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Family caregivers play a crucial role in providing care and support for people with mental health conditions, such as schizophrenia. A quantitative design was used to assess caregivers of people with a diagnosis of schizophrenia (PWS) in relation to their stress levels, perceived social support, resilience, and life satisfaction. Standardized instruments to assess the manifestation of the key variables were administered to 75 caregivers identified within a clinical setting in south India using survey methodology. Regression analyses reveal that while resilience mediates the influence of stress on life satisfaction, social support did not moderate the effect of stress on resilience. [ABSTRACT FROM AUTHOR]

The abrupt onset of the COVID-19 pandemic necessitated an unprecedented shift to remote schooling for students across the United States and required many caregivers to take a primary or secondary role as schoolteacher. The goal of this study was to better understand caregivers' experiences of schooling from home during the spring 2020 COVID-19 closures. Roughly 1,000 caregivers, the majority of whom were White, highly educated mothers, responded to the survey, documenting their children's daily remote learning experiences and providing insight into the frequency and perceived quality of specialized services and individualized support plans. Results highlight the wide variability in students' daily educational experiences. Estimates of assigned work ranged from less than 30 minutes to more than three hours per day across grade levels, and approximately 1 in 4 caregivers reported that their child received no synchronous instruction. Furthermore, reports provide insight into the specific stresses experienced by caregivers in navigating schooling from home, most notably related to time and communication. Impact Statement Results of the first national survey of caregivers regarding their experiences of schooling from home during the spring 2020 COVID-19 closures highlight how different remote schooling looked—both from typical in-person learning and across the country. Caregivers described limited synchronous instruction, inconsistent home–school communication, and lack of adequate supports for students requiring specialized services. Limited time and content knowledge were reported as common barriers to caregiver assistance with schooling. [ABSTRACT FROM AUTHOR]

The purpose of this study is to determine how individual and contextual factors that contribute to homicide-suicide (HS) differ between young adults, middle-aged adults, and older adults, and to describe, in detail, the circumstances that lead to HS by older adults. Data were obtained from the Center for Disease Control and Prevention (CDC) National Violent Death Reporting System. We used a sequential mixed methods approach to the analysis. Guided by the Marzuk HS framework, we conducted quantitative analyses to identify characteristics distinguishing older adult HS perpetrators from younger HS perpetrators. These results guided the qualitative content analysis, which further described the circumstances surrounding HS incidents perpetrated by older adults. While HS perpetrated by young and middle-aged adults were quite similar, the demographic characteristics, victim-perpetrator relationship, and contributing factors in HS incidents perpetrated by older adults were substantially different. Mental health and depressed mood were more common among older adult perpetrators, and jealousy, fights, and substance use issues were less common, relative to younger perpetrators. Escalating intimate partner violence and caregiving/health-related issues, including caregiving strain, housing transitions, and financial problems, were the primary contributors to older adult HS. HS perpetrated by older adults was both similar and different from incidents perpetrated by younger adults. Programs that prevent or de-escalate intimate partner violence would likely prevent many HS incidents perpetrated by older adults, but health and aging-related issues must also be considered. [ABSTRACT FROM AUTHOR]

Compare care demands, strain, and health across 912 primary and secondary caregivers of parents, other family, and friends aged 50 and older. Data came from the nationally representative Caregiving in the U.S. 2015 data set. Two by three factorial ANOVAs and binary logistic regression examined the effects of primary caregiver status and relationship type on care demands and well-being. Primary caregivers provided more hours of care for a longer duration and were more likely to report financial stress, and that caregiving made their health worse. Primary caregivers did not differ from secondary caregivers in emotional stress, and physical strain was comparable in primary and secondary caregivers of parents and other family. Caregivers of parents generally reported the highest levels of demands and stress/strain. Controlling for amount of care provided attenuated some of these differences. Secondary caregivers provide less care but report emotional stress comparable to primary caregivers. Primary caregivers of friends provide high levels of assistance that may increase their physical strain. Caregiver research and intervention should include greater attention to needs of secondary caregivers, and caregivers of friends, and ways to strengthen their potentially critical roles. [ABSTRACT FROM AUTHOR]

