregivers using newspaper advertising to explore their perceptions of providing home care for frail elders and to generate a theoretical model that (1) describes the dynamics of good quality and poor quality family caregiving; (2) explains the relationships among certain contextual and perceptual variables and the behaviors exchanged by elders and caregivers; and (3) identifies points where interventions by nurses could be effective.
Hirst, S.P., & Metcalf, B.J.
Learning Needs of Caregivers
Journal of Gerontological Nursing; Vol. 12 (4), 24-28, April 1986
Keywords: Alzheimer's dementia, Caregiver-other family, Education/training, Health care, Needs assessment, Socio-economic status
This paper focuses on meeting the information needs of family caregivers, particularly caregivers of demented elderly. Education is stressed for the families along with maintaining family involvement in the care of the older patient confined to an institutional setting. The education and training of nurses is also stressed. The article discusses who has the responsibility for fulfilling these learning needs.
Parent to Child-Child to Parent-Obligation and Abuse in America
Delaware Lawyer; 20-25, (summer) 1985
Keywords: Caregiver-children, Legislative issues, Intergenerational abuse, Dependence, Caregiver stress/burden
This article provides an overview of the history of intergenerational relations and current parent-child relations and the event of elder abuse. Issues addressed include filial responsibility, child abuse, caregiver burden, and legislative and service needs.
Comparing the Depression of Elders in Two Types of Caregiving Arrangements
Family Relations; Vol. 34 (2), 235-240, April 1985
Keywords: Depression, Caregiver-spouse/partner, Caregiver-children
This paper compared elders living in two types of caregiving households and explores the elder's level of depression in each setting. The level of depression proved to be similar for elders residing with their spouse and for those residing with a child/grandchild. Length of time in residence and non-economic contributions to the household related to depression.
Stress and Caring for Elderly Relatives: Interpretations and Coping Strategies in an American Indian and White Sample
The Gerontologist; Vol. 24 (3), 251-256, 1984
Keywords: Native Americans, Caregiver stress/burden, Race
This study used semi-structured interviews with ten American Indian and ten white caregivers of ill elderly relatives in the rural northwest. Eleven dimensions were used to define caregiving with a focus on control. Dimensions included: apprehension, independence, emotional involvement, responsibility, emotional desirability, conflict, respect, guilt, anger and loss. Results show effects of cultural background and meaning of caregiving on the selection of coping strategies.
Reese, D., Walz, T. and Hageboeck, H.
Intergenerational Care Providers of Non-Institutionalized Frail Elderly: Characteristics and Consequences
Journal of Gerontological Social Work; Vol. 5 (3), 21-34, (Spring) 1983
Keywords: Caregiver-children, Caregiver-other family, Frail Elderly
This article looks at intergenerational care providers (family) on non-institutionalized elders. A study is conducted to explore several aspects of family caregiving. The characteristics of the caregivers, their perceptions of providing care and their perceptions of outside assistance needed and desired for carrying out caregiving tasks.
Dependency, Stress, and Violence Between Middle-Aged Caregivers and their Elderly Parents
Abuse and Maltreatment of the Elderly: Causes and Interventions; 134-149, 1983
Keywords: Caregiver-children, Domestic violence, Dependence, Caregiver stress/burden
This article provides an overview of demographic changes in the age of distribution of the population and household structure. Findings from a study of caregivers are presented concerning caregiver burden and stress, elders' dependence and abusive conflict tactics. The chapter ends with implications for service providers.
Strain Among Caregivers: A Study of Experience in the United States
The Gerontologist; Vol. 23 (6), 597-618, 1983
Keywords: Caregiver-family, Caregiver-spouse/partner, Caregiver-children, Caregiver stress/burden, Support groups
This article describes results of a study of frail elderly and their caregivers (N=111). Findings show that the amount of distress and disruption of daily life differs for distinct groups of caregivers. Generally, stresses included financial and emotional strain, problems resulting from role reversal especially between spouses, multiplicity of roles especially for children, and lacking knowledge of or access to formal supports. Alternative solutions need to be considered, dependent on caregivers' divergent needs.
Reifer, B., Cox, G., and Hanley, R.
Problems of Mentally Ill Elderly as Perceived by Patients, Families and Clinicians
The Gerontologist; Vol. 21 (2), 165-170, 1981
This study investigates the similarity of elders' family members' and clinicians' assessment of the elders' mental impairment. Assessments of clinicians and family were similar, indicating that elders are often unaware of mental health problems or unwilling to report them. Implications for research based on elders' reports are addressed.