The well-being of adult children while caring for a parent in home hospice: Evaluation of an automated remote monitoring and coaching system.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 222-222
Author(s):  
Kathi Mooney ◽  
Patricia Berry ◽  
Jacquee Blaz ◽  
Gary Donaldson
Keyword(s):  
Family Caregivers ◽  
Adult Children ◽  
Remote Monitoring ◽  
Negative Binomial ◽  
Hospice Care ◽  
Adult Child ◽  
Well Being ◽  
Poor Sleep ◽  
Significant Finding ◽  
At Home

222 Background: Health and well-being often deteriorates for family caregivers providing home hospice care. This includes adult children managing multiple demands while supporting their parent to remain at home. Automated remote monitoring of patient symptoms has shown promise in home cancer care and could be extended for monitoring and supporting the wellbeing of adult child caregivers (ACC) providing care to their parent at home. Methods: In a RCT, 97 ACCs were monitored using a telephone based automated reporting and coaching system, and randomly assigned to the ACC care intervention (Rx) (N = 51) or usual care (UC) (N = 46). All ACCs were asked to call the system daily reporting presence and severity (0-10 scale) of their own fatigue, poor sleep, depressed mood, anxiety and interference with normal activities. The Rx ACCs received automated tailored coaching based on reported patterns of moderate to severe symptom levels and alert reports were also sent to their hospice nurse. Results: ACCs were females (78%) with a mean age of 51. There were no differences between groups on any demographic or baseline measures. Utilizing negative binomial modeling, Rx ACCs had significantly fewer days/week of moderate-severe symptoms overall (.6 vs 2.4, p < .001) and for each individual symptom (all p < .001). Among those attempting to maintain work, Rx ACCs were able to work 80% of work days and UC ACCs worked 68% of work days. Six weeks after their parent’s death, there was a statistical trend (p = .07) for Rx ACCs to be less depressed than UC ACCs (11.94 vs 18.04). This is a clinically significant finding as UC ACCs’ CESD scores were at the clinically actionable level ( > 16) for referral for evaluation of depression. Rx ACCs’ CESD scores had dropped an average of 1.37 points below their baseline whereas UC ACCs’ scores had increased an average of 3.86 points from baseline at 6 weeks post death. Conclusions: Automated remote monitoring and coaching for adult child family caregivers offers impressive benefit in reducing the physical burden and psychosocial distress of caregiving during and after parental hospice care. Clinical trial information: NCT02112461.

scholarly journals CORESIDENCE OF OLDER PARENTS AND ADULT CHILDREN BENEFITS OLDER ADULTS’ PSYCHOLOGICAL WELL-BEING: PATH ANALYSIS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S324-S324 ◽  
Author(s):  
Soohyoung r Lee
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Path Analysis ◽  
Adult Children ◽  
Adult Child ◽  
Well Being ◽  
Health Measurement ◽  
Living Situation ◽  
Psychological Well Being ◽  
Older Parents

Abstract Even though the coresidence of older parents and their adult children is no longer a rare phenomenon in current society, a little is known about the benefit of living with adult children from older adults’ perspectives compared to the risk of this living situation. Previous research suggests that older adults’ psychological well-being is low when they live with their adult children, and this become more salient among single parents, such as widowed or divorced. The current paper utilizes the National Health Measurement Study with a sample of age 55 and over, and their SF-36 Mental Health Component score, and psychological well-being self-acceptance score was measured. Path analysis reveals while mental health and psychological well-being scores are lower among single older adults at the time of the survey (e.g., divorced, widowed) than non-single, coresidence of older adults and adult children completely mediates the negative relationship between being single and both mental health psychological well-being. A complete mediation effect of living with an adult child on older adults’ mental health and psychological well-being is consistent with both white and non-white minority older adults. This suggests that living with adult child benefits older adults’ mental health and psychological well-being. The current study seeks to stimulate ideas that might generate the next answer to community-based care in our current aging society.

scholarly journals CHILDREN CAREGIVERS’ EXPERIENCES OF OLDER ADULTS WITH DEMENTIA IN CARE TRANSITION: A QUALITATIVE SYSTEMATIC REVIEW

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S841-S841
Author(s):  
Rungnapha Khiewchaum
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Adult Children ◽  
Care Transitions ◽  
Adult Child ◽  
Well Being ◽  
Community Services ◽  
Care Transition ◽  
Thematic Synthesis ◽  
People With Dementia

