Carey Wexler Sherman

Stability and change in the intergenerational family: A convoy approach

ABSTRACT There have been fundamental changes in the intergenerational family, and yet families continue to be an important part of peoples lives. We use the convoy model to describe the factors that influence supportive relations within intergenerational families, beginning with a description of the changing structure of the intergenerational family. We next outline support exchanges, detailing how personal characteristics, especially gender, race, age and socio-economic status, and situational characteristics, in particular family structure and intergenerational context, influence support exchanges. Instrumental and emotional family exchanges are described, with special attention to the unique circumstances of care-giving in intergenerational families. We also examine the importance of recognising differences in the quality of intergenerational relations, again noting the influence of personal and situational characteristics. Variations in support quality, e.g. positive, negative and ambivalent, and its influence on wellbeing are discussed. As families and individuals change, differences emerge at the individual, family and societal levels. We consider the implications of changes and stability in intergenerational relations and make recommendations about how best to envisage and plan future intergenerational family support. Societies with fewer resources as well as individuals and families with diverse individual histories must be innovative and creative in meeting the needs of older people as well as those of all family members.

Spousal dementia caregiving in the context of late-life remarriage

Increasing numbers of older couples entering late-life remarriage will face dementia and spousal caregiving. This qualitative study, informed by grounded theory methods, is a first to explore spousal caregiving in the late-life remarried context. Interviews with nine late-life remarried wife caregivers identified complex intergenerational stepfamily dynamics that appear to amplify isolation and stress for this group of caregivers. Most women reported experiencing rejection of remarriage by adult children, minimal family involvement in caregiving, and intergenerational conflict regarding decision making. Nonetheless, caregivers described proactive, strategic approaches toward caregiving. This study examines the construct of boundary ambiguity as it relates to late-life remarriage and dementia caregiving, thus merging the unique challenges of caregiver and stepfamily dynamics. Findings are discussed in light of the potential risks highlighted for remarried couples facing chronic health issues. Future dementia research that accounts for diverse marital and family histories is suggested.

Remarriage as Context for Dementia Caregiving: Implications of Positive Support and Negative Interactions for Caregiver Well-Being

Growing numbers of adults age with complex marital and family histories. At the same time, aging persons may require family care. This qualitative study focuses on later-life remarried wives (N = 60) caring for husbands with dementia to explore positive and negative care-related support from family and stepfamily members. Telephone interviews included open-ended questions and support networks diagrams to depict support experiences. Caregivers reported receiving support from own family, but noted an absence of support or assistance, or active interference, from stepfamily members. Remarried caregivers face specific support challenges, isolation and demoralization. Opportunities for interventions and future research are discussed.

Caring for an individual with mild cognitive impairment: a qualitative perspective of health-related quality of life from caregivers.

ABSTRACT Objectives: Little is known regarding the effect that caring for an individual with Mild Cognitive Impairment (MCI) has on health-related quality of life (HRQOL). We sought to identify the most important aspects of HRQOL related to caring for an individual with MCI. Methods: Six focus groups were conducted with caregivers of individuals with MCI (n = 32). Qualitative frequency analysis was used to analyze the data. Results: Findings indicated that caregivers most frequently discussed social health, including changes in social roles and an increased need for social support (51.2% of the total discussion). This was followed by mental health concerns (37.9%) centering on anger/frustration, and a need for patience in the caregiving role, as well as caregiver-specific anxiety. Other topics included physical health (10.0%; including the impact that stress and burden have on medical heath), and caregivers’ cognitive health (0.9%; including memory problems in relation to caregiver strain, sleep disruption, and cognitive fatigue). Conclusions: Findings illustrate the multiple domains of HRQOL that are affected in individuals providing care for someone with MCI. Moreover, the findings highlight the need for extending support services to MCI caregivers, a group that is typically not offered support services due to the ‘less severe’ nature of an MCI diagnosis.

So Close and Yet So Irritating: Negative Relations and Implications for Well-being by Age and Closeness

Objectives Negative social relationships are associated with poor health, chronic illness, and mortality. Yet, we know little about the dynamics of negative aspects of relationships within individuals closest relationships over time, how those experiences vary by age, and the implications of those relationships for well-being. Method A total of 592 participants (ages 25 to 97; M= 57.5; 63.3% women) from the Social Relations Study completed monthly web surveys for up to 12 months. Each month they reported negative relationship quality with their three closest network members and multiple dimensions of well-being (positive affect, negative affect, self-rated health, and sleep quality). Results Multilevel models revealed older individuals reported less negativity in their relationships than younger people, but fewer age differences in the closest tie. Greater negative relationship quality predicted poor well-being (i.e., greater negative affect, sleep problems). Links between negative relations and well-being were less strong among older individuals; especially in the closest ties. Discussion Results were partially consistent with the strength and vulnerability integration (SAVI) model, which proposes fewer age-related improvements in emotion regulation when individuals are unable to avoid tensions. Despite feeling just as negative as younger individuals, older individuals may be more resilient to tensions in their closest relationships.