Burden experienced by care-givers of persons with bipolar affective disorder

1999 ◽  
Vol 175 (1) ◽  
pp. 56-62 ◽  
Author(s):  
Deborah Perlick ◽  
Robert R. Rosenheck ◽  
John F. Clarkin ◽  
Jo Anne Sirey ◽  
Patrick Raue ◽  
...  
Keyword(s):  
Bipolar Affective Disorder ◽  
Family Care ◽  
Clinical State ◽  
Care Giver ◽  
Illness Beliefs ◽  
Family Control ◽  
Bipolar Illness ◽  
Care Givers ◽  
Multivariate Relationships ◽  
The Impact

BackgroundFamily members of patients with schizophrenia frequently report burdens associated with caring for their relatives.AimsWe evaluate the impact of illness beliefs on the burden reported by family care-givers of people with bipolar illness.MethodThe multivariate relationships between patient symptomatology and family illness beliefs and report of burden were examined at baseline among care-givers of 266 patients with Research Diagnostic Criteria-diagnosed bipolar illness who were subsequently followed for 15 months.ResultsAt baseline, 93% of care-givers reported moderate or greater distress in at least one burden domain. As a group, care-giver illness beliefs (illness awareness, perception of patient and family control) explained an additional 18–28% of variance in burden experienced beyond the effects of the patients clinical state and history.ConclusionsCare-givers of patients with bipolar illness report widespread burden that is influenced by beliefs about the illness.

Neural mechanisms of childhood-onset bipolar illness

2000 ◽  
Vol 12 (3) ◽  
pp. 139-143
Author(s):  
R.M. Post ◽  
G.S. Leverich ◽  
A.M. Speer ◽  
G. Xing ◽  
S.R.B. Weiss
Keyword(s):  
Sexual Abuse ◽  
Maternal Separation ◽  
Suicide Attempts ◽  
Early Recognition ◽  
Bipolar Affective Disorder ◽  
Childhood Onset ◽  
Course Of Illness ◽  
Bipolar Illness ◽  
Axis I ◽  
The Impact

ABSTRACTSubstantial evidence exists for a cohort effect (earlier onset and increased prevalence) for both unipolar and bipolar affective disorder in every generation born since World War II. This effect could be related to inherited mechanisms (e.g., bi-Hneal pedigrees or genetic anticipation) or to environmental/experiential effects on gene expression (e.g., stressor effects on the induction of transcription and growth factors, enzymes, hormones and their receptors, and signal transduction molecules) as documented in preclinical models of neonatal maternal separation.This laboratory evidence is summarized and new clinical data on the impact of severe stressors on the unfolding course of bipolar illness are noted. The reported occurrence of childhood or adolescent physical or sexual abuse, compared to those who report their absence, is associated with: earlier bipolar illness onset; faster cycling (including ultradian) patterns; increased Axis I and II comorbidities; and increased time ill in a prospective year of follow-up. Selectively, physical abuse was associated with a reported pattern of increasingly severe mania and sexual abuse with increased numbers of serious suicide attempts.In a retrospective survey of parents of children with an approximate average age of 13 who were diagnosed with bipolar illness (compared to those with other diagnoses and those with no diagnosis), a cluster of symptoms related to irritability and dyscontrol differentiated the bipolar children earliest. These symptoms included: temper tantrums, irritability, inattention, hyperactivity, impulsivity, poor frustration tolerance, and increased aggression.Given the growing evidence that episodes of affective dysfunction can not only convey morbidity and mortality, but may also sensitize to further recurrence and thus change the course of illness, opportunities abound for early recognition and intervention in childhood onset bipolar illness. Such a successful endeavor would both allow a more normal psychobiological development and allow the possibility of preventing the unfolding of more full-blown bipolar illness altogether.

scholarly journals Unpacking the impact of older adults' home death on family care-givers' experiences of home

2016 ◽  
Vol 38 ◽  
pp. 103-111 ◽  
Author(s):  
Christine Milligan ◽  
Mary Turner ◽  
Susan Blake ◽  
Sarah Brearley ◽  
David Seamark ◽  
...  
Keyword(s):  
Older Adults ◽  
Family Care ◽  
Home Death ◽  
Care Givers ◽  
The Impact

scholarly journals Disruption, control and coping: responses of and to the person with dementia in hospital

2013 ◽  
Vol 35 (1) ◽  
pp. 37-63 ◽  
Author(s):  
DAVINA POROCK ◽  
PHILIP CLISSETT ◽  
ROWAN H. HARWOOD ◽  
JOHN R. F. GLADMAN
Keyword(s):  
Participant Observation ◽  
Family Care ◽  
Sense Of Control ◽  
Care Giver ◽  
Structured Interviews ◽  
Coping Responses ◽  
Care Givers ◽  
Sharing Space ◽  
Person With Dementia ◽  
Constant Comparative Analysis

