The Other Caregivers: Informal Non-Spousal Male Caregivers for Persons With Dementia

Informal caregivers for persons with Alzheimer's disease and related dementias (ADRD) have become an integral part of the long-term health care system. They are relied on to provided day-to-day care that is challenging, complex, and often spans several years. Most of the research on informal caregivers for persons with ADRD have focused on spousal caregiving, mother-daughter dyads, and daughters. There is sparse literature on informal non-spousal male caregivers for persons with ADRD. The objective of this research was to obtain an understanding of the experiences of informal non-spousal male caregivers for persons with ADRD. This descriptive qualitative pilot study consisted of in-depth one-on-one interviews with three informal non-spousal male caregivers for persons with ADRD. Four themes emerged through data analysis: 1) the male perspective and experience of caregiving, 2) relationship dynamics, 3) caregiving challenges, and 4) finding meaning within caregiving. Conclusion: Similar to other caregivers, informal non-spousal male caregivers assisted with transportation, managing medical appointments, as well as bathing and personal care. Differences with other caregivers, specifically female caregivers, emerged in terms of descriptions of traditional versus non-traditional gender roles. The implications of this study are that public policies, support services and medical professionals need to understand and be able to address the different experiences and needs of informal non-spousal male caregivers.

Dyadic Relationships Between Self-Rated Health and Cognition Among Older Adults and Their Spousal Caregivers

This study examines spouses who are in a caregiving situation to discern how they influence each other’s health. Previous studies reported health concordance and cross-domain effects among caregiver and care-recipient dyads. However, it is less understood of the health dyadic relationships among spouses who are in a caregiving situation. No studies have specifically looked into the relationship between self-rated health (SRH) and cognitive functioning among spousal caregiving dyads over time. In this study we analyzed the longitudinal reciprocal relationships between SRH and cognitive functioning measured by the Telephone Interview for Cognitive Status among older adults and their spousal caregivers, and whether the relationship differed by whether husband or wife was the caregiver. Longitudinal data from the Health and Retirement Study (2010-2016) on 540 dyads were pooled and analyzed using structural equation modeling under an actor-partner interdependence model. Results revealed cognitive concordance among older spouses in which caregivers’ cognition is associated with care-recipients’ cognition subsequently (β=0.05, p<.05). SRH concordance was not significant. Cross-domain results showed only one significant direction, that is, care-recipients’ cognition in the subsequent time was significantly correlated with caregivers’ SRH, regardless of whether husband (β=0.09, p<.05) or wife (β=0.08, p<.05) was the caregiver. Our study found that married couples in a spousal caregiving situation displayed cognitive but not overall health concordance, and cross-domain effects of caregiver’s SRH on spousal care recipient’s cognition subsequently. The reciprocal associations suggest that addressing and improving either partner’s physical health and cognition may benefit both dyad members.

Couple relationship satisfaction: The role of recollection of parental acceptance, self-differentiation, and spousal caregiving

The actor–partner interdependence model (APIM) was employed in this study to investigate the mediating effect self-differentiation and spousal caregiving have on the relationship between recollection of parental care and acceptance and couple satisfaction. One hundred and forty-four non-clinical couples (N = 288) in enduring relationships were recruited. Results for actor effects revealed two mediating paths whereby, among both partners, recollection of maternal (but not paternal) acceptance was associated with their self-differentiation and responsive spousal caregiving, which, in turn, were linked to their spousal relationship satisfaction. Partner effects revealed three mediating paths: for both partners, recollection of childhood maternal acceptance was associated with responsive caregiving, which, in turn, was linked with their partner’s relationship satisfaction. Interestingly, the husbands’ recollection of maternal acceptance was associated with their partners’ responsive spousal caregiving, which was linked to both spouses’ relationship satisfaction. Our results may support the theoretical assumptions regarding intergenerational continuity from perceptions of childhood via self-differentiation effecting couple caregiving to couple relationship, but only on the mother’s part.

Couplehood as a compass: Spousal perspectives on the diminished everyday competence of partners

Research on spousal relations and caregiving, when one of the persons in the dyad has a dementia diagnosis, has recognized that the degree of diminished everyday competence (DEC) the person with dementia is experiencing has implications for these relations and for how spousal caregiving is ultimately experienced. The present exploratory study uses an inductive approach to analyze data from 22 qualitative interviews with and observation notes on couples living with dementia to shed light on the ways in which the person without dementia views the DEC his/her partner is experiencing. The findings show that spouses can choose to disregard their partners’ DEC or to acknowledge it in either an egocentric or a couple-centered way; they also show that spouses’ choice of approach does not seem to be dictated by how cognitively impaired their partners have become. This suggests that spouses’ approach to partners’ DEC deserves more of our attention as it could have implications not only for transitions into spousal caregiving but also for caregiving experiences as such.

The Differential Effects of Caregiving Intensity on Overnight Hospitalization in the Previous 2 Years

Caregiving for a spouse is considered a major stressor many Americans will encounter during their lifetimes. Although most studies indicate caregiving is associated with experiencing diminished health outcomes, little is known about how this role affects caregivers’ use of acute health services. To understand how spousal caregiving affects the use of acute health services, we use data from the Health and Retirement Study. We apply fixed effects (FE) logistic regression models to examine odds of experiencing an overnight hospitalization in the previous two years according to caregiving status, intensity, and changes in caregiving status and intensity. Models controlled for caregiver gender, age, race, ethnicity, educational attainment, health insurance status, the number of household residents, and self-assessed health. Overall, caregivers were no more likely to experience an overnight hospitalization compared to non-caregivers (OR 0.92; CI 0.84 to 1.00; p-value=0.057). However, effects varied according to the intensity of caregiving and the time spent in this role. Compared to non-caregivers, for example, spouses who provided care to someone with no need for assistance with activities of daily living had lower odds of experiencing a hospitalization (OR 0.77; CI 0.66 to 0.89). In contrast, caregivers who provided care to someone with dementia for 4 to <6 years had 3.29 times the odds of experiencing an overnight hospitalization (CI 1.04 to 10.38; p-value=0.042). Findings indicate that, although caregivers overall appear to use acute health services about as much as non-caregivers, large differences exist between caregivers. Results emphasize the importance of recognizing diversity within caregiving experiences.