Abstract Background/Purpose: Young and adult children have experienced caring for people who have been diagnosed with dementia. Caregiving needs affect family members who become the primary caregivers in care transition from hospital to home. This study aims to synthesize primary qualitative research on the experiences of children caregivers of older adults with dementia. Method: This is a systematic review describing young and adult child caregivers’ experiences in caring for patient with dementia in home-based care. Data sources were published literature written in English from CINAHL, Scopus, PubMed, and PsychoINFO (published from January 1976 to October 2018). The thematic synthesis approach was also applied to generate theory generating meta-synthesis research (TGMS). and to describe the process of caring for demented patients by caregivers. Result: Eight primary studies reporting 388 potential studies were included. Four themes emerged: 1) well-being which included encouraging and destructive well-being; 2) role transition which included positive or negative role transformations; 3) caregiver needs which included medical and nursing information or knowledges and health care services/community services; and 4) the challenge of dementia which included symptoms of dementia which were impairing. Conclusion The findings of this meta-synthesis study support evidence of well-being among adult children in caring for people with dementia in transition phases. We present thematic synthesis that could be useful to professionals working with caregivers and patients with dementia. We suggest that research importance should shift towards the development and evaluation of care transitions intervention, especially professionals preparing support after diagnosis.

scholarly journals Parents’ experiences of abuse by their adult children with drug problems

2019 ◽  
Vol 37 (1) ◽  
pp. 69-85 ◽  
Author(s):  
Bengt Svensson ◽  
Torkel Richert ◽  
Björn Johnson
Keyword(s):  
Drug Use ◽  
Adult Children ◽  
Emotional Abuse ◽  
Physical Violence ◽  
Qualitative Interviews ◽  
Adult Child ◽  
Well Being ◽  
Drug Problems ◽  
Parents Experiences ◽  
Parent Child

Aims: To examine parents’ experiences of abuse directed at them by their adult children with drug problems. Material and Method: The material consists of 32 qualitative interviews on child-to-parent abuse with 24 mothers and eight fathers. The interviewees had experienced verbal abuse (insults), emotional abuse (threats), financial abuse (damage to property and possessions) and physical abuse (physical violence). Findings: In the parents’ narratives, the parent-child interaction is dominated by the child’s destructive drug use, which the parents are trying to stop. This gives rise to conflicts and ambivalence. The parents’ accounts seem to function as explaining and justifying their children’s disruptive behavior in view of the drug use. The fact that an external factor - drugs - is blamed seems to make it easier to repair the parent-child bonds. The parents differentiate between the child who is sober and the child who is under the influence of drugs, that is, between the genuine child and the fake, unreal child. The sober child is a person that the parent likes and makes an effort for. The child who is on drugs is erratic, at times aggressive and self-destructive. Conclusions: The interviewed parents’ well-being is perceived as directly related to how their children’s lives turn out. The single most important factor in improving the parents’ situation is to find a way for their adult child to live their lives without drug problems.

The Structure and Determinants of Intergenerational Support Exchange Flows in an Eastern European Setting

2020 ◽  
Vol 42 (9-10) ◽  
pp. 262-271
Author(s):  
Boróka Bó ◽  
Zachary Zimmer ◽  
Codrina Rada
Keyword(s):  
Adult Children ◽  
Latent Class ◽  
Population Aging ◽  
Adult Child ◽  
Well Being ◽  
Physical Distance ◽  
Migrant Children ◽  
Intergenerational Support ◽  
And Migration ◽  
Bidirectional Exchange

Although the provision, receipt, and bidirectionality of support exchanges are important for generational well-being, our understanding of them is lacking in Eastern Europe, a region undergoing swift population aging and social change. This study links intergenerational support exchanges to determinants in Romania, with a focus on proximity of adult children. Data are from the Romanian Aging and Migration Survey ( N = 1,398). Analyses involve two stages. First, latent class analysis (LCA) is conducted to develop an intergenerational support typology. The second uses the typology as a dependent variable in multivariate equations predicting exchange determinants. LCA analysis yielded six propensity classes. Physical distance strongly predicts class membership. Having coresident adult children increases the likelihood of bidirectional exchange. Having an international migrant adult child reduces the chances, even with coresident adult children present. International migrant children lead to a higher probability of being a nonexchanger or receiving monetary support. There is a need for continued consideration of bidirectional exchange models in rapidly developing contexts.

scholarly journals Intensive Mothers, Cautionary Tale Fathers: Adult Children’s Perceptions of Parental Influence on Health

2019 ◽  
Vol 41 (3) ◽  
pp. 312-337 ◽  
Author(s):  
Alexandra Kissling ◽  
Corinne Reczek
Keyword(s):  
Adult Children ◽  
Parental Influence ◽  
Adult Child ◽  
Later Life ◽  
Well Being ◽  
Negative Influence ◽  
Family Systems Theory ◽  
Future Health ◽  
Midlife Adults ◽  
Cautionary Tales

