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To understand the challenges African American families face when combining employment commitments and informal caregiving responsibilities, uses data from a sample of 119 African American elder-caregiver dyads. Examines the nature of caregiving relationships and extent to which caregivers' employment statuses affect the hours of care provided. (Contains 57 references and 5 tables.) (GCP)

Investigates the extent of multiple-role occupancy among midlife individuals in Britain, focusing on work and family commitments. The proportion of individuals in midlife who have multiple roles, in terms of paid work and family care, at any one point in time is low, but a much higher proportion of individuals have occupied multiple roles over their life course. (Contains 47 references and 8 tables.) (GCP)

Examines the effects of transitioning into caregiving activity for a child, spouse, parent, other relative, or non-kin associate on nine dimensions of psychological well-being. Results from multivariate regression models confirmed that the transition to caregiving for primary kin was associated with an increase in depressive symptoms. However, in selected instances, caregiving was associated with beneficial effects. (Contains 42 references and 3 tables.) (GCP)

Discusses the application of training in social problem solving with family caregivers of persons who have incurred severe physical disabilities. Outlines training procedures (i.e., Project FOCUS) that enable counselors to assist family caregivers in developing effective problem-solving skills that may translate to increased wellness for each caregiver, and by extension, their care recipients. (Contains 45 references and an appendix.) (GCP)

A review of eight studies investigated the life quality of people caring for a relative with a severe disability within their family. An analysis of both qualitative and quantitative data indicate that primary caregivers are at considerable risk of high stress, clinical depression, and abnormally low subjective quality of life. (Contains references.) (Author/CR)

Evaluates burden as experienced by a group of American Indian primary family caregivers. Analysis of items composing the Caregiver Burden scale indicate that caregiver burden is multidimensional and consists of several types of burden. Finds that caregiver burden is composed of four dimensions: role conflict, negative feelings, lack of caregiver efficacy, and guilt. (Contains 49 references and 4 tables.) (GCP)

Examines the full range of family care responsibilities, including care for children and for ill and disabled adults, among employees of a government-funded research center. Employees with childcare responsibilities were found to experience higher levels of caregiving strain and occupational impacts than those caring for adults alone. (Author/GCP)

While an increasing number of clinical reports and descriptive studies have documented stress-related dysfunction in family caregivers of older adults with chronic dementia, little is known about specific factors that place members at risk for negative outcomes. This study examined the relative effects of psychological and social characteristics on well-being in spousal caregivers of older adults with chronic dementia. Fifty-one spouses completed questionnaires assessing dementia severity, distress in appraisal of dementia symptoms, perceived support from family and peers, reliance on specific coping strategies, and psychological well-being. The results of the path analysis showed that gender, appraisal of dementia symptoms, perceived peer support, and three types of coping strategies (problem-solving, positive focus, and wishful thinking) were significant predictors of well-being. Overall, the predictor variables accounted for 60.3 percent of the variance in psychological well-being. The findings document the salience of these characteristics in further study of caregiver functioning. More generally, results provide support for multi-dimensional models of stress, coping, and adaptation. The findings have implications for clinical intervention. (Author/NB)

The family is the primary source of support and caregiving for the frail, dependent elder, providing emotional support, logistical services, supplemental finances, and the link to the outside community for the homebound elder. The caregiving systems of 84 of Texas's Adult Protective Services' (APS) cases were examined. The definition of neglect that was used was neutral in attribution, referring neither to self nor caregiver responsibility nor to active or passive intention. Case studies examined what caseworkers found entering the situation; what intervention was chosen; how the elder and family responded; and what the outcome was. The neglected elder is one whose needs are not adequately met in one or more of these areas: personal care, nutrition, medical care, or condition of the environment. Whether inadequate care was due to self-neglect or caregiver neglect was not always easy to determine. Case analyses resulted in five profiles of situations and problems that describe why caregiving systems seemed to fail: (1) the caregivers were overwhelmed; (2) the elder refused care; (3) caregivers were more interested in their own gain than in the elder's welfare; (4) the caregiving system was dysfunctional due to poor relationships or difficult personalities; and (5) the elder was alone and had no one on whom to rely. Interventions ranged from caregiver support; emergency action, including forced removal; and general assistance. Caseworkers felt the most critical need was for greater resources, increasing what was already in place, more emergency funds, and more medical services. The need for more preventive services was also emphasized. Abuse and neglect were thought to be the result of multifaceted problems which required multiagency resolution. (ABL)

