Deborah J. Monahan

Mental and physical health of spouse caregivers : the role of personality

Although personal resources of caregivers, such as coping skills and social support, have been shown to be important in understanding caregiver stress and health outcomes, personality traits have not previously been considered. The purpose of this study was to examine the association between the personality traits of neuroticism and dispositional optimism and mental and physical health outcomes. It was predicted that personality would have direct effects, and indirect effects through perceived stress, on health outcomes. Participants were spouse caregivers of patients diagnosed with Alzheimers disease. Results showed that neuroticism and optimism were significantly related to mental and physical health. Furthermore, neuroticism had significant direct effects on all of the health outcomes, and substantial indirect effects, through perceived stress, on mental health outcomes. Optimism showed stronger indirect than direct effects on all health outcomes. These findings demonstrate the importance of including personality of the caregiver in theoretical and empirical models of the caregiving process.

Informal caregivers of institutionalized dementia residents: Predictors of burden

When older adults are placed in nursing homes, care- giving responsibility continues, despite long held beliefs to the con- trary. Although the American family is in transition, bonds of care- giving and of filial responsibility are strong and persist into old age. Knowledge about characteristics of caregivers who have actually placed their relative in a nursing home is limited. The purpose of this study is to examine whether demographic and facility-related char- acteristics as well as knowledge about dementia and participation in support groups and workshops are signif~cant predictors of burden in caregivers of institutionalized dementia residents. Sixty-seven per- cent of caregivers of residents in a dementia unit in a nursing home participated in the study. Overall, the regression explained 68% of the variance in burden and was highly simcant statistically. In- formation gained from this study will assist social workers in mak- ing referrals to nursing homes or in direct practice with cognitively impa...

CAREGIVER SUPPORT GROUPS: EFFICACY ISSUES FOR EDUCATORS

An increasing number of older persons with chronic illnesses are being cared for by family members in the community with the assistance of respite, adult day care, and home care services. The growth in the number of persons providing care has led to the development of interventions, particularly psychoeducational support groups, to support family caregivers. The literature on the efficacy of support group interventions is reviewed, and the planning, implementation, and evaluative issues of particular relevance to educators are identified. Most studies have determined that participants are satisfied with the programs; however, whether they have decreased felt burden or stress has yet to be determined. Methodological issues such as interpreting significance levels, controlling for regression artifacts and reactivity bias, and using standardized instruments and more sophisticated analytical methods (e.g., prediction analysis) require more careful attention in future research. Striking the balance between eff...

Staff Perceptions of Behavioral Problems in Nursing Home Residents with Dementia: The Role of Training

Residents of nursing homes with a dementing illness constitute a challenge for direct practitioners because of the presence of behavioral problems often accompanying the illness. A before‐after evaluation design was used to assess characteristics of patients and their staff caregivers at baseline and 1 year after the educational intervention. Overall, resident cognition and functioning declined at posttest, as would be expected due to the nature of the illness. Thirty‐six behaviors were assessed to identify staff perceptions of the frequency and difficulty of managing these behaviors. The most frequently reported behavioral symptoms at baseline were poor personal hygiene and bladder and bowel incontinence; however, after the intervention there were no reports of frequently occurring disruptive behavioral symptoms. Overall, staff perceptions of the frequency and difficulty in managing behavioral symptoms declined by 47% at the post‐test. Although managing difficult behaviors of dementia patients is a chall...

KinNet:A Demonstration Project for a National Support Network for Kinship Care Providers.

Summary The KinNET project came into existence because of the need to support a growing number of grandparents and other relatives providing care for children within the foster care system. It was a demonstration project funded by the Childrens Bureau designed to create a national network of support groups for older relatives mostly grandparentscaring for children in and associated with the foster care system. Grandparents and other relatives are an invaluable resource to the child welfare system. However, these caregivers are also an overburdened population that needs creative and supportive interventions to enhance their capacity to provide quality care and reduce the risks to the children. In this intervention the support group approach was tested (a replication of the Brookdale Foundation model with project management from Generations United). Support groups often provide kinship caregivers with access to important emotional and community support, information and referral, relaxation, and respite. This article briefly describes the project, a profile of the caregivers (n = 102) and the children in their care (n = 226), and highlights from the survey data. In addition, we discuss the three key lessons learned from the project and make recommendations to better serve this population.

Kinship Caregivers: Health and Burden

Grandparents and other relatives are raising more than seven million children in kinship care households in the United States. Kinship caregivers are increasingly sought out to provide care for children as a mechanism for preventing children from entering the formal foster care system. Kinship caregivers who were participants in the KinNET program were surveyed to assess their level of perceived burden, health, and experience in support groups. Satisfaction was high for the support groups and facilitators. The independent variables in the model account for 43% of the variability in the caregivers burden score. The effect of the number of hours of care provided is negligible in magnitude and statistically insignificant.

Family Caregivers for Seniors in Rural Areas

In this article, the demographic characteristics of family caregivers for seniors in rural communities are assessed to examine whether their circumstances could facilitate or impede their well-being. Services available in rural communities for family members providing ongoing care to frail seniors is examined, particularly those that provide health and social services. How families access these services and whether there are specific barriers in service provision are analyzed based on current social work practice and the research literature. Trends for future services are identified as well as whether these trends support new roles for social workers in rural settings.

Effectiveness of an abstinence-only intervention sited in neighborhood community centers

Choices Enhanced is a community-based demonstration and evaluation project targeting inner-city youth, ages nine to 15 at pretest, in Syracuse, New York. The projects evaluation design is a randomized field trial, and the intervention uses an education and youth development curriculum designed to deter unmarried teen pregnancy. Findings reported here are from early in the third year of the project. The intervention was designed to provide each treated subject 24 hours of intervention contact. The projects central goal is to delay the onset of sexual intercourse among unmarried-youth subjects. This was to be achieved through: (1) strengthening commitments to the values of abstinence and the importance of marriage; (2) informing youth more fully with respect to the risks and consequences of youth sexual intercourse outside marriage; (3) strengthening the ability to resist social pressures to have intercourse; and (4) encouraging restraint with regard to future behavior. Hypotheses tested specifically address the goals listed above, using linear and logistic regression methods. The magnitude of estimated treatment effects was modest, and change was sometimes not in the expected direction. At a 0.05 significance level, none of the estimated intervention effects were found to be statistically significant.

Utilization Patterns of Caregiver Education and Support Programs

This chapter analyzes the utilization patterns of caregiver education and support programs with an emphasis on psychoeducational support groups and respite. An overview of the issues, definitions, conceptual frameworks, and evidence from research and current practice is provided. The structure of utilization patterns reviewed in this chapter includes (1) who attends education and support group programs, (2) what specific interventions are used, (3) implications of attendance at these programs, and (4) their beneficial outcomes. Studies reviewed in this chapter include those that focus on utilization patterns as well as outcome studies that examine utilization. Some of the later include studies of service use such as health-care utilization and cost outcomes. This chapter also discusses the status of educational and supportive interventions for caregivers in the future along with their attendant research, practice, policy, and advocacy implications. Families increasingly are caring for frail older adults with the assistance of community-based education and supportive programs. As more baby boomers enter retirement and become chronically ill over the next several decades, the incidence and prevalence of frail older persons needing supportive educational services will increase (National Alliance for Caregiving-NAC, AARP, & Metlife, 2009; NAC & AARP, 2005).