Spouse versus other family caregivers: Psychological impact on impaired aged

This correlational study examined negative affect among impaired aged who live with and receive care from either a spouse or a younger relative. Covariance analyses, controlling for group differences in age, health, and functional disability, soundly disconfirmed hypotheses that spouses' care would prove less stressful than would that of children. In fact, the reverse obtained for measures of number of expressed worries, negative affect toward caregivers, and perceptions of both negative affect and negative behavior of caregivers toward elderly respondents. The two care groups did not, however, differ in self-rated depression or in feelings of dependency upon care providers. Examination of social support indices revealed that Spouse and Other care groups differed only in number of other household residents who assist with health care activities; this variable was, however, unrelated to affect measures. Results are discussed in terms of differential stressors upon aged couples in contrast with recipients of second-generation relatives' assistance, and of kinship factors which may influence elders' perceptions and affect.     

Ethical dilemmas in testing for late onset conditions: reactions to testing and perceived impact on other family members

This paper examines some of the ethical dilemmas that arise when testing for the late onset, untreatable condition of Huntington disease (HD) specifically now that technology allows us to test younger generations of the family for the mutant gene. Drawing on interview data from families with Huntington disease, the reactions to testing and perceived impact on other family members are considered. These are discussed in the light of the possible lowering of the age of test applicants. This potentially raises problems for a younger generation as they are confronted with reproductive decisions that the older generation did not have to face. It also means that individuals have the prospect of living with knowledge of a future illness for much longer.     

Stories of family caregivers of people with dementia in Greece: Implications for counselling

A substantial body of literature has identified high rates of burden, psychological morbidity, social isolation, health and financial difficulties among dementia caregivers. The present qualitative study adopted an Interpretive Phenomenological Analysis approach in order to explore the lived experiences of dementia family caregivers within the Greek sociocultural context. The sample was purposive and consisted of 10 women dementia family caregivers from Athens and Thessaloniki. Individual in-depth interviews were conducted and analysed according to IPA. The participants’ personal accounts included themes related to ethical/existential and cultural aspects of family caregiving; changes in family relationships; impact of the caregiving experiences; sources of support and help seeking; positive and meaningful aspects of the care experience. The research findings are discussed in the context of Gilligan’s moral psychological theory, and cultural dimensions of family caregivers. Implications for counselling interventions aiming at supporting caregivers are presented.     

The effects of parental illness and other ill family members on youth caregiving experiences

Informed by a model of family role redistribution derived from the family ecology framework, this study examined differences in two proposed psychological components of role redistribution (youth caregiving experiences and responsibilities) between youth of a parent with illness and their peers from ‘healthy’ families controlling for the effects of whether a parent is ill or some other family member, illness type and demographics. Based on self-report questionnaire data, four groups of Australian children were derived from a community sample of 2474 youth (‘healthy’ family, n = 1768; parental illness, n = 336; other family member illness (OFMI), n = 254; both parental and OFMI, n = 116). The presence of any family member with a serious illness is associated with an intensification of youth caregiving experiences relative to peers from healthy families. This risk is elevated if the ill family member is a parent, if more illnesses are present and by certain youth and family demographics, and especially by higher caregiving responsibilities. The presence of a family member, particularly a parent, with a serious medical condition has pervasive increased effects on youth caregiving compared to healthy families, and these effects are not fully accounted for by illness type, demographics or caregiving responsibilities.     

Effectiveness of individual counseling by professional and peer helpers for family caregivers of the elderly

This study of the effectiveness of individual counseling for daughters and daughters-in-law (N = 87) who were the primary caregivers for frail elderly parents revealed that participants who received professional counseling demonstrated significantly better outcomes than a no-treatment control group in regard to subjective well-being, level of psychiatric symptomatology, and perceived change in aspects of the caregiver-care-receiver relationship. Participants who received peer counseling demonstrated similar gains but did not improve significantly more than did control subjects in subjective well-being. Both forms of counseling had no significant effect on caregivers' formal and informal social support networks.     

Burden in schizophrenia caregivers: impact of family psychoeducation and awareness of patient suicidality

Family caregivers of persons with schizophrenia and other psychotic disorders experience high levels of burden. Although a number of patient and caregiver predictors of burden have been identified, little research has investigated the contributions of patient depression, suicidal ideation, and substance abuse. In addition, family psychoeducation interventions have reduced patient symptoms, as well as inpatient treatment utilization; however, it is not known whether or not these interventions reduce family burden. This study investigated predictors of family burden and tested to what degree multiple family group treatment (MFGT), relative to a standard care condition, was associated with reduced family burden. Participants were 90 outpatients with a diagnosis of schizophrenia or other psychotic disorders, and their caregivers who were enrolled in a 2 year psychoeducation intervention. The best set of predictors of burden, identified by stepwise linear regression, was young patient age, awareness of patient's suicidal ideation, and family resources. These variables accounted for 32% of the total variance in burden. Findings suggest that caregiver's awareness of patient's suicidal ideation, not patient's report of suicidal ideation; and that patient age, not duration of the illness, were significant independent predictors of burden. When compared to a standard-care condition over 2 years, MFGT did not reduce family caregiver burden. Discussions focus on the relationship between burden and its predictors, and possible reasons why MFGT did not decrease burden. Modifications are proposed that may increase the impact of MFGT.     