Studies consistently have found that caregivers who use respite care are satisfied with and appreciate such care. However, preliminary evaluations of the effect of respite care on caregiver burden have had mixed, limited, and in some cases null empirical findings of program effectiveness. This study explored the relationship between caregiver characteristics and utilization of respite care in order to understand the caregivers' perceptions of burden and social support as well as their need for formal support services. Subjects included 22 caregivers using respite care for families with dementing relatives and 26 demographically matched caregivers not using respite care. Also included were 43 caregivers of mentally or physically disabled children using the in-home respite care program. Subjects responded to a questionnaire focusing on caregiver demographics, length of care, sources and availability of social supports, and attitudes toward and utilization of respite care. Results indicated that caregivers who used the respite care perceived a higher level of burden than did non- users. While differences in burden could be due to varying degrees of physical, cognitive, or behavioral problems that drive caregivers to seek respite, examination of severity, mental status, and prescription of behavioral management medications revealed no differences in the patient samples. (ABL)

A conceptual framework for studying the role of social support in explaining family caregivers' psychological well-being is developed in this paper. In particular, the framework presented emphasizes the importance of conceptualizing caregiving as a social status, and drawing upon the broader literature on status acquisitions, social support, and psychological well-being. This literatuare can be used to suggest that social support is likely to be most effective in reducing caregiver stress when it is provided by individuals with whom the caregiver shares a greater number of social statuses such as age, occupational prestige, and religion. Explanations are presented for the more positive effect of support from status-similar network members, and proposes longitudinal designs for investigating this issue are proposed. It is concluded: that the most obvious implication of reconceptualizing caregiving as a social status is the need to develop methodologies that permit an explanation of changes in the structure and function of individuals' social networks across the caregiving career; (2) that the study of family caregivers provides an important and unique context in which to study the buffering effects of social support; and (3) that the research that investigates the structure of social networks across the early stages of the caregiving career will have a number of important implications for practitioners. (Author/ABL)

Caregiving studies often focus on the impaired elder who is the care receiver and the one family member who is perceived as the primary caregiver. Such studies fail to consider all members of the family, whether or not they are involved in providing care. This study was conducted to explore the effects of an elder's health-related dependency on the family network through the eyes of family members other than and including the primary caregiver and care receiver. It focused on the nature of the caregiving experience and the types of changes that family members experience in response to a health-related dependency. Subjects were participants in the University of Southern California's Longitudinal Study of Generations and included 20 families interviewed in 1973, 1985, and 1986. Semi-structured interviews concerned with the health decline of the older family member and the effects on other family members were completed by an average of three to four members per family. The results suggest that: (1) caregiving is often a shared responsibility between either multiple primary caregivers, very involved secondary caregivers, or both; (2) a substantial part of the family network is affected by the experience of caregiving for an older adult; (3) the effects on family relationships are often positive as well as negative; and (4) network effects include altered perspectives about aging, one's own mortality, and other family members. (NB)

There is growing evidence that the stress of caring for a relative with Alzheimer's disease may have adverse effects on the caregivers. This study was conducted to explore the mental health consequences of caregiving. Psychological data and mental health status information were obtained from 50 Alzheimer's disease spousal caregivers and from 50 category matched (age, sex, and socioeconomic status) comparison subjects. The results revealed that caregivers had significantly higher rates of depressive disorder while caregiving than the comparison subjects during the same period. Additionally, caregivers had significantly higher current dysphoria as measured by the Hamilton Depression Rating Scale (p>.001). The data suggest that certain chronic stressors may be linked to the onset of depressive disorder. As the population continues to age and the number of Alzheimer's disease patients increases, family caregivers may become an increasingly important risk group. (Author/NB)

This report was prepared because of the growing national interest in the questions of work and family dynamics. It puts together 82 key statistics on work and family issues in four major areas: child care, parental leave, alternative work schedules, and elder care. In addition, a chapter of miscellaneous statistics covers areas such as the demographics of women in the work force, corporate nepotism policies, employer relocation policies, and employee assistance programs involving work and family concerns. The source for each statistic is listed; any trends that can be discerned are also set forth in the report. (KC)