Parents strongly influence children’s health, yet how parents continue to shape the health of midlife adult children remains unknown. Moreover, while most adults are married by midlife, research has failed to identify the effects of parent-in-law relationships on midlife adult well-being. Using interviews with 90 individuals in 45 marriages, we investigate how midlife adults perceive the influence of parents and parents-in-law on adult child health. Findings reveal that particularly mothers and mothers-in-law positively influence child’s health via support during, or in anticipation of, illness and injury. The health experiences of parents and in-laws, particularly fathers/in-law, become cautionary tales preparing adult children for future health issues. Yet parents/in-law also have negative influence on adult children during midlife due to parents’ compounding health needs. We use family systems theory to show how parents/in-laws are intertwined in ways that influence health during children’s midlife that has ramifications into later life.

scholarly journals ‘She Can’t Support Me Because She’s so Old’: A Mixed-Methods Study of Support Experiences and Needs in Adult Child–Parent Dyads at the End of Life

2021 ◽  
pp. 003022282110087
Author(s):  
Franziska A. Herbst ◽  
Laura Gawinski ◽  
Nils Schneider ◽  
Stephanie Stiel
Keyword(s):  
Mixed Methods ◽  
End Of Life ◽  
Family Caregivers ◽  
Adult Children ◽  
Qualitative Interviews ◽  
Terminally Ill ◽  
Adult Child ◽  
Self Report ◽  
Children And Parents ◽  
Parent Caregivers

Little is known about support experiences and needs in the dyads of (1) terminally ill adult children and their parent caregivers and (2) terminally ill parents and their adult child caregivers. The current study aimed at investigating the experiences and needs of adult children and parents in end of life situations regarding their provision and receipt of support. The study employed a convergent parallel mixed-methods design, combining explorative qualitative interviews with the quantitative self-report Berlin Social Support Scales. Sixty-five patients (dyad 1: 19; dyad 2: 46) and 42 family caregivers (dyad 1: 13; dyad 2: 29) participated in the study (02/2018–11/2019). Results show that ill adult children felt less (well) supported than ill parents. Parent caregivers were often limited in the support they could provide, due to their age and health conditions. Hypotheses were deduced from patients’ and family caregivers’ notions to inform dyad-specific recommendations for support interventions.

Evaluation of the Reitman Centre CARERS program for supporting dementia family caregivers: a pre–post intervention study

2021 ◽  
pp. 1-12
Author(s):  
Joel Sadavoy ◽  
Sima Sajedinejad ◽  
Mary Chiu
Keyword(s):  
Family Caregivers ◽  
Group Intervention ◽  
Adult Child ◽  
Cost Effective ◽  
Skills Training ◽  
Well Being ◽  
Community Dwelling ◽  
Rank Test ◽  
Post Intervention ◽  
People With Dementia

ABSTRACT Objectives: While family caregivers (CGs) of persons with dementia are cost-effective for the health system, this form of caregiving leads to disproportionate vulnerability to physical, mental, and social adverse health consequences among CGs. The study goal was to determine the effect of the Reitman Centre CARERS program on key outcomes in family CGs of people with dementia. The Reitman Centre CARERS program is an innovative, group psychotherapeutic skills training intervention based on integrated problem-solving techniques (PST), simulation learning, and group psychotherapy designed to address each CGs’ unique situation. Design: A quasi-experimental, non-randomized, pre–post evaluation, multiple groups, multisite trial. Setting: Multisite group intervention provided in community agencies and hospital-based locations. Participants: Spousal or adult child family CGs (n = 264) living in the community and providing care to community-dwelling family members with dementia. Measurement: CGs were assessed for depression (CES-D); stress (PSS); burden (12-item SZBI); role overload, mastery, caregiving competence, and role captivity (Perlin scales), coping (CISS – Coping Inventory for Stressful Situations), CG reactions to CR’s memory and behavioral symptoms (RMBPC). Care recipients (CRs) were assessed on basic and complex activities of daily living (Katz and Lawton). Paired t-tests and Wilcoxon signed-rank test were used for statistical analysis of both the whole group and a more compromised subgroup of CGs. Results: For the group as a whole, CGs showed significant positive change on post-intervention outcome measures of stress, depression, burden, competence, role captivity, overload, mastery, coping, and reaction to memory issues. The intervention showed especially robust effect sizes (ES) in more compromised CGs. These positive outcomes emerged despite a significant measured deterioration in CRs’ function. Conclusion: The CARERS program may be an effective multicomponent intervention to improve the well-being, functioning, and coping skills of dementia CGs.