Objectives: The capability to 'live well' in people with dementia can be influenced by many factors, including those related to the experiences of their informal caregiver. How caregivers experience their own role can affect not only their well-being but also the way they provide care and hence the experience of the person with dementia. The aim of this study is to identify the potential impact of the caregiver's perception of the caregiving experience on how people with mild to moderate dementia self-rate their QoL, well-being and satisfaction with life. Method: This study utilised time-point 1 data from 1283 informal caregiver and the 1283 people with dementia whom they provide care from the IDEAL cohort study. Multivariate modelling was used to investigate the associations between measures related to the caregiver's perception of the caregiving experience (caregiving stress, perceived social restrictions, caregiving competence, positive aspects of caregiving, and coping) and the self-ratings of QoL, satisfaction with life, and well-being by the person with dementia. Results: Lower QoL ratings by the person with dementia were associated with high caregiver stress (−1.98; 95% CI: −2.89, −1.07), high perceived social restrictions (−2.04; 95% CI: −2.94, −1.14) and low caregiving competence (−2.01; 95% CI: −2.95, −1.06). Similar associations were found for satisfaction with life and wellbeing. Positive aspects of caregiving and coping were not associated with outcomes for the person with dementia. Conclusion: The findings indicate that how the caregiver experiences caregiving can affect the person with dementia. This finding reinforces the importance of providing support to caregivers. [ABSTRACT FROM AUTHOR]

This article reports a study examining the impact of an internet-based meditation program in mitigating stress and promoting wellbeing among older adult caregivers of their spouses with acquired late-life disability in Central Europe and South Asia compared to leisure. Posttest (T2) the meditation cohort exhibited lower caregiver burden and psychological distress, improved responses to care challenges, and greater wellbeing compared to the leisure group. South Asians, women, middle class, college educated, whose spouses had locomotor and sensory disabilities and lived as a couple alone, reported lesser caregiving burden, improved responses to care challenges, lesser distress and greater wellbeing at T2. Meditation lessons attended and self-practice mediated the relationship between demographic predictors and outcomes and self-practice had the largest positive impact. Meditation influenced certain aspects of caregiver wellbeing more such as self-care and certain specific aspects of wellbeing. Internet-based caregiver interventions are evidence as useful for social work with older caregivers. [ABSTRACT FROM AUTHOR]

Previous studies have noted the inadequacies within Ghana's mental health system. These studies highlighted challenges associated with caregiving before the passage of Ghana's current Mental Health Act (Act 846) of 2012. Yet, there is paucity of research on the wellbeing of caregivers in community-based mental health care, following the passage of the Mental Health Act. This study investigated the influence of caregiver stress and affiliate stigma on family caregiver wellbeing. Further, it assessed the differences in stress, affiliate stigma, and wellbeing between community and institutional family caregiver groups in the Eastern Region of Ghana. Two hundred and eighty family caregivers of persons living with any type of mental illness were purposively sampled for the study. Results of Hierarchical Multiple Regression analysis showed that, caregiver stress negatively significantly influenced caregiver wellbeing. Moreover, results of a Multivariate Analysis of Covariance showed a significant difference between community and institutional family caregivers in the combined experience of stress, affiliate stigma and wellbeing, with community family caregivers scoring higher on wellbeing than did institutional family caregivers. Implications for caregiver interventions in the Eastern Region of Ghana are discussed. [ABSTRACT FROM AUTHOR]

Objectives: Parents of children with autism spectrum disorder (ASD) report high levels of stress that can interfere with important child and family treatments. Limited past research considers how the caregiving experience and social determinants of health may contribute to treatment engagement and outcomes, particularly in underrepresented families, who already experience service and health disparities. We aimed to assess the experiences of caring for an individual with ASD, with specific emphasis on perceptions of stress. Methods: Three key informant interviews were conducted with parents (n = 1) and providers (n = 2) of children with ASD to refine interview guide questions. Once questions were refined, four focus groups (n = 17) and one key informant interview were conducted with parents of children with ASD who were (a) non-white, (b) Spanish speakers, (c) of limited financial resources, and/or (d) living in rural counties. All participants lived in Western New York, with the majority residing in Rochester. Content analysis by two independent coders was used to identify and refine themes. Results: Themes included: (a) caregiving for an individual with ASD can cause interference with family functioning, (b) misperceptions of ASD contribute to caregiver stress, (c) culture contributes to stressors for parents, and (d) service navigation difficulties are a significant source of stress. Suggestions for interventions to address parents stress included: modular and integrative treatments for multiple content areas, addressing cultural barriers to treatment engagement, and education on ASD to the community. Conclusions: Parent-focused interventions for caregivers of children with ASD should specifically explore and address service and health disparities for parents, especially those predicated on race, ethnicity, rurality, and language of origin. Interventions should also be individualized to parent characteristics and experiences. In future research on parent training, the unique contributions of caregiver stress and other characteristics (e.g. race-related stress, geographic location) should be included as potential modifiers of treatment. [ABSTRACT FROM AUTHOR]