ABSTRACTThis qualitative study aimed to gain insight into the experience of hospitalisation from the perspectives of the older person with dementia, their family care-giver and other patients sharing the ward (co-patients). Non-participant observation of care on 11 acute hospital wards was supplemented by 39 semi-structured interviews with 35 family care-givers and four co-patients following discharge. Constant comparative analysis produced the core problem facing all those involved: disruption from normal routine meaning that the experience of hospitalisation was disrupted by the presence and behaviour of the person with dementia. Disruption adversely affected the person with dementia, triggering constructive, disengaged, distressed and neutral behaviours. Using Kitwood's model of person-centred care, these behaviours were interpreted as attempts by the person with dementia at gaining a sense of control over the unfamiliar environment and experience. Family care-givers' lives and experiences both inside and outside the hospital were disrupted by the hospitalisation. They too attempted to gain a sense of control over the experience and to give a sense of control to the patient, co-patients and staff. Co-patients experienced disruption from sharing space with the person with dementia and were left feeling vulnerable and sometimes afraid. They too attempted to gain a sense of control over their situation and give some control by helping the person with dementia, the family care-giver and the staff.

Elasticity of care networks and the gendered division of care

2014 ◽  
Vol 35 (4) ◽  
pp. 675-703 ◽  
Author(s):  
WILCO KRUIJSWIJK ◽  
BARBARA DA ROIT ◽  
MARCEL HOOGENBOOM
Keyword(s):  
Primary Care ◽  
Qualitative Analysis ◽  
Gender Gap ◽  
Research Finding ◽  
Family Care ◽  
Care Giver ◽  
Care Givers ◽  
Care Giving ◽  
Dynamic Perspective ◽  
Primary Care Giver

ABSTRACTThe gender gap in family care-giving is an established research finding: men dedicate less time to care-giving and provide specific gendered types of help. This article argues that in order to grasp men's contribution to care arrangements one should recognise the multifaceted nature of care and examine care networks beyond the ‘care receiver–primary care-giver’ dyad with a dynamic perspective. A qualitative analysis of the care networks of three large Dutch families with an older parent in need of care confirms the greater involvement of women in care-giving and men's tendency to provide specific types of care. However, men also contribute to the elasticity and stability of the care arrangement by filling temporary gaps and supporting the female care-givers. This article puts forward the idea that men's contribution is in turn a factor in the perpetuation of the gendered structure of care-giving.

Characteristics of care-givers and care recipients influencing the impact of paid care services on family care-giver burdens

2013 ◽  
Vol 34 (8) ◽  
pp. 1314-1334 ◽  
Author(s):  
YOSHINORI NAKAGAWA ◽  
RINA YAMADA ◽  
SEIGO NASU
Keyword(s):  
Family Care ◽  
Entire Sample ◽  
Social And Emotional ◽  
Care Services ◽  
Care Givers ◽  
Care Recipients ◽  
People With Dementia ◽  
Male Care ◽  
Specific Care ◽  
The Impact

ABSTRACTIn the last few decades, a number of researchers have attempted to identify the effects of paid care services on alleviating the sense of burden of family care-givers, especially care-givers to people with dementia. However, few researchers have considered the possibility that paid care services alleviate the sense of burden only among those care-givers who possess specific characteristics. Without considering this point, the impact of paid care services would be averaged over an entire sample, and one might overlook the effects on these specific care-givers. With this background, this study examines the relationship between family care-givers' sense of burden and the amount of paid care services in Japan and identifies groups of care-givers among whom these services are significantly associated with a lesser sense of burden. The sense of burden of 339 family care-givers to older care recipients with dementia was measured using a modified version of the Caregiver Burden Inventory. In order to examine their association with the amount of paid care services received, logistic regression analysis was individually applied to groups of care-givers who exhibit specific characteristics. The results suggested that paid care services alleviated two out of five components of burden, provided the groups to which the analyses are applied are appropriately defined. In particular, two subsets of the entire sample, comprising young care-givers aged 49 or below, and including male care-givers, indicated that their overall sense of social and emotional burden were alleviated by the use of paid care services. The practical implications for policy makers are discussed.

scholarly journals The impact of informal care-giving networks on adult children's care-giver burden

2010 ◽  
Vol 31 (1) ◽  
pp. 34-51 ◽  
Author(s):  
NATALIA TOLKACHEVA ◽  
MARJOLEIN BROESE VAN GROENOU ◽  
ALICE DE BOER ◽  
THEO VAN TILBURG
Keyword(s):  
Informal Care ◽  
Adult Children ◽  
Adult Child ◽  
Path Model ◽  
Care Giver ◽  
Term Care ◽  
Older Parents ◽  
Care Givers ◽  
Care Giving ◽  
The Impact

ABSTRACTPrevious research on the care-giver burden experienced by adult children has typically focused on the adult child and parent dyad. This study uses information on multiple informal care-givers and examines how characteristics of the informal care-giving network affect the adult child's care-giver burden. In 2007, 602 Dutch care-givers who were assisting their older parents reported on parental and personal characteristics, care activities, experienced burden and characteristics of other informal care-givers. A path model was applied to assess the relative impact of the informal care-giving network characteristics on the care-giver burden. An adult child experienced lower care-giver burden when the informal care-giving network size was larger, when more types of tasks were shared across the network, when care was shared for a longer period, and when the adult child had no disagreements with the other members of the network. Considering that the need for care of older parents is growing, being in an informal care-giving network will be of increasing benefit for adult children involved in long-term care. More care-givers will turn into managers of care, as they increasingly have to organise the sharing of care among informal helpers and cope with disagreements among the members of the network.

