scholarly journals COMBATTING LONELINESS: SERVICE USE AMONG RURAL FAMILY CAREGIVERS OF PERSONS WITH DEMENTIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S888-S888
Author(s):  
Emily K Hoyt ◽  
Karen A Roberto ◽  
Jyoti Savla
Keyword(s):  
Family Caregivers ◽  
Service Use ◽  
Well Being ◽  
Personal Care ◽  
Rural Caregivers ◽  
Rural Family ◽  
Emotional Loneliness ◽  
Formal Services ◽  
Rural Appalachia ◽  
Social Loneliness

Abstract According to a 2018 AARP study, 42% of unpaid caregivers experience loneliness. While findings across multiple studies suggest that caregivers experience loneliness either because they lack intimacy in close relationships (i.e., emotional loneliness) or they feel disconnected from their social network (i.e., social loneliness), little is known about how aspects of dementia caregiving influence loneliness, particularly among rural caregivers. The purpose of this study was to examine the association between in-home service use and caregivers experience with both types of loneliness. Eighty-eight co-residing dementia caregivers in rural Appalachia (Mean Age = 68 years; 91% White; 58% Spouses) completed telephone interviews that included questions about their use of formal services and perceptions of emotional and social loneliness. More than half (58%) of the caregivers accessed 1 to 4 formal services. Regression models revealed that caregivers who experienced greater social loneliness were more likely to access personal care services (p=0.013) and respite services (p=0.004) compared to caregivers who experienced less social loneliness. Further, caregivers who experienced greater emotional loneliness were also more likely to access personal care (p=0.028) and respite (p=0.039) services compared to caregivers who experienced lower emotional loneliness. These associations remained robust even after controlling for relationship to the PwD (spouse vs. non-spouse). Findings suggest that beyond assisting with the care of the PwD, the use of formal services may help family caregivers manage loneliness and relieve social isolation. Discussion will focus on the importance of service accessibility and use for the health and psychological well-being of rural family caregivers.

scholarly journals Family Caregivers in Rural Appalachia Caring for Older Relatives with Dementia: Predictors of Service Use

2021 ◽  
Author(s):  
Jyoti Savla ◽  
Karen A Roberto ◽  
Rosemary Blieszner ◽  
Aubrey L Knight
Keyword(s):  
Family Caregivers ◽  
Support Services ◽  
Structural Equation ◽  
Service Use ◽  
Structural Equation Models ◽  
Behavioral Model ◽  
Community Dwelling ◽  
Personal Services ◽  
Formal Services ◽  
Rural Appalachia

Abstract Background and Objectives Residents of rural Appalachia tend to experience poorer health and greater economic distress than rural dwellers elsewhere in the U.S. Although family is the first line of support for older adults needing care, it is unclear whether dementia caregivers in Appalachia assume these care responsibilities because of strong informal networks that support them in their caregiving role, under-resourced formal services for persons with dementia, or culture-based reluctance to accept help from outsiders. This research examines how rural residents of Appalachia manage the care of relatives with dementia. Research Design and Methods The study was grounded in the Andersen Behavioral Model, supplemented with culturally-relevant variables. Family caregivers from rural Appalachian counties in Virginia caring for community-dwelling relatives with dementia participated in a structured phone interview (N = 163). Generalized structural equation models were estimated, with predisposing, need, and enabling variables as predictors. Use of support services (e.g., meal delivery) and personal services (e.g., home health nurse) by family caregivers to care for the person with dementia were the dependent variables, and caregiver’s rural community identity and attitude toward services were moderators. Results Approximately half the sample utilized at least one support service and one personal service. Predisposing and need factors predicted the use of support services, whereas predisposing, need, and enabling factors predicted personal services. Caregivers who strongly identified with their cultural roots were less likely to use personal services unless they held a generally positive view of formal services. Discussion and Implications Although the extent of needs and the caregiver's economic situation were essential influences on formal service utilization, the main drivers were the caregiver's identification with rural Appalachian culture and attitude toward services. Findings point to within-group heterogeneity that requires differential approaches to delivery of community-based services accounting for varying attitudes, preferences, and family resources.

scholarly journals When the Day Goes Awry: Families Caring for Persons With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 638-639
Author(s):  
Karen Roberto ◽  
Jyoti Savla ◽  
Steven Zarit
Keyword(s):  
Family Caregivers ◽  
Rural Areas ◽  
Service Use ◽  
Management Strategies ◽  
Care Quality ◽  
Future Research ◽  
Full Time ◽  
Daily Lives ◽  
Formal Service ◽  
Formal Services

Abstract The daily lives of family caregivers of persons with dementia (PwD) often require that they manage multiple competing demands in a context of unpredictability. Memory and behavior changes associated with dementia can cause PwD to act in random and irrational ways that create stress and influence all aspects of caregivers’ everyday life. Supportive others, including informal helpers and formal service professionals, should provide relief to primary caregivers; however, help may not alleviate caregiver stress and can sometimes compound the burden of care. This symposium draws on daily diary surveys and face-to-face interviews to focus on four aspects of managing everyday care of PwD among family caregivers in rural areas. Brandy Renee McCann explores how caregivers’ vigilance on behalf of PwD care quality interacts with service use. Karen Roberto examines the ways in which caregivers manage PwD resistance to help, including their use of forceful care strategies. Rosemary Blieszner focuses on competing caregiver roles and demands that may contribute to or alleviate caregiver stress. Tina Savla addresses the unexpected, and often hidden, challenges involved in using formal services. Collectively, the four presentations provide in-depth insight into the complicated daily lives of families coping with dementia and the ways in which they meet the demands of full-time caregiving under often difficult and challenging circumstances. Discussant Steve Zarit considers the efficacy of these management strategies for various aspects of everyday care and offers suggestions for future research and person-centered programs and interventions to reduce health disparities among caregivers in rural areas.