Purpose:This systematic review aimed to reconceptualize experiences from a variety of papers to provide direction for research, policy and practice. Method:Meta-ethnography was used to inform the review, and 21 studies were included. Findings:The analysis identified a core theme of “engaging in care: struggling through”, as carers, who wanted to be involved in caring, learnt to live with the intense and stressful impact of caring and changes to their life. The core theme is represented through three themes (1) Helping another to live, (2) Adapting ways of living and (3) Negotiating the unknown. Conclusions:The discussion identified a focus on carers of people suffering from a hip fracture, the willingness of informal carers to engage in caring and the intense experience of adapting to changes in relationships and dependency alongside a steep experiential learning curve. Tensions exist in negotiations with complex health care systems as carers do not feel their expertise is valued and struggle to find and understand information. Implications for RehabilitationIncluding relatives/carers in the umbrella of care within a family-centred approach.Involving relatives/carers within shared decision-making about care requirements and rehabilitation goals.Utilizing forms of experiential learning to help the development of relatives/carers skills in relation to their role as carer.Providing opportunities for carers to explore ways of sustaining their own health through self-compassion. [ABSTRACT FROM PUBLISHER]

Research has found that viewing nature reduces stress and improves mood, but few studies have focused on the potential of viewing nature to reduce negative emotions associated with dementia. Using a counterbalanced design, 14 memory care residents were alternately exposed to a virtual nature experience (treatment) and a generational movie (control). Before and after each exposure, heart rate was measured, and emotions were assessed with the Observed Emotion Rating Scale and the Agitated Behavior Scale. Results are that heart rate declined significantly compared with the generational movie, and anxiety and pleasure showed greater improvements during the nature intervention, although the difference was not significant. [ABSTRACT FROM AUTHOR]

Purpose: Psychosis is often seen as a "burden" on families and affected individuals frequently hold a negative view of themselves. This study explored the ways in which young adults who have experienced first-episode psychosis make a positive contribution within their families. Methods: Fifteen participants (seven young people with experience of psychosis and eight relatives) were interviewed separately. Their accounts were analysed using grounded theory methodology. Results: For many individuals, their experience had led to a catastrophic redefinition of their identity. However, they continued to contribute significantly both within their families and within their wider communities. The redefinition of identity sometimes appeared to create a "perceptual filter" whereby both the person themselves and family members overlooked or minimised their contribution, focusing instead on being alert to signs of psychosis or illness. Conclusions: Shame and a focus on symptoms rather than achievements and contributions can significantly limit opportunities, expectations and movement beyond an illness identity. It is important for clinicians to be aware of this and to help young people and their families to notice and value positive contribution, and so promote recovery, well-being and post-traumatic growth. [ABSTRACT FROM AUTHOR]

This exploratory qualitative study examined the feasibility of utilizing gaming technology that will ultimately assess task performance and stress among caregivers of dementia patients. The long-term goal is to use this unobtrusive application (app) to detect caregiver burnout for the purposes of early intervention. This preliminary study examined participant interface with a specific gaming technology called CAST (Caregiver Assessment Using Serious Gaming Technology). Ten dementia caregivers participated. Participants attended a demonstration and then interacted with a preliminary version of the CAST tablet application. Social work researchers interviewed participants using open-ended questions to gauge interest, technology skill level, and comfort with the app. Participants expressed interest and identified potential ways to further develop the system in order to increase ease of use, decrease time commitment, and improve suitability for daily use. The provided feedback will be used to refine the user interface of the application, which will then be used to monitor caregivers’ stress in future development. [ABSTRACT FROM PUBLISHER]