The assessment experience of spousal dementia care-givers: ‘It's made me realise that I am a person also’

2018 ◽  
Vol 39 (11) ◽  
pp. 2443-2464 ◽  
Author(s):  
Nancy Guberman ◽  
Janice Keefe ◽  
Pamela Fancey
Keyword(s):  
Cognitive Impairment ◽  
Nursing Student ◽  
Structured Interview ◽  
Assessment Instrument ◽  
Care Giver ◽  
Care Givers ◽  
Care Giving ◽  
Post Test ◽  
Quasi Experimental ◽  
The Impact

AbstractThis article is based on a study that used a validated care-giver assessment instrument known as ‘The C.A.R.E. (Caregivers’ Aspirations, Realities, and Expectations) Tool’ to understand its usefulness in working with older adults caring for a spouse with cognitive impairment. It draws on data collected as part of a larger, quasi-experimental pre- and post-test study examining the impact of a care-giver assessment on older spousal care-givers of a partner with cognitive impairment. One hundred community-living individuals (average age of 74) participated in the study. Participants met with a third-year nursing student who administered The C.A.R.E. Tool. Within three to seven days following this, a research team member conducted a semi-structured interview by telephone. This interview provided participants with the opportunity to comment on their experience and the usefulness of The C.A.R.E. Tool. Transcriptions of the interviews were analysed using a thematic analysis. Results indicate that the assessment experience was evaluated positively by most participants. Two broad themes emerged: assessment encourages care-givers to take stock of their situation, and it provides a relationship with a caring professional. In particular, the assessment experience gave these care-givers to have the opportunity to reflect, while expressing emotions and developing awareness, and provided them with an appreciated relationship with a caring professional who helped to validate and normalise their situation. For care-givers, the results suggest that assessment may serve as a catalyst for taking action in their care-giving situation or turning to services for help. For practitioners, assessment may increase awareness of the experience of spousal care-givers, potentially leading to interventions to support them. This study found that the attitudes and knowledge of practitioners play a role in care-givers’ experience of the assessment as positive. However, the goal of assessment must be clarified, as outcomes of other tools will differ depending on the aims.

Geographic distance and social isolation among family care-givers providing care to older adults in Canada

2021 ◽  
pp. 1-26
Author(s):  
Lun Li ◽  
Andrew Wister
Keyword(s):  
Social Isolation ◽  
Short Distance ◽  
General Social Survey ◽  
Geographic Distance ◽  
Family Care ◽  
Analysis Of Covariance ◽  
Care Giver ◽  
Long Distance ◽  
Care Givers ◽  
Care Giving

Abstract Family care-giving is associated with social isolation, which can lead to adverse health and wellbeing outcomes among family care-givers. The role of geographic distance in care-giver social isolation (CSI) is unclear and has received mixed research findings. Framed by the Ecological Model of Caregiver Isolation, this study examined the relationship between geographic distance and CSI, including the interaction between geographic distance and care-giving intensity for CSI. Linear regression and analysis of covariance were used to test these hypotheses using a sub-set of family care-givers from the 2012 Canadian General Social Survey (N = 2,881). Care-givers living a short distance from receivers reported lower levels of social isolation than co-resident, moderate-distance and long-distance care-givers. Being involved in higher-intensity care-giving as the primary care-giver, undertaking more care-giving tasks and providing care more frequently resulted in higher CSI scores. Long- and moderate-distance care-givers reported greater CSI than co-resident and short-distance care-givers only when providing higher-intensity care-giving. Employing a granulated measure of geographic distance positioned within an ecological framework facilitates an understanding of the nuanced association between geographic proximity and CSI. Furthermore, the identified interaction effects between geographic distance and care-giving intensity on CSI further explicate the complexity of care-giving experiences. The findings are relevant for programmes supporting care-givers in different contexts, especially distance care-givers.

“I WRITE LETTER, AND AROUND GOES BATTLE”: CULTURAL GAPS IN WARTIME

2019 ◽  
pp. 67-72
Author(s):  
Anna Kimerling
Keyword(s):  
World War Ii ◽  
Cultural Models ◽  
Family Care ◽  
World War ◽  
Family Control ◽  
Individual Level ◽  
The Family ◽  
Care Practices ◽  
Flow Of Information ◽  
Cultural Gaps

The article is devoted to the features of the wartime culture. The source was a unique collection of letters from the fronts of World War II, written by political instructor Arkady Georgievich Endaltsev. The war led to the breakdown of familiar cultural models. It is important to understand how, adaptation to new standards occurred on an individual level. For A. Endaltsev, family care practices were a way to bridge cultural gaps. They are reflected in the letters. There, framed by ideologically verified stamps, one can find financial assistance to the family, control over the education of the daughter, the need for a continuous flow of information about the life of the wife and children.

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