Cancer family caregivers during the palliative, hospice, and bereavement phases: A review of the descriptive psychosocial literature

2011 ◽  
Vol 9 (3) ◽  
pp. 315-325 ◽  
Author(s):  
Anna-Leila Williams ◽  
Ruth McCorkle
Keyword(s):  
Family Caregivers ◽  
Hospice Care ◽  
Psychometric Testing ◽  
Direct Consequence ◽  
Well Being ◽  
Critically Ill Patient ◽  
Measurement Instruments ◽  
Psychological Burden ◽  
Cancer Family ◽  
Increased Risk

AbstractObjective:Because caregiving to an adult with cancer is a dynamic process, a caregiver's perceived burden and psychosocial concerns may be different at different phases of the patient's disease. There is evidence of escalation in caregiver anxiety, depression, and psychological distress as the patient's functional status declines and as the patient nears death. The purpose of this review was to organize the literature in a meaningful way that can potentially capture the unique needs of caregivers to patients receiving palliative and/or hospice care, and caregivers who are in the post-death bereavement phase.Method:A systematic review was conducted. Major databases were searched for non-intervention descriptive studies that included psychosocial variables of family caregivers to adults with cancer during the palliative, hospice, or bereavement phases.Results:The 19 studies reviewed were conducted in six countries and varied considerably by samples, outcome measures, methodologies, and analytic approaches. Despite limiting to the palliative, hospice, and bereavement phases, inconsistent results were found for key variables, such as age, gender, and relationship to the patient. When patient–caregiver dyad analysis was conducted, with rare exception, there was mutuality between the patient's condition and the caregiver's response. Across the 19 studies, 89 unique instruments were used, almost half of which were study specific with no psychometric testing reported.Conclusions/significance of research:As a direct consequence of assuming the caregiver role, cancer family caregivers in the palliative, hospice, and bereavement phases are at increased risk for physical and mental morbidity. Often, the psychological burden of the caregiver exceeds that of the critically ill patient. It is possible that distressed caregivers have a deleterious influence on patient well-being. This review demonstrates the need to develop research standards, especially regarding measurement instruments, so that caregiver research can mature and interventions can be developed to support family caregivers.

scholarly journals Dementia Caregiving During the “Stay-at-Home” Phase of COVID-19 Pandemic

2020 ◽  
Author(s):  
Jyoti Savla ◽  
Karen A Roberto ◽  
Rosemary Blieszner ◽  
Brandy Renee McCann ◽  
Emily Hoyt ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Stress Responses ◽  
Well Being ◽  
Role Overload ◽  
Transactional Model ◽  
Dementia Caregivers ◽  
Telephone Interviews ◽  
Primary Appraisal ◽  
Secondary Appraisal ◽  
At Home

Abstract Objective The objective of this study was to assess family caregivers’ primary appraisal of stressors related to COVID-19 stay-at-home orders, secondary appraisal of resources and support availability, and use of coping strategies as predictors of perceived role overload during the stay-at-home phase of the pandemic. Method Telephone interviews with 53 family caregivers of persons with dementia from rural Virginia 2 weeks after enactment of the governor’s stay-at-home order using structured and open-ended questions were conducted. Results Caregivers who were more concerned about the COVID-19 pandemic were at greater odds of experiencing high role overload than those who recognized positive aspects of the pandemic, as were those who received insufficient support from family and friends. Discussion Use of the transactional model of stress responses yielded important insights about families coping with dementia. Caregivers’ perceptions of the pandemic’s impact varied, with differential effects on their well-being.

scholarly journals THE ROLE OF AMBIVALENCE ON WELL-BEING OF AGING PARENTS WHO HAVE A DISABLED CHILD: MULTILEVEL MEDIATION APPROACH

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S37-S38
Author(s):  
Eun Ha Namkung
Keyword(s):  
Adult Children ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Comparison Group ◽  
Adult Child ◽  
Well Being ◽  
Mental Illnesses ◽  
Physical And Mental Health ◽  
Aging Parents ◽  
Adults With Disabilities

Abstract According to the family systems theory, strains from parenting an adult with disabilities may spillover to parents’ relationships with their other children and disrupt family dynamics and their well-being in later life. This study examined whether parental ambivalence toward their non-disabled children is greater in families of adults with disabilities [developmental disabilities (DD) or serious mental illnesses (SMI)] than families without an adult child with disabilities. The study also investigated whether ambivalence mediates the associations of having an adult child with DD or SMI on parents’ health. Data were from the 2011 Wisconsin Longitudinal Study in which aging parents (Mage = 71; n = 6,084) were asked about their relationship with each of their adult children. Multilevel regression models and multilevel structural equation models (MSEM) were estimated to analyze the data. Our findings showed that parents of an adult with SMI felt greater ambivalence toward their non-disabled adult children than comparison group parents of adults without disabilities, whereas no significant differences were found between parents of an adult with DD and comparison group parents. Parental ambivalence toward their non-disabled adult children played a significant indirect role in the negative association between having a child with SMI and parental physical and mental health, after adjusting for parent- and child-characteristics associated with parental health and/or ambivalence. The findings have implications for clinical practice with aging families of adults with disabilities and suggest the need for additional research to better understand intergenerational dynamics in these families.

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