This study examined experiences of 156 informal caregivers of older adults who transitioned to the community through the Connecticut Money Follows the Person (MFP) Rebalancing Demonstration after prolonged nursing home stays. Caregiver burden, positive aspects of caregiving, depressive symptoms, anxiety, and comparative subjective stress were examined in relation to caregiver demographics and care receiver characteristics with a cross-sectional survey. Caregivers reported low burden, depressive symptoms, and anxiety, and fairly high levels of positive aspects of caregiving and satisfaction with community services. Most caregivers were less stressed compared to the time the care recipient was in, or before they entered, a nursing home. Live-in caregivers experienced more positive aspects of caregiving, but adult children reported higher burden than other caregivers. Unmet service needs also increased caregiver burden. Programs like MFP are a viable option with broadly positive outcomes from a caregiver's perspective. Enthusiasm for increasing access to community care is growing for older adults who otherwise would reside in nursing homes for extended periods. Identifying unmet service needs and needs for targeted functional support could further enhance caregiver experiences and contribute to the successful transition of older adults to the community. [ABSTRACT FROM AUTHOR]

Background:Spatial neglect prolongs stroke survivors’ recovery to independence. However, little is known about the impact of spatial neglect on caregivers of stroke survivors. Objective:To explore the factors associated with burden and stress among informal caregivers of stroke survivors with spatial neglect. Methods:Following the previous study of 108 stroke survivors, we reached 24 stroke survivors’ caregivers, and 20 caregivers (age: M±SD=56.9±12.7 years; 12 females) completed the study. 10 survivors had symptoms of spatial neglect, and 10 did not (i.e., SN+ or SN-, respectively) at the time when discharged from inpatient rehabilitation, which was 9.3±6.2 months before the present study. Via a semi-structured telephone interview, we assessed caregivers’ burden and stress qualitatively and quantitatively. Results:No difference was observed across caregiver groups in cognitive function, depressive mood, or community mobility. In comparison, caregivers of the SN+ group allocated more time to care, controlling for survivors’ disability (adjusted effective sized= 1.80). Their self-perceived burden and stress were more severe than the other group (adjustedd= .99). Qualitative analysis indicated caregivers of the SN+ group were more likely to describe economic stressors and undesirable changes in career and vacation planning. While 80% of participants preferred their care recipients to receive additional motor or mobility therapy, caregivers of the SN+ group were more likely to suggest additional therapy for cognitive impairment. Conclusions:This exploratory study suggests that spatial neglect may heighten caregivers’ burden and stress levels. Future studies with a large sample size are required. [ABSTRACT FROM PUBLISHER]

This study examined how state expenditure on home- and community-based services (HCBS) and individual factors are associated with caregiver stress. A total of 1,849 cases from the 2004 National Long-Term Care Survey were included. Gender, education, perceived physical strain, and economic hardship, as well as the number of limitations in instrumental activities of daily living (IADL) for the care recipient, were associated with caregiver stress. The cross-level interaction between service utilization and state expenditure on HCBS was significant, suggesting that living in states with a higher expenditure on HCBS is associated with reduced stress regardless of service utilization. [ABSTRACT FROM AUTHOR]

Perception of caregiver burden among stroke survivors varies based on socioeconomic and cultural backgrounds. The objectives of this study were to identify the burdens among Thai caregivers of older stroke survivors, characteristics of caregivers and severity of caregiver burden. Caregivers of older stroke survivors were randomly interviewed (March–June, 2012). Information on baseline characteristics and caregiver burden using Zarit Burden Inventory (ZBI) was collected. One hundred one participants were assessed. The mean ZBI was 21.6 ± 14.5 [95% CI, 18.7–24.8]. More than half of caregivers reported no burden (54.5%). High burdens were associated with low self-reported income, high numbers of basic activities of daily living needed and coexisting musculoskeletal conditions. The observed low degree of burden might be the result of the sociocultural view of the study participants. [ABSTRACT FROM AUTHOR]

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Home-based child caregivers face unique stressors related to the nature of their work. One hundred and fifty-five home-based child care providers in Oregon, USA, participated in this cross-sectional correlational study. We investigated associations between indicators of caregiver stress and child care working conditions, the quality of caregiver practices, frequency of child behaviour challenges, and caregivers' tolerance for those behaviours. Levels of stress in this sample were moderate to low. Significant associations were found between greater caregiver stress with higher child–caregiver ratio, working in isolation, less frequently observed caregiver positive attention, more caregiver-reported child problem behaviours and lower tolerance for problem behaviours. A multiple regression analysis with these variables significantly contributed to 23% of the variance of caregiver stress. Number of hours worked, observed caregiver negative attention, and responsiveness to children were not associated with caregiver stress. Implications of these findings and the need for future studies are discussed. [ABSTRACT FROM PUBLISHER]

