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OBJECTIVES To examine factors associated with caregiver burden from a multifactorial perspective by examining caregiver and care recipient characteristics and a full range of caregiving tasks. DESIGN Nationally representative surveys of community‐dwelling older adults and their family caregivers residing in the United States. SETTING 2011 National Health and Aging Trends Study and National Study of Caregiving. PARTICIPANTS Community‐dwelling older adults and their family caregivers. MEASUREMENTS Caregiver burden, comprising emotional, physical, and financial difficulties associated with caregiving. RESULTS: An estimated 14.9 million caregivers assisted 7.6 million care recipients. More than half of caregivers reported burden related to caregiving. In a multivariable regression model, caregivers who assisted with more activities of daily living and instrumental activities of daily living, health management tasks, and health system logistics were more likely to experience burden, as were female caregivers, adult child caregivers, caregivers in poor health, caregivers with anxiety symptoms, and those using respite care. Dementia was the only care recipient characteristic associated with burden. CONCLUSION: Caregiver characteristics and provision of caregiving tasks determine caregiver burden more than care recipient characteristics. Absence of an association between type of a care recipient's chronic conditions and burden, except for dementia, suggests that the tasks that caregivers who assist older adults with a variety of health conditions undertake shape the experience of caregiving. J Am Geriatr Soc 67:277–283, 2019. [ABSTRACT FROM AUTHOR]

The need for long-term care (LTC) services has been growing, and is escalating with the aging of the baby boomers. Women are the main providers and recipients of care in the formal (paid) and informal (family) LTC system, meaning they bear the brunt of the gap between the need for care and available resources. Without strong public resistance, this gap is likely to be filled by relying upon family care, mainly provided by women. This re-familization of care could turn our crisis of care into a catastrophe for low- and middle-income families. [ABSTRACT FROM AUTHOR]

Duchenne/Becker muscular dystrophy (DBMD) is a disorder of progressive muscle weakness that causes an increasing need for assistance with activities of daily living. Our objective was to assess the psychosocial health and contributing factors among female caregivers in families with DBMD. We conducted a survey of adult women among families with DBMD in the United States (US) from June 2006 through January 2007, collecting data related to the care recipient, perception of caregiving demands, personal factors, and socio-ecologic factors. Life satisfaction, stress, and distress were assessed as outcomes. Existing validated instruments were used when available. We received responses from 1238 women who were caring for someone with DBMD, 24.2% of whom were caring for two or more people with DBMD. Caregivers were more likely to be married/cohabitating than women in the general US population, and a high level of resiliency was reported by 89.3% of caregivers. However, the rate of serious psychological distress was significantly higher among caregivers than among the general population. Likewise, 46.4% reported a high level of stress, and only 61.7% reported that they were satisfied with their life. A high level of caregiving demands based on the Zarit Burden Interview (ZBI) was reported by 50.4% of caregivers. The post-ambulatory phase of DBMD was associated with decreased social support and increased ZBI scores. In multivariate logistic regression modelling, life satisfaction was dependent on high social support, high resiliency, high income, and form of DBMD. Distress and high stress were predicted by low resiliency, low social support, and low income. Employment outside of the home was also a predictor of high stress. Interventions focused on resiliency and social support are likely to improve the quality of life of DBMD caregivers, and perhaps caregivers of children with other disabilities or special health care needs as well. [ABSTRACT FROM AUTHOR]

Little is known about Chinese American dementia caregivers’ psychological and physical response to caregiving. In the present study, descriptive information is presented for a sample of 47 Chinese American dementia caregivers on a variety of psychosocial measures, including measures of depressive symptoms, overall perceived stress, stress specific to caregiving, coping, positive aspects of caregiving, caregiving self-efficacy, and belief in Asian values. Additionally, the association between these psychosocial factors and diurnal cortisol patterns is examined. Generally speaking, these caregivers were found to report significant levels of distress (e.g., depressive symptoms) but also showed indications of resiliency, as suggested by their high levels of self-efficacy, positive caregiving experiences, and problem solving. Stronger beliefs in Asian values were associated with more normal cortisol patterns, less depressive symptoms, and greater self-efficacy, highlighting the salience of culture in shaping the caregiving experience of Chinese Americans. [ABSTRACT FROM AUTHOR]

This paper treats the political and ethical issues associated with the new caretaking technologies. Given the number of feminists who have raised serious concerns about the future of care work in the United States, and who have been critical of the degree to which society 'free rides' on women's caretaking labor, I consider whether technology may provide a solution to this problem. Certainly, if we can create machines and robots to take on particular tasks, we may lighten the care burden that women currently face, much of which is heavy and repetitious, and which results in injury and care 'burnout' for many female caretakers. Yet, in some contexts, I argue that high-tech robotic care may undermine social relationships, cutting individuals off from the possibility of social connectedness with others. [ABSTRACT FROM AUTHOR]