Gender and Marital-History Differences in Emotional and Social Loneliness among Dutch Older Adults

2004 ◽  
Vol 23 (2) ◽  
pp. 141-155 ◽  
Author(s):  
Pearl A. Dykstra ◽  
Jenny de Jong Gierveld
Keyword(s):  
Older Adults ◽  
Gender Differences ◽  
Living Arrangements ◽  
Well Being ◽  
Social Embeddedness ◽  
Men And Women ◽  
Marital History ◽  
Emotional Loneliness ◽  
Social Engagements ◽  
Social Loneliness

ABSTRACTIn this study, Weiss's (1973) theorizing about the sources of emotional and social loneliness is elaborated – with notions about the asymmetric gratifications derived from marriage, about the conflicting loyalties that result from remarriage, and about selection into marriage – in order to reach an understanding of gender differences in loneliness, both in and outside of marriage. First and subsequent marriages are considered, as well as marital disruptions and never marrying. The data (N = 3737) are from the 1992 Dutch survey on older adults' living arrangements and social networks (NESTOR-LSN). Marital-history differences emerge, not only for emotional loneliness, but also (and contrary to Weiss's theoretical conceptualizations) for social loneliness. The marital-history differences in emotional and social loneliness are greater among men than women. For men, the marriage bond appears not only to be more central to emotional well-being than is the case for women but also to play a pivotal role in their involvement with others. Marital history offers the best explanation for differences in emotional loneliness among men, but social embeddedness characteristics also account for differences in emotional loneliness among women. Apparently, whereas men are more likely to find an intimate attachment in marriage, women also find protection from emotional loneliness in other close ties. The marital-history differences in social loneliness are largely mediated by social embeddedness characteristics, partly in different ways for men and women. Involvement in activities outside the home serves as the context for sociability for men, whereas parenthood plays a more important role in women's social engagements.

scholarly journals SERVICE USE AND BARRIERS TO SERVICE ACCESS AMONG FAMILY CAREGIVERS IN RURAL APPALACHIA

2018 ◽  
Vol 2 (suppl_1) ◽  
pp. 868-868
Author(s):  
A S Vipperman ◽  
J Savla ◽  
Karen A Roberto ◽  
A Harris ◽  
E Hoyt ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Service Use ◽  
Service Access ◽  
Barriers To Service ◽  
Rural Appalachia

scholarly journals Patterns of individual coping, engagement with social supports and use of formal services among a five-country sample of resilient youth

2015 ◽  
Vol 2 ◽  
Author(s):  
M. Ungar ◽  
L. Theron ◽  
L. Liebenberg ◽  
Guo-Xiu Tian ◽  
A. Restrepo ◽  
...  
Keyword(s):  
Coping Strategies ◽  
Service Use ◽  
Service Providers ◽  
Social Supports ◽  
Well Being ◽  
Substantive Theory ◽  
Formal Service ◽  
Full Dataset ◽  
Formal Services ◽  
Individual Capacity

Background.Although resilience among victims of child abuse is commonly understood as a process of interaction between individuals and their environments, there have been very few studies of how children's individual coping strategies, social supports and formal services combine to promote well-being.Method.For this study, we conducted a multi-phase analysis of a qualitative dataset of 608 interviews with young people from five countries using grounded theory strategies to build a substantive theory of young people's service and support use patterns. We started with an analysis of ten interviews (two from each country) and then compared these findings to patterns found in each country's full dataset.Results.The substantive theory that emerged explains young people's transience between individual coping strategies (cognitive and behavioral), reliance on social supports (family members, peers and teachers), and engagement with formal service providers whose roles are to provide interventions and case management. Young people's patterns of navigation were shown to be contingent upon the individual's risk exposure, his or her individual capacity to cope, and the quality of the formal and informal supports and services that are available and accessible.Conclusion.Differing amounts of formal resources in low-, middle- and high-income countries influence patterns of service use. Implications for better coordination between formal mental health services and social supports are discussed.

scholarly journals Exploring the Relationship Between Day-to-Day Care and Caregiver Vigilance

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 639-639
Author(s):  
Brandy Renee McCann ◽  
Karen Roberto ◽  
Rosemary Blieszner ◽  
Tina Savla ◽  
Emily Hoyt ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Service Use ◽  
Care Facility ◽  
Well Being ◽  
Community Based ◽  
Term Care ◽  
Long Term Care Facility ◽  
Formal Services ◽  
Community Based Services