This article is written by two university social work professors who illustrate the value of spiritual practices in caring for their elderly mothers, one who had Alzheimer's disease and the other who has a mental illness. The article discusses ways that human service professionals (e.g., social workers, mental health practitioners, nurses, chaplains, and other professional caregivers) can support caregivers and care receivers to explore and enhance the spiritual dimension of life, using activities such as reading sacred texts, listening to religious music, attending faith-based services, engaging in private devotional practices, praying, or connecting in a spiritual community. [ABSTRACT FROM PUBLISHER]

Kinship care is defined as informal custodial care for children (typically grandchildren) due to parental hardship or absence. In contrast, dementia family caregiving refers to care rendered to an impaired, demented adult, typically an older husband or wife. Literature is reviewed and parallel issues relating to stress and coping that impact both caregiver groups are noted. Data are presented from both survey and focus groups conducted with kinship caregivers and their social service caseworkers. In light of previous research conducted with dementia caregivers, practice implications are discussed and several specific recommendations are presented for program development and further research with kinship caregivers. [ABSTRACT FROM AUTHOR]

In this study the authors investigated stress, anticipatory mourning, and cultural practices among family caregivers from independent and interdependent cultural groups. Focus groups were used to collect data from 56 caregivers providing care to family members with terminal cancer, representing four cultural groups in Hawai‘i: Chinese, European Americans, Japanese, and Native Hawaiians. Participants from all four cultural groups identified similar stressors and agreed that support groups helped them cope with the stresses and sadness they were experiencing and differed in culturally based motivations for caregiving, perceived roles, and processing of grief. The findings of this study indicated a need for additional conceptual models of the caregiving trajectory and more culturally sensitive strategies, particularly indirect methods, for working with diverse populations of caregivers. [ABSTRACT FROM PUBLISHER]

This paper reports on data from a population of caregivers of people with Autism Spectrum Disorders (ASD) to examine the extent and motivations for their use of the Internet to obtain information on caregiving. The study found not only considerable interest for web-based information but also a strong bifurcation among respondents on the preferential type of information. The majority of respondents indicated that websites that provide factual information about caregiving are most important. Other respondents saw the Internet as a vehicle for social exchanges about ASD. Regardless of their preferred method to consume web-based information, all respondents reported using websites to obtain caregiving information. [ABSTRACT FROM AUTHOR]

The literature clearly denotes that spouses differ from other family members in their reactions to caregiving, their patterns of service use and their assessment of specific services. Yet, despite their prevalence as caregivers, little is known about their unique perceptions of community services and the factors that impact their experiences with the service system. The purpose of this study was to explore the relative influence of (a) spouses' personal factors (e.g., gender, family support) and (b) service factors (e.g., one-on-one professional support), on spousal caregivers' perceptions of community services. The study employed a survey design with a sample of 73 spousal caregivers caring for their partners with dementia at home. This study found that spousal caregivers have more negative perceptions of the service system when their in-home workers are not informed about their spouses' likes, dislikes and routines. This service factor was the most significant predictor of caregivers' service perceptions. The study further found that most spousal caregivers receive fewer than five consultations from a non-medical professional over a one year period. While spouses longed for more professional support, this service factor was not uniquely associated with service related stress. The policy and practice implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

This study examined the role that faith-based organizations play for caregivers in maintaining the elderly and disabled in their homes. The study explored if persons who use religious beliefs and practices cope with caregiver stress better than those who do not use religious beliefs and practices. The study also explored the role of religious coping as a factor affecting decisions to institutionalize, and the role that faith based practices and organizations play in helping caregivers maintain the elderly and disabled in their homes. [ABSTRACT FROM AUTHOR]

