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Family quality of life (FQOL) is a multidimensional social construct that can be used to enhance a family's well‐being by providing a framework to plan interventions and evaluate outcomes. Although researchers and policymakers see value in the FQOL domains and dimensions, families and practitioners are often skeptical of lengthy evaluations and aggregate scores. Furthermore, many practitioners find that family caregivers who require support and services overwhelmingly focus on the family member needing the most care. In doing so, they perceive their situations in a "spaghetti‐like" way. This strong focus on one aspect of the situation, or one "spaghetti" strand, can result in conversations about planning and implementing interventions becoming cyclical, like a messy tangle of strands. The FQOL lens can be used in intervention planning to transform overlapping spaghetti‐like thoughts into a waffle‐like system of interconnected and compartmentalized thoughts. The purpose of this paper was to describe the individual‐level application of the FQOL theory to plan and evaluate the benefits of a peer‐mediated family empowerment project for aging caregivers of adults with intellectual/ developmental disabilities in Michigan, USA. The study provides examples of how individual‐level FQOL evaluation at pretest informed the development of individualized action plans that focused on the strengths, desires, and challenges of 100 aging families in this statewide project. [ABSTRACT FROM AUTHOR]

Repeated claims that a dwindling supply of potential caregivers is creating a crisis in care for the U.S. aging population have not been well-grounded in empirical research. Concerns about the supply of family care do not adequately recognize factors that may modify the availability and willingness of family and friends to provide care to older persons in need of assistance or the increasing heterogeneity of the older population. In this paper, we set forth a framework that places family caregiving in the context of older adults' care needs, the alternatives available to them, and the outcomes of that care. We focus on care networks, rather than individuals, and discuss the demographic and social changes that may alter the formation of care networks in the future. Last, we identify research areas to prioritize in order to better support planning efforts to care for the aging U.S. population. [ABSTRACT FROM AUTHOR]

This study examines caregiver networks, including size, composition, and stability, and their associations with the likelihood of hospitalization and skilled-nursing facility (SNF) admissions. Data from the National Health and Aging Trends Study linked to Center for Medicare and Medicaid Services data were analyzed for 3855 older adults across five survey waves. Generalized estimating equation models assessed the associations. The findings indicate each additional paid caregiver was associated with higher adjusted risk ratios (aRR) for hospitalization (aRR = 1.24, 95% CI 1.10–1.41) and SNF admission (aRR = 1.28, 95% CI 1.06–1.54) among care recipients, a pattern that is also observed with the addition of unpaid caregivers (hospitalization: aRR = 1.13, 95% CI 1.06–1.20; SNF: aRR = 1.12, 95% CI 1.02–1.23). These results suggest that policies and approaches to enhance the quality and coordination of caregivers may be warranted to support improved outcomes for care recipients. [ABSTRACT FROM AUTHOR]

Family care provision is the norm for adults with intellectual and developmental disabilities (I/DD), even as they and their support networks grow older. As families age together, the role of primary carer frequently transitions from the parent to a sibling, as aging parents die or become too frail to provide continued support. The purpose of this paper is to explore the transition in care from the perspective of a sibling who has replaced parents as the primary carer for an individual aging with I/DD. Data are drawn from semi-structured, in-depth interviews with a sample of adults over age 40, living in the United States, and caring for a sibling with I/DD (n = 15). Data were analyzed using a constant comparative qualitative approach. Results reveal themes impacting the adjustment to the role of primary carer, the extent to which aging transformed the content of care needs, the importance of planning, and the availability of supplementary support. Findings from this study underscore the need to develop long-term services and supports as well as educational resources that accommodate this population of carers as they age together with their sibling with I/DD. [ABSTRACT FROM AUTHOR]

Heavy demands upon dementia caregivers can lead to a number of poor health outcomes including declines in physical, mental, and brain health. Although dementia affects people from all backgrounds, research in the US has largely focused on European American caregivers. This has made providing culturally-competent care more difficult. This study begins to address this issue by empirically examining how culturally-shaped beliefs can influence loneliness in family caregivers of people with dementia. We conducted a preliminary questionnaire study with Chinese American and European American family caregivers of people with dementia (N = 72). Chinese American caregivers were more concerned than European American caregivers about losing face, which in turn, was associated with greater loneliness. This pattern remained when accounting for caregiver gender, age, and relationship to the person with dementia. These preliminary findings highlight the role that cultural beliefs can play in adverse caregiver outcomes, and suggest that addressing concerns about losing face may be an important way for healthcare providers to help reduce loneliness among Chinese American caregivers. Understanding how cultural beliefs influence caregiver outcomes is critical as healthcare professionals work to provide culturally-competent care and design culturally-sensitive interventions. [ABSTRACT FROM AUTHOR]