The professional evaluation of depression

Endogenous depression overwhelms the individual without a known or external causal event; the authors suggest that it is both constitutionally and biochemically based. They utilize a case to demonstrate the evaluation of such depression and identify a wide range of symptoms as characteristic of it. They describe professional responsibility and discuss several modes of relating to and caring for depressed people. The pastor's work with depressed persons emphasizes the effects of the systems in which such people work as potential assets and liabilities and involves the proper direction and use of the pastor's compassion.     

Impact of close family members on older adults' early response to depression treatment

This study of 130 depressed older adults and their spouses or adult children examined the impact of caregiver burden specific to patients' depressive symptoms on patients' response to antidepressant treatment. Primary care patients completed medical, psychiatric, and neuropsychological assessments prior to treatment, and interviews were conducted with their identified family member. As hypothesized, caregivers' depression-specific burden predicted greater depression severity for the patient at the 6th week of treatment after accounting for patients' pretreatment characteristics, caregivers' depressive symptoms, and caregivers' relationship satisfaction. Future research may identify family attitudes and behaviors that stem from burden and compromise older adults' ability to recover from depression.     

Aging family caregivers: policies and practices

This review examines later life family support for adults with developmental disabilities from a life course perspective that takes into account social trends and changes in service patterns and in attitudes of families. Key issues addressed include: (1) trends affecting family caregiving, (2) health and social outcomes of life-long caregiving, (3) support needs of families, (4) family support policies and practices, and (5) recommendations for a research and policy agenda. Research examining outcomes of life-long caregiving has shown that most families adapt well to having a family member with disabilities. However, some families are at risk for poorer physical and mental health outcomes. These include cultural minorities and families of adults with behavioral challenges. Caregiving does seem to have a negative impact on maternal employment and family income as mothers often give up or cut back on employment to care for a child with developmental disabilities, who is more likely to continue living in the family home throughout adulthood than other adult children. Federal and state initiatives are addressing issues of family support through both the developmental disabilities and aging service systems.     

The relationship between family support; pain and depression in elderly with arthritis

The prevalence and chronic nature of arthritis make it the most common cause of disability among U.S.A adults. Family support reduces the negative impact of chronic conditions generally but its role in pain and depression for arthritic conditions is not well understood. A total of 844 males (35.0%) and 1567 females (65.0%) with arthritic conditions (n = 2411) were drawn from the 2012 Health and Retirement Study to examine the effect of family support on pain and depressive symptoms. Using regression analysis and controlling for age, ethnicity, gender, marital/educational status and employment/income, physical function/disability status, pain and antidepressant medications, and other clinical indicators of chronic health conditions, we examined the effects of family support (spouse, children, other) on pain and depression levels. Results indicated that depressive symptoms decreased significantly with strong family and spousal support (p < .05). Pain decreased as support levels increased, but was non-statistically significant. This study provides new insights into the relationship between family support, pain, and depression for individuals with arthritis. Future longitudinal studies are needed to evaluate family support and relationships over a wider spectrum of demographics.     

Family discussion group therapy for major depression: a brief systemic multi‐family group intervention for hospitalized patients and their family members

This paper describes a brief systemic multi‐family group intervention for hospitalized patients with major depression and their family members. The presented treatment integrates elements of systemic therapy, social constructionist and narrative concepts and the family systems‐illness model. It has further adapted a specific multi‐family group format combining marital group sessions and family group sessions. Similarities and differences with other family interventions for depression are discussed. The therapeutic foundations and goals, the organization, and the therapeutic process are explained. A number of clinical vignettes are presented to illustrate the treatment procedure. Although the first clinical impressions about the usefulness of the family discussion group intervention are promising, the efficacy of the treatment awaits the completion of a clinical trial that is currently underway.     

Spiritual support for caregivers of dementia patients

Dementia is considered the major psychiatric disorder of old age and affects over 4 million people in the United States. As Alzheimer's disease and other dementias progress, the patient can become increasingly dependent on the family for care. This dependency can place the caregiver in a role that is both difficult and demanding. In this study coping strategