The Sandwich Generation: Dealing with Aging Parents

This article discusses a workshop designed to provide middle-aged adults with information and opportunities to process their attitudes, emotions, and the realities of exchanging roles with aging parents.     

The Ebbs and Flows: Stresses of Sandwich Generation Caregivers

The term sandwich generation describes individuals who are caught between the competing demands of caring for at least one dependent child and one or more aging parents. Of the approximate 8.1 million caregivers in Canada, 28 % were considered “sandwiched”. Similar trends were found in the United States, with 15 % of middle-aged adults being sandwiched financially. Currently, little is known about the unique experiences of those providing care at both ends of the generational ladder. The purpose of this qualitative investigation was to explore the lived experiences of two married sandwich generation caregivers through the use of a case study. A married male and female who were caring for two dependent children and three aging parents each completed two one-on-one interviews with the researcher. The aging parents had varying ailments and needs, and thus the level of care required for each senior fluctuated. Several salient themes emerged from the data, but the following will be the focus of this paper: (1) Ebbs and Flows and (2) Stresses of Being Sandwiched. Notably, the participants’ discussed how their lived experience differed depending on their current situation, as was also evident when the two interviews were compared. During difficult times, the participants’ faced a number of challenges which will be discussed within the paper. As such, future research being conducted with this population should be conducted at multiple time points in order to fully capture the dynamic lived experiences of sandwich generation caregivers.     

Gender Role Identity and the Caregiving Experience of Widowed Men

The relationship between gender role identityand caregiving experience was explored in a sample ofelderly widowed men. A total of 200 males (82.5%Caucasian) were interviewed 12 to 16 months after the death of their wives. Results indicated thatmen who had served as caregivers scored higher on themasculine dimension of the Bem Sex Role Inventory, andmasculinity was a significant predictor of well-being for both caregivers and noncaregivers.Following a cognitive dissonance model (Hirsch, 1996),the results do not support the adoption of feminine orandrogynous ideals as a way of coping with this life demand. Instead, the results add to the growingbody of work in support of a masculine model ofwell-being.     

Caregiving in Attachment Relationships: A Perspective for Counselors

This article examines how caregiving, an aspect of attachment theory, can be applied in counseling. Discussion begins with an overview of attachment theory, then focuses on the counselor's position as caregiver, adult relationship issues, and termination of counseling.     

复杂问题解决：探索人们如何控制复杂动态系统

复杂问题解决研究的目的是探索人们如何处理复杂、动态任务。Dorner作为该领域的先驱,将计算机模拟情境作为研究工具,后来的研究者从不同的角度进行复杂问题解决研究。本文介绍了复杂问题解决研究的发展历史,总结了复杂问题解决情境的特征,包括动态性、复杂性、模糊性以及时间滞后性,进一步比较了复杂问题解决与自然决策和动态决策的差别。在此基础上,从控制系统的个体要求以及系统特征等方面总结了在Dorner的个体差异比较范式下复杂问题解决研究的进展。最后提出复杂问题解决研究的展望。     

Caregiving: The Forgotten Element in Attachment

In attachment theory, an attachment behavioral control system in the child and a complementary caregiving system in the parent act together to protect the young. The attachment account, however, fails to supply a motivation for caregiving. As a result, it cannot give a theoretical explanation for the responsive and attentive behaviors empirically observed in caregivers of secure children. In this article, we present an account of caregiving that places emotion at the center of caregiving (the connection theoretical orientation). In this account, the dyadic emotion of caring serves as an autonomous motivation to see that the needs of a specific dependent are met. Unlike the "on-off" caregiving in attachment theories, connection caring is conceptualized as enduring and variable: Caregivers experience different levels of caring over the course of a relationship. Through the emotional concepts of caring, empathy, and responsibility, the connection theoretical orientation is able to provide the coherent account of caregiving that the attachment theoretical orientation's cybernetic concepts have been unable to supply.     