Abstract A demanding aspect of caregiving for a relative with dementia is need for constant vigilance of their behavior and well-being. Vigilance is associated with higher quality of care, but can take a toll on caregivers who have few opportunities for respite. Home- and community-based services have the potential to offer caregivers relief from constant vigilance. Using in-depth interviews with 30 rural caregivers, we found that service use did not necessarily provide relief from constant vigilance. Caregivers typically needed to monitor aspects of home- and community-based services and care facilities such as scheduling and quality of care from CNAs. In contrast, some caregivers found respite from constant vigilance when they used formal services—typically in extreme situations such as when a husband with dementia became violent and moved temporarily to a long-term care facility. Findings connect caregiver needs and concerns related to vigilance with availability, quality, and use of formal services.

scholarly journals Caring Beyond the Challenges: Grit in Dementia Family Caregivers

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 8-8
Author(s):  
Rosemary Blieszner ◽  
Jyoti Savla ◽  
Karen Roberto ◽  
Brandy McCann ◽  
Emily Hoyt
Keyword(s):  
Family Caregivers ◽  
Process Model ◽  
Well Being ◽  
Sem Analysis ◽  
Role Overload ◽  
Stress Process Model ◽  
Dementia Caregivers ◽  
Family Solidarity ◽  
Rural Appalachia

Abstract Scholars and practitioners recognize the importance of family caregivers for persons with dementia (PwD) persevering through difficulties and remaining committed to providing care (i.e., possessing grit). Based on Pearlin’s stress process model, we examined how grit is associated with stressors and strains that interfere with caregiver well-being and jeopardize continued caregiving. The sample included 158 family caregivers of PwD from rural Appalachia. SEM analysis revealed that grit and family and friend affectual solidarity contributed significantly to mastery. Grit and family solidarity were associated indirectly with role overload through their effect on mastery. Results demonstrate the value of acknowledging the role of grit in enhancing caregivers’ confidence about managing difficulties they face and reducing their sense of being overwhelmed by caregiving responsibilities. Thus, strengthening dementia caregivers’ commitment to and perseverance in their role is crucial for sustaining their motivation to provide care, despite the challenges they face.

scholarly journals Caring ability of urban and rural family caregivers: association with overburden, stress and coping

2021 ◽  
Vol 55 ◽  
Author(s):  
Fernanda Duarte Siqueira ◽  
Nara Marilene Oliveira Girardon-Perlini ◽  
Rafaela Andolhe ◽  
Roselaine Ruviaro Zanini ◽  
Evelyn Boeck dos Santos ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Family Caregivers ◽  
Stress And Coping ◽  
Moderate Correlation ◽  
Cross Sectional ◽  
Rural Caregivers ◽  
Brief Cope ◽  
Rural Family ◽  
Overburden Stress ◽  
And Coping

ABSTRACT Objective: To correlate caring ability with overburden, stress and coping of urban and rural family caregivers of patients undergoing cancer treatment. Method: Cross-sectional study, carried out in a referral hospital for cancer treatment, with urban and rural caregivers who responded the following instruments: questionnaire of sociodemographic characterization of the caregiver and the care provided, Perceived Stress scale, Burden Interview scale and Brief COPE. Pearson's correlation test was used for statistical analysis, with a significance level ≤5%. Results: A total of 163 urban caregivers and 59 rural caregivers participated in the study. Between the caring ability and stress, a negative and moderate correlation was found in rural caregivers. In the relationship between the caring ability and the overburden, there was a statistically significant correlation in urban caregivers in the interpersonal relationship and perception of self-efficacy factor. Between coping and the caring ability, a positive and moderate correlation was identified in coping focused on the problem in the knowledge dimension in urban caregivers. Conclusion: Urban caregivers had greater intensity of overburden and coping focused on the problem in relation to the caring ability.

scholarly journals Do Competing Demands Elevate Caregiver Challenges?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 639-639
Author(s):  
Rosemary Blieszner ◽  
Tina Savla ◽  
Karen Roberto ◽  
Brandy Renee McCann ◽  
Aubrey Knight ◽  
...  
Keyword(s):  
Low Income ◽  
Process Model ◽  
Well Being ◽  
Role Overload ◽  
Family Ties ◽  
Rural Caregivers ◽  
Competing Demands ◽  
Rural Appalachia ◽  
Limit Access ◽  
Informal Help

Abstract Family members caring for relatives with dementia simultaneously hold other roles and face other everyday challenges related to employment, finances, interactions with others, and the like. Using the Pearlin stress process model as a foundation, we evaluated contributions of secondary role and intrapsychic stressors such as health, relationship, and financial worries, and role captivity and overload, to 157 rural caregivers’ morale and well-being. Whereas family conflict and role overload contributed significantly to higher agitation, money worries, poor health, and role captivity interfered with positive mental health (p<.05). Nevertheless, some caregivers characterized employment and volunteering as respite from caregiving and appreciated informal help even when family ties were complicated. Findings highlight complex responses to dementia-related caregiving and point to the need for a range of resources and support deployed creatively to assist caregivers in places such as rural Appalachia where geography, underfunding, and low income limit access to services.

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