Forty medical residents from major teaching hospitals in Boston, Massachusetts. participated in small group teaching sessions about caregiver stress. A teaching tool was developed that included a teaching handout, interactive cases, standard instruments for assessing caregiver stress, peer-reviewed articles about caregiving, and a list of resources that would be useful to a caregiver. These materials and teaching format were evaluated using a pre- and posttest and a feedback form. Forty residents completed the pretest and posttest. They scored significantly higher on the posttest for questions that covered estimated cost of caregiving (p = 0.0073). physical stress from caregiving (p = 0.0196). and identifying elder abuse (p = (1.0006). Ninety percent of the residents completed the evaluation form and rated the intervention highly. Teaching medical residents about caregiver stress resulted in a significant increase in knowledge about this topic. This study makes the case for the integration of "Caregiver Stress" into the primary care residency curriculum. [ABSTRACT FROM AUTHOR]

This paper provides a description of a pilot (feasibility) study conducted with Iranian caregivers in northern CA. The intervention program was based on a previously successful program with ethnically diverse dementia family caregivers; it was "tailored" for Persian caregivers, most of whom were Farsi-speaking. A brief description of the intervention is provided, along with a summary of evaluation data collected. Caregivers were very appreciative of the opportunity both to talk about their caregiving distress, and to learn skills for better coping. A complete Farsi translation of the culturally modified "coping with caregiving" class was one of the end-products of this pilot study. [ABSTRACT FROM AUTHOR]

The emotional needs of family caregivers are not often addressed during the resident's transition into a Long-Term Care (LTC) setting. This may be particularly true for urban African American caregivers since many urban nursing homes are primarily Medicaid-only bed facilities and have correspondingly low staffing ratios. The current study describes observational data for two caregiver interventions: (1) a peer mentoring intervention for informal caregivers having just admitted a loved one to an LTC and (2) training sessions for informal caregivers who have a loved one in an LTC. Examination of baseline and 3-month follow-up data indicated that caregivers demonstrated decreased stress in both groups, while depression levels remained unchanged. The project led to a series of caregiver pamphlets, specific for nursing home settings. [ABSTRACT FROM AUTHOR]

Complex medication regimens that result in medication administration hassles, the daily irritants that caregivers experience when assisting another person with a medication regimen, are now known to be related to increased caregiver strain. This paper reports data regarding the prevalence of the most intense individual medication administration hassles by selected caregiver characteristics (gender, race, age, employment status). The results underscore the necessity and utility of asking caregivers specific questions about multiple aspects of their medication administration responsibility, and provide insight into groups that should be targeted for information access and educational support. [ABSTRACT FROM AUTHOR]

While past research has focused on various factors related to caregiver adaptation to institutionalization, a comprehensive measure of social class has yet to be considered as a possible predictor of caregiver stress and psychosocial well-being. The present study investigated this relationship in caregivers of family members institutionalized with dementia (N = 185). Results showed that caregivers in higher social strata visited less frequently and reported lower levels of guilt than those in lower social strata. The findings illustrate the importance of recognizing the influence of social class following placement and point toward practice implications that may ease this transitional period. [ABSTRACT FROM AUTHOR]

There has been growing awareness that respite for family caregivers of persons with Alzheimer Disease can be conceptualized as a positive inner psychological experience as well as a service to provide a physical break. Little is known, however, about the specific activities and strategies caregivers use to achieve therapeutic mental breaks from caregiving concerns. This study examined the strategies and circumstances identified by 15 adult primary caregivers as providing mental breaks. Caregivers participated in two qualitative interview sessions and followup member checks. Case-by-case and cross-case analyses, and structural synthesis were conducted to develop a working model describing mental breaks. This paper overviews the model, presents two cases illustrating model components, and provides preliminary implications for practice to stimulate therapists' thinking about applications for helping caregivers achieve mental breaks. [ABSTRACT FROM AUTHOR]

In this longitudinal study of stress among caregivers of patients up to one year following hip fracture, scores on the Caregiver Strain Index (Robinson, 1983) declined overall from 2, 6, to 12-month follow-up. However, 2 of the 13 items were reported at increasing rates and caregiver strain increased by twelve-month follow-up among caregivers living with a patient who fell during the follow-up period. Recommendations for addressing modifiable factors associated with caregiver stress include promoting functioning in activities of daily living, medication monitoring and environmental modifications, addressing positive aspects of caregiving, plus further exploration of social supports and services for caregivers. [ABSTRACT FROM AUTHOR]