Family Structure and Intervention Strategies: Beyond Empirical Research

Choosing an appropriate conceptual framework, theoretical perspective, and methodology to conduct psychosocial research on families with sickle cell anemic children is a major step in understanding the realities of their family functioning and coping. However, research approaches used to study black families, regardless of the presence of a sick child, have historically used frameworks and perspectives that have focused on pathologies rather than the range of family conditions. As a result, very few data exist on black families that describe and explain the variety and levels of family functioning. Thus, little is known about resilient and organized black families versus those that are dysfunctional and disorganized

The Effects of Placement on Dementia Care Recipients’ and Family Caregivers’ Quality of Life: A Literature Review

Purpose – The purpose of this paper is to review and synthesize the research literature on the quality of life (QoL) of both caregivers (CGs) and care recipients (CRs) with dementia after admission to long-term care facilities. Design/methodology/approach – Four databases – AgeLine, Medline, EBSCO, and PyscINFO – were searched and the relevant literature from 2002 onwards was reviewed. Findings – The review of 12 studies (five studies, including only family CGs; six studies including residents; one study including both family CGs and CRs) reveals a discrepancy regarding the effects of institutionalization on the CRs’ and CGs’ QoL. Among seven studies on CRs’ QoL change, some reviewed studies found a significant decline in CRs’ QoL after placement with others showing that CRs’ QoL was improved or stable. While some reports indicated that some family CGs benefited from placement, others showed that CGs merely maintained their QoL. However, family CGs in the reviewed studies were more likely to report improved QoL than were their CRs after institutionalization. Research limitations/implications – The authors recommend that future studies should focus on understanding the individual’s adaptation to placement, dyadic changes in QoL (includingmediators/moderators). They emphasize the need for a comprehensive longitudinal study with more than one wave and includes diverse groups including racial/ethnic minority CGs and CRs. Originality/value – This study reviewed and synthesized the research literature on the QoL of both caregiver and the people with dementia they cared for after those they cared for were admitted to long-term care facilities. The conclusions drawn about influences on QoL provide guidance for identifying best practices and research

Baby boomer caregiver and dementia caregiving: findings from the National Study of Caregiving

Background: previous studies have well documented the characteristics of baby boomers but less is known about the experiences of boomer caregivers (CGs) of people with dementia

Predictors of Discrepancy between Care Recipients with Mild-to-Moderate Dementia and Their Caregivers on Perceptions of the Care Recipients' Quality of Life

Purpose: The goal of this study was to explore predictors of discrepancy between reports of caregivers (CGs) and care recipients (CRs) with mild-to-moderate dementia about CRs’ quality of life (QOL). Design and Methods: This study was a secondary analysis of cross-sectional data drawn from a study of 200 care dyads of CRs with mild-to-moderate dementia and their primary family CGs. Paired t test, ordinary least squares multiple regression, and binary logistic regression were used for the analyses. Results: Caregivers rated CRs’ QOL significantly lower (worse) than CRs did. Ordinary least square regression results showed that greater incongruence in perceptions of CRs’ decision-making involvement (DMI) and higher level of CR impairment in activities of daily living were significantly related to higher absolute discrepancy between CG and CR about CRs’ QOL. In the logistic models, when the dyad had more DMI incongruence, or CG reported higher relationship strain, the CG was more likely to report a lower CR QOL than CR reported. Implications: Practitioners should consider incorporating CRs’ perspective when planning care instead of solely depending on CGs’ perspective. Also, practitioners should pay attention to any gap between perceptions of CGs and CRs, particularly with regard to CRs’ QOL

Adaptive Health Behaviors Among Minorities

Race. ethnicity. and cultural attitudes and practices are among the variables that influence health behaviors. including adaptive health behaviors. The following discussions highlight the important role of social conditions in shaping health behaviors and the central role of family in promoting health across the Asian, Hispanic. Native American, and African American ethnic groups. Factors that may lead to health-damaging behaviors are also discussed. The need for additional research that identifies correlations among physiological, social. and behavioral factors and health behaviors, as well as underlying mechanisms, is called for

Quality of Life for Dementia Caregiving Dyads: Effects of Incongruent Perceptions of Everyday Care and Values

Purpose of the Study: This dyadic study investigated incongruence in care recipients’ (CRs’) and caregivers’ (CGs’) perceptions of (a) CRs’ involvement in decision making and (b) how much CRs value social relations as predictors of subjective quality of life (QOL) of CRs with mild-to-moderate dementia and their primary family CGs. Design and Methods: A secondary analysis of cross-sectional, dyadic data from in-person interviews with 205 CRs with mild-to-moderate dementia and their primary family CGs Incongruence was operationalized in two ways: absolute difference and direction of difference. Paired t tests and multilevel modeling were used to analyze differences. Results: CGs reported CRs were significantly less involved in decision making and valued social relations significantly less than CRs. Greater incongruence on CRs’ values significantly predicted lower QOL of CG and CR. When CGs reported that CRs valued social relationships less than the CR himself/herself reported, CGs’ and CRs’ QOL was significantly lower compared with QOL for dyads where there was no incongruence on CRs’ values. Incongruent perceptions of CRs’ involvement in decisions were not a significant predictor of QOL. Implications: This study provides evidence for the importance of assessing both CRs’ and CGs’ QOL, as well as incongruence in their perceptions in domains that may affect both of their QOL

Racial and Ethnic Differences in the Delivery of the Resources for Enhancing Alzheimer's Caregiver Health II Intervention

Previous analyses of the Resources for Enhancing Alzheimer’s Caregiver Health (REACH II) intervention have found that it was less effective for African American than for Hispanic or White caregivers. We examined whether there were race/ethnicity group differences in REACH II intervention delivery

Positive Aspects of Family Caregiving for Dementia: Differential Item Functioning by Race

Due to increasing interest in the positive experiences associated with family caregiving, potential demographic group differences were examined on the Positive Aspects of Caregiving (PAC) scale at both the item and scale levels

Associations of Social Support and 8-Year Follow-Up Depressive Symptoms: Differences in African American and White Caregivers

The present study used data from the Alzheimer’s Study of Emotions in Caregivers (ASEC) to evaluate perceptions of social support assessed at baseline, as well as changes in social support assessed at a follow-up eight-years later, as predictors of symptoms of change in depression, with a focus on race as a potential moderator of these relationships. Specifically, multiple regression analyses adjusted for age, sex, income, education, race, living arrangement of care recipient at baseline, death of care recipient, the cultural justification for caregiving scale (CJCS), and baseline depressive symptoms were conducted to assess baseline social support ratings, as well as the change in social support over time as a predictor of depression at follow-up—with a focus on moderation by race. Baseline social support (F(1,77) = 7.60, p=.008) was associated with fewer depressive symptoms at follow-up for all participants. The change in social support over time was also related to depressive symptoms, with effects moderated by race (F(1,77) = 7.97, p = .007), such that when support decreased over time depressive symptoms at follow-up were higher for Whites, as compared with African Americans, whereas, when social support increased over time depressive symptoms tended to be similar for both groups. These findings indicate that research designed to plan interventions in caregivers must not ignore potential racial differences with regard to the effects of caregiving on mental health

Caregiving, residence, race, and depressive symptoms

The objective of this study is to evaluate the psychological responses to caregiving between black and white dementia caregivers measured by self-reports of depressive symptoms evaluating the impact of sub-components of the Center for Epidemiologic Studies Depression Scale (CES-D) and residential arrangements of the caregiving dyad. The method included 87 intergenerational family caregivers enrolled in the Duke Caregiver Study (50 white and 37 black). Total CES-D and the four sub-components were modeled as dependent measures in separate linear regressions. Three models were examined. The first model tested race, living arrangements, and their interaction. The second model adjusted for age, gender, education, income, health status, cultural justification for caregiving, crime concerns, systolic blood pressure, diastolic blood pressure, and glycosylated hemoglobin. A third model added adjustment for caregiver burden. The results showed that there was a significant race by residence interaction for CES-D, somatic symptoms and depressive affect such that when the dyads are living apart – with the care recipient in their own home or in an institutional setting – whites reported more depressive symptoms than blacks. When the dyads lived together, this was reversed, and blacks reported higher depressive symptoms than whites. To conclude, all the parameters such as race, living arrangements, and the components of depression need to be taken into account to understand the impact of caregiving on the emotional health of caregivers