Focus group research on elderly Filipino women living in the United States yields preliminary findings regarding their attitudes toward caregiving and formal service use. Filipino cultural values and the economic challenges attributed to their immigration status were perceived to be the greatest strengths and challenges in caring for the aged. Results identify generally positive attitudes toward formal service use and governmental assistance. Together, these findings shed light on Filipinos' acceptance and use of formal services. Further research to confirm and explore these findings can guide the design of the nation's practice and policy interventions for an increasingly ethnic and cultural diverse older population. [ABSTRACT FROM AUTHOR]

Purpose: Drawing from stress and coping models, we examined heterogeneity in the expression of familism (i.e., beliefs about the caregiving role) and its impact on psychological distress among African American women caregivers. Design and Methods: We relied on data from the Black Rural and Urban Caregivers Mental Health and Functioning study, a cross-sectional study of 521 midwestern African American women family caregivers. First we used the ordinary least squares regression method to examine the factors predicting caregiving beliefs. Subsequently, using hierarchical linear regressions, we regressed caregivers' depressive symptoms and perceived stress on their familism beliefs while controlling separately for interpersonal, personal, and situational contextual factors. Results: Wife caregivers, caregivers with lower levels of education, and caregivers with lower levels of mastery held significantly more traditional caregiving beliefs. Also, having poor caregiving relationships; being younger; being unemployed; and having lower levels of education, self-rated health, and mastery were all associated with higher levels of depression and perceived stress in caregivers. Traditional caregiving beliefs were also significant predictors of higher levels of depression and perceived stress. Implications: Although familism is culturally and socially popular, traditional beliefs in the caregiving role can lead to negative psychological consequences for African American women caregivers. Policies that support the realistic involvement of caregivers are needed to prevent negative consequences for caregivers. [ABSTRACT FROM AUTHOR]

When feminist bioethicists express concerns about health-related gender disparities, they raise considerations about justice and gender that traditional bioethicists have either not raised or raised somewhat weakly. In this article, I first provide a feminist analysis of long-term healthcare by and for women in the United States and women in Taiwan. Next, I make the case that, on average, elderly US and Taiwanese women fare less well in long-term care contexts than do elderly US and Taiwanese men. Finally, I explore some suggested practical remedies to reduce gender disparities in long-term care contexts. [ABSTRACT FROM AUTHOR]

In 2004, there were approximately 44 million men and women in the United States who were providing unpaid care to a family member, friend, or neighbor; these caregivers represented an estimated 22.9 million households (21% of all U.S. households). The 1-year economic value of this unpaid labor force was recently estimated to be $306 billion. Caregiving is an important issue for women, as they represent 61% of those providing care and 65% of those receiving care. Women caregivers tend to fare worse than men, reporting higher levels of symptoms tied to depression and anxiety and lower levels of subjective well-being, life satisfaction, and physical health. In addition, the care that women provide is not without cost to them in terms of their financial future. Still, despite the burden, most caregivers consider providing care to family and friends a rewarding experience. [ABSTRACT FROM AUTHOR]

This study describes a group of seven, urban African American grandmother caregivers' perceptions of family resources. Data for this ethnography design were collected through participant observation, field notes, taped interviews and a genogram to capture. those who were available and unavailable to provide support. The identification of themes yielded that grandmothers could only depend upon family members with resources; sons were viewed as most reliable and dependable; and family members were unable to contribute when managing their own problems. The study results suggest intergenerational programs aimed at the family system is important for meeting the needs of grandmother caregivers. [ABSTRACT FROM AUTHOR]

Research on changes in women's parenting has focused primarily on their increased likelihood of combining parenthood with paid employment, exploring the pressures that result from this "second shift" or "double burden." This article complements this approach by focusing instead on the likely reduction in the help that mothers of small children have received as declines both in fertility and the coresidence of nonnuclear adults have reduced the number of other women in the household. Using national census data for the period 1880 to 2000, we show a substantial decline in the presence and availability of other females in the household, as fewer are coresident and more of those who are coresident are employed or in school. Although all mothers experience this decline, it is most acute for mothers working for pay in nonagricultural activities. [ABSTRACT FROM AUTHOR]