Objectives: To examine the need for and arrangements pertaining to personal care assistance among individuals 65 and older, and how life stage at migration impacts nativity differences in aging-related care. Methods: Using data from the Survey of Income and Program Participation (2001, 2004, and 2008), I examine the odds of needing care assistance, who provides care assistance, and the duration of time care assistance is needed, comparing U.S.-born individuals to migrants who arrived before age 50 ("earlier-life migrants") and those who arrived after age 50 ("later-life migrants"). Results: While earlier-life migrants showed similar patterns to U.S.-born, later-life migrants showed higher care needs, were more likely to receive care from an adult child, and were particularly likely to need care for longer durations compared to U.S.-born. Discussion: Aging later-life migrants have strikingly distinct care needs and arrangements, with implications for individual and family well-being, especially considering their barriers to public support. [ABSTRACT FROM AUTHOR]

The U.S. population of older adults living with dementia is projected to double by 2060. They rely on over 16 million family and unpaid caregivers to provide for their increasingly complex needs and care transitions. Caregivers frequently feel underprepared and without adequate support or access to resources. This systematic review seeks to identify the needs of family and unpaid caregivers of older adults living with dementia across various care settings in the U.S. A systematic search was conducted to identify articles pertaining to the needs of caregivers of older adults living with dementia. The data extraction tool was developed using aspects from the Care Transitions Framework and the Family Caregiver Alliance. Data were organized based on 3 domains of caregiver needs and the care setting(s) of the older adults living with dementia and their caregivers. A total of 31 articles were eligible for inclusion. The majority met the MMAT screening criteria, but more than half only met 2 or less of the 5 quality criteria. Caregivers' needs were identified in the care settings of home/community-residing, assisted living, long-term care, skilled nursing, and memory care. Most articles either did not specify a care setting or included more than 1 and did not report the findings separately. Caregivers in each care setting, except memory care, identified needs in all 3 of the following domains: (1) social support—formal and informal, (2) confidence, competence, and strengths in the caregiving role, and (3) values and preferences. [ABSTRACT FROM AUTHOR]

Objectives To examine (a) the relationship between own depressive symptoms and spouses' health condition changes among mid- and later-life couples and (b) the roles of marital relationship quality and spousal caregiving in this relationship. Method Fixed-effect analyses were conducted using data from 3,055 couples aged 45 and older from Waves 1 (2006) to 4 (2012) of the Korean Longitudinal Study on Ageing. Results Spousal stroke was linked with higher depression symptoms. Spouses' onset of cancer was related to an increase in depressive symptoms for wives, but not for husbands. Spousal caregiving and marital satisfaction were significant moderators: Wives caring for spouses with cancer reported more depressive symptoms than those not providing care; husbands caring for spouses with lung disease reported more depressive symptoms than those not providing care. The associations between wives' heart disease, husbands' cancer diagnosis, and depressive symptoms were weaker for couples with higher marital satisfaction. Discussion The findings suggest variations across health condition types and gender. Relationship quality and caregiving are important contexts moderating the negative impact of spousal chronic illness on depression. Health care providers should be aware that spouses' health statuses are connected and that type of illness may affect the care context. [ABSTRACT FROM AUTHOR]

Objective. To examine the effect of changes in parent-child coresidence on caregiving decisions of non-resident siblings over a 5-year period while controlling for characteristics of the elderly parent and adult children in the family network. Method. We use difference-in-difference models applied to Health and Retirement Study-Assets and Health Dynamics of the Elderly data to test the hypothesis that the formation of a joint household between a parent and one of her children raises the bargaining power of non-resident siblings, who then reduce their care to the parent. Similarly, the dissolution of a parent-child household is expected to increase the bargaining power of the child who no longer coresides with the parent relative to her siblings. Results. We find that children whose parent and sibling begin coresiding during the study period are less likely to provide care and provide fewer hours of care than children whose parents never coresided with a child. Adult children whose parent cease coresiding with a sibling, on the other hand, have a higher likelihood of providing care and provide significantly more hours of care relative to children whose parents either coresided with a sibling in both time periods or never coresided with a child. Discussion. Meeting the needs of the growing elderly population while maintaining them in the community is a particular focus of long-term care policy. To the extent that shared living is an important component of such care, the observed sensitivity of nonresident children's caregiving efforts has implications for the well-being of both disabled parents and their coresiding adult children. [ABSTRACT FROM AUTHOR]