This demonstration program was designed to impart specific nursing, psychosocial, and community knowledge skills to caregivers, particularly those who themselves were older adults and were caring for a family member at home. Begun in October 1986, this program featured basic home nursing instruction and an orientation to the demands and rewards of caregiving. The Caregiver Education and Training (CET) Project included two components. Two integrated home nursing courses demonstrated basic nursing skills to families who cared for an ill, frail, impaired, or older family member in the home. A companion course focused on the psychosocial aspects of caregiving and provided information about community resources. During its 18-month duration, CET offered 65 classes to the community at no charge. Some 342 individuals representing 221 families and 62 paraprofessionals/professionals participated. Their response was quite favorable. Pretests and posttests demonstrated the acquisition of significant caregiving knowledge and skills. A 60-minute videotape and two teaching guides for the two components of the program were developed. Appendixes include pretests, posttests, and questionnaires. (YLB)

The popularity of home care for chronically ill or technology-dependent children has moved professionals into unfamiliar settings. Factors responsible for the relatively sudden surge of effort to place children with complex needs at home include costs, individualism and autonomy, changing views of medicine and its institutions, limits of medical technology, and growth of technical capability. The movement carries many imperatives for behavior and attitude changes in adapting to the public nature of the care, the need for families to assume risks usually assumed by hospital staff, and the need for professionals to dissociate the management of risk from their direct control. Bringing home the medically complex child may create problems which must be anticipated by candidate families, such as loss of privacy, terror concerning the patient's survival, role confusion, exhaustion, endlessness, and guilt. Participation of caretakers from outside the immediate household requires establishment of criteria for training and clear negotiation of the terms of the arrangement. Psychological concerns of professionals who participate in home-care planning include belief in the hospital as the best locus of care and the nature of professional responsibility. The plan for discharge should consider the: adequacy of funds, screening and supervising of paid and volunteer caregivers, best use of home space, respite care, and other issues. Includes 11 references. (JDD)

A recently published national profile of caregivers of the frail elderly suggests potentially negative consequences of caregiving for work and employment for as many as one-third of the employed caregivers in a large 1983 sample. The study was undertaken to explore a comprehensive set of issues on informal caregiving and to determine the extent to which caregiving by employees has consequences for work and job. A survey instrument adapted from The Travelers Employee Caregiver Survey was completed by 583 employees, 159 of whom identified themselves as caregivers for at least one person age 60 or older. Women are not more likely to be caregivers than men. Of all women in the sample, 28.71% were caregivers and of all men, 27.27%. The findings revealed that only 10% of men surveyed experienced caregiving related problems on the job, compared to 52% of the women. The difference was accounted for in part by men's greater freedom to rearrange their job schedules and reduce work time to render care. Men are more likely than women to give personal care and medication care. Men are almost as likely as women to offer companionship. (NB)

This document describes the situation of people 65 years and older in Denmark, Finland, Norway, and Sweden. There is growing concern in the Scandinavian countries with provision for the elderly in the future and the feeling that government involvement may not be as great in the future as it has been in the past. The growth of formal care, the changing family structure, and the relationship between formal and informal care of the elderly are addressed. Support to families who are providing care for their own elderly members is cited, and the use of home help as an example of formal care is discussed. Fifty-six references are listed, and the document concludes with an appendix that details the statistical variables used in a study on the use of home help among the aged reported in the document. (CML)

Because women have predominated as caregivers of the elderly, very little is known about the family support systems of men who assume this role. This study, based on a national study of male caregivers, examined the availability and level of family help received by male caregivers; the closeness, allegiance, and supportiveness in their families; and the relationship between these variables and such issues as caregiver burden and the degree of affectionate reciprocity between the caregivers and the recipients of their care. The results revealed that the average male caregiver was a white, protestant, middle class, moderately well-educated, retired man who was 68 years old. Most caregivers were husbands taking care of their wives. A minority were sons caring for a parent; instances of men helping in-laws, siblings, or friends were rare. Caregivers spent many hours each day performing a broad range of caregiving tasks and had been doing so for long period of time. Although most had living children or siblings, levels of concrete assistance from relatives were uneven. Study findings have implications for gender-sensitive service delivery and suggest directions for future research on male caregivers. (Author/NB)