This paper presents an intensive analysis of 61 Northwest Washington State (USA) elder family care providers and their stories of choice, challenge and wisdom as they care for their aged and chronically ill spouses, parents and other loved ones. Family caregivers typically experience crisis conditions in their efforts to deal with their chronically ill relatives or friends. Overall, they lack the skill, knowledge and familiarity with elderly illness conditions to provide the level of care demanded of them. Additionally, they face inadequate financial, social and emotional resources for coping with the extended care of their chronically ill loved ones. The result? Caregivers succumb to depression, illness, financial upheaval and even death long before their work is done. Through their stories, we capture the fundamental imbalances of a society that ignores the needs of the very elderly and those confronting the end of life, as well as those who care for them. As the number of persons living in their 80s, 90s and beyond continues to grow in the U.S. and abroad, so, too, does the need to revamp ill-conceived social policies that fail to address the needs of both the frail elderly and their family caregivers. The stories and experiences of the caregivers will be analyzed using both caregiver data derived from the closed-ended interview schedule, and caregiver narratives, drawing on the responses of the women to open-ended questions. After a description of the sample, the paper explores the ‘caregiver burden’ concept, as an integral part of a descriptive model. This model explores a twofold approach to managing stress among these caregivers: negative emotions, experiences, and outcomes versus positive emotions, experiences and outcomes. As our interview data reveal, these women display high levels of compassion that enable them to overcome their unexpected challenge of care, despite severe self sacrifices. The paper concludes with recommendations for a transformation to a humanistic policy of care that addresses various issues raised by the plight of these overburdened and largely unskilled—although life-affirming—caregivers struggling with their family crisis. [ABSTRACT FROM AUTHOR]

This study examined the relative importance of caregiver substance abuse as a correlate of child-reported exposure to violence. A total of 407 female African-American primary caregivers and their children age 6 to 7 were evaluated. The association between child report of violence and exposure to substance abuse by others (both within and outside the home) was considered after controlling for variance accounted for by child characteristics, caregiver characteristics, home environment, and neighborhood environment (including neighborhood crime). Caregiver alcohol abuse, children's witnessing of drug use in the home, and children's witnessing of drug deals all explained significant additional variance in violence exposure. These findings suggest that for early elementary-age children, meaningful prevention of violence exposure may be possible via addressing their exposure to substance abuse in their home and community. [ABSTRACT FROM AUTHOR]

This study explores how cultural values affect the meaning and experiences of daughter (or daughter-in-law) caregivers of elderly persons with dementia by comparing caregivers in the United States and Japan. Nine American and seven Japanese caregivers were interviewed twice at 6-month intervals. Interviews were audiotaped and analyzed using constant-comparative techniques. Data suggest that moral obligation to care and intense loss are two universal themes of caregiving. However the experiences and perceptions of the role of caregivers from these two cultures differed in select ways that were captured within three categories: reasons for caregiving, caregiving as a career, and caregiving as a life phase or detour. Findings suggest that American caregivers may need greater anticipatory socialization regarding the caregiving role, whereas Japanese caregivers may benefit from assistance in accepting needed services. [ABSTRACT FROM AUTHOR]

Caregiving to family members comprises a major part of familial obligations in the United States. Informal caregiving is unevenly distributed in society, with women performing most of the work and bearing the burden of its costs. This paper addresses the cost dimension of informal caregiving to family members by examining whether and how it penalizes women’s employment. Drawing data from the 1987 and 1992 National Survey of Families and Households, we examine whether and how caregiving transitions affect changes in women’s labor force participation and the implications of this caregiving transitions for their earnings. We calculate how these effects vary for demographically different groups of women: those older and younger, with and without high levels of education, and married and not married. Our findings reveal that for most women, the initiation of caregiving led to a substantial reduction in their weekly hours worked and annual earnings. However, the effects were different for various subgroups of women: those older, with fewer skills, and more competing roles paid substantial costs if they began caregiving between 1987 and 1992. [ABSTRACT FROM AUTHOR]

Women and racial/ethnic minority dementia caregivers have unique caregiving experiences and support needs. To ensure the identification of potentially important differences in outcomes within these groups, the amended National Institutes of Health (NIH) Policy on Inclusion of Women and Minorities mandates reporting by gender and race/ethnicity. The objective of this study was to determine the inclusion and reporting rates among NIH-funded dementia caregiver support interventions. A focused systematic literature review of studies published from 1994 to 2015 located 48 articles meeting inclusion criteria. The majority of studies included women and racial/ethnic minorities; however, 67% did not report results by gender or racial/ethnic group. Acknowledgment of underreporting was more common for race/ethnicity than gender. Our findings suggest limited NIH guideline compliance that may reflect a lack of awareness regarding potential gender disparities in caregiving roles. Ensuring NIH guideline compliance necessitates shared investments from researchers, editors, and reviewers to ensure group differences are systematically identified and reported.

The article reveals that a study by the Alzheimer's Association called "The Shriver Report: A Woman's Nation Takes on Alzheimer's" shows that women are significantly and disproportionately affected by the disease. The report adds that about 10 million American women are suffering from Alzheimer's or are providing care for someone who is. Experts also forecast that the number of Alzheimer's patients will triple by 2050.