Links Between Reactive Attachment Disorder,Caregiving and Temperament: A Differential Susceptibility Perspective

Abstract

The links between Reactive Attachment Disorder (RAD) and temperament received relatively little research attention, in spite of their clinical and social relevance. Children with RAD sustain disproportionate burdens of early adversity related to their caregiving environment. However, there seem to be important individual differences in susceptibility to adversity, since only a small number of children show signs of RAD. Based on the work of Zeanah and Fox, this review aims to bring new insights to this relevant clinical issue in light of recent research. A differential susceptibility hypothesis will be considered as a promising and innovative approach toward a further understanding of the links between temperament and RAD.     

Caregiving in multiple sclerosis and quality of life: A meta-synthesis of qualitative research

Objective: The lack of adequate conceptualisation and operationalisation of quality of life (QoL) limits the ability to have a consistent body of evidence to improve QoL research and practice in informal caregiving for people with multiple sclerosis (MS). Thus, we conducted a meta-synthesis of qualitative research to improve the conceptual understanding of the experiences of MS carers and to identify factors that affect carers’ QoL.

Design: Systematic searches of five electronic databases yielded 17 qualitative studies which were synthesised using the principles of meta-ethnography.

Results: The synthesis resulted in nine inter-linking themes: Changes and losses; challenges revolving around MS; caregiving demands; burden of care; future concerns; external stressors; experiences of support; strategies used in managing the caregiving role; and motivating factors. Our findings suggest that MS carers can have both positive and negative experiences which may bring challenges and rewards to the carers.

Conclusion: We present a proposed QoL model for MS caregiving which can be used to inform the development of interventions for MS carers to improve their QoL. However, further empirical research is needed to examine the utility of this model and to explore the concept of QoL in MS carers in more detail.     

Exasperations as Blessings: Meaning-Making and the Caregiving Experience

This study examines the process of how caregivers can shape the frustrations and exasperations of caring for a family member with Alzheimer's disease into blessings. Heidegger's hermeneutic phenomenological perspective is used to interpret a caregiver's narrative, in which she describes caring for her husband with Alzheimer's disease. The interpretive analysis focuses specifically on how the caregiver finds meaning in the caregiving process. The analysis reveals that the caregiver constructs meaning by emphasizing particular aspects of her experiences, including cherished memories, creating a happy life by living life intensely, and counting her blessings. While some caregivers naturally find such meaning, this study suggests that reading the narratives of others as well as writing about one's own thoughts and feelings can facilitate this meaning-making process. Structured written emotional expression, in particular, fosters meaning-making, diminishes psychological distress, improves immune function, and promotes health and well-being.     

Filial Responsibility and Transitions Involved: A Qualitative Exploration of Caregiving Daughters and Frail Mothers

One of the consequences of an aging society is the growing need for caregivers to the increasing number of frail older persons. This study is a qualitative examination of filial responsibility between caregiving daughters and frail mothers. It explores filial expectations and motivations and how incongruencies are met and negotiated. Twenty-two women (eleven caregiving dyads) were interviewed using a semi-structured interview format. Employing the grounded theory methodology, interviews were analyzed both individually and dyadically for content and themes. What emerged from the analysis was a grounded theory framework of four intrapsychic caregiving and care-receiving transitions: (1) Realizing I am a Caregiver/Care-receiver; (2) Defining the Caregiver/Care-receiver Roles; (3) Redefining the Caregiving Relationship; and (4) Relationship Acceptance. The transitions identified here comprise a loose framework influenced by different levels of filial responsibility—personal, parental, family, and religious. In addition to the four transitions, one overarching theme called “Emotional Responses to Informal Caregiving and Care-receiving” was evident throughout the findings. Findings from this research provide a framework for understanding the often unclear transitions that daughters and mothers believe they go through. Research implications are discussed for researchers, therapists, caregiving support group leaders, and women who are contemplating or confronted with filial responsibility.     

The Fate of the Moros: A Cross-cultural Exploration of Strategies in Complex and Dynamic Decision Making

The ways in which people deal with complex and dynamic problems are shaped by their learning experiences within their culture as well as the functional constraints within which they have to operate. An experiment is described that explores the interaction of culture and ways of problem solving. University students from India and Germany had to work on one of two different versions of a computer-simulated interactive complex problem. The anaylsis focuses on the strategic aspects of problem solving. Indian and German problem solvers clearly differed in their approach: German students used a more active and control-oriented strategy and committed fewer strategic and tactical errors. The results form the basis of a discussion on the factors important in the development of problem-solving expertise.     

Measuring Team Performance in Complex and Dynamic Military Environments: The SPOTLITE Method

The Scenario-based Performance Observation Tool for Learning In Team Environments (SPOTLITE) provides a systematic method for developing team performance measurement instruments comprised of behaviorally anchored rating scales that are tied to observable behaviors that tap critical knowledge and skills and can be assessed at specific intervals during a training scenario. We developed a measurement instrument for four-person teams of F-16 pilots training for air-to-air combat in a high-fidelity simulation environment and implemented it in a handheld computer to support fast and accurate data entry as a team executes a scenario. An experiment demonstrated the sensitivity, reliability, and validity of the instrument.     

Women's Caregiving Careers and Retirement Financial Insecurity

Providing the essential care for children and aged relatives has immediate and long‐term financial consequences for women, particularly financial insecurity in retirement. Women's caregiving careers are examined in relationship to the impact on retirement. The need for career and retirement education and counseling aimed at women who assume caregiving roles is addressed.     

Stress Generation in Adolescent Depression: The Moderating Role of Child Abuse and Neglect

The present study examined the role of childhood abuse and neglect and depression recurrence in moderating the generation of stressful life events in adolescent depression. Maltreatment history and stressful life events were assessed using two rigorous contextual interviews and rating systems. In a sample of 59 community depressed adolescents we found significantly higher rates of interpersonal events in the 3-month period immediately following depression episode onset versus the 3-month period immediately preceding onset in adolescents with a history of childhood maltreatment. By contrast, rates of events remained constant over a matched period in a control group of non-maltreated adolescents. Furthermore, the generation of interpersonal events only held among those on a first onset of depression. These results suggest that a history of childhood abuse and neglect exacerbates the psychosocial dysfunction associated with the onset of depression, particularly in the very first episode.     

Another Side to Caregiving: Negative Reactions to Being Helped

Until recently, caregiving research focused almost exclusively on caregivers of older adults with health problems, and there was little focus on care recipients' perceptions of the care they receive. The present article reviews relevant research on reactions to caregiving assistance. Several recent studies indicate that help in these contexts can be viewed negatively by care recipients. As many as two thirds of physically impaired older adults who receive assistance with daily activities, such as preparing meals, climbing stairs, or dressing, experience negative reactions to some of the help they receive. Negative reactions seem to have important consequences for the care recipient, because they are associated with higher depression concurrently and 1 year later. Because some of the findings are inconsistent with theoretical models of negative responses to help, an alternative framework, based on social-support and social-conflict research, is briefly proposed.     

Relationship Dynamics Between Aging Mothers and Caregiving Daughters: Filial Expectations and Responsibilities

Using qualitative analysis, this research examined filial responsibility and the relationship dynamics between aging mothers and their caregiving daughters. In-depth interviews with 11 mother–daughter pairs explored respondents' sense of filial responsibility, filial expectations, the congruence between mothers' and daughters' expectations, and strategies used to negotiate incongruent expectations. Employing grounded theory, seven categorical themes emerged describing the daughters' perceptions and experiences of providing care. Themes were later linked to the mothers' responses concerning filial responsibility and their experiences of receiving care. Three approaches to caregiving emerged: undifferentiated, dispassionate, and mutually balanced. Findings from the present study have important implications for practitioners working with older adults and their family caregivers.     

Culturally Sensitive Dementia Caregiving Models and Clinical Practice

Family caregiving for individuals with dementia is an increasingly complex issue that affects the caregivers' and care recipients' physical, mental, and emotional health. This article presents 3 key culturally sensitive caregiver models along with clinical interventions relevant for mental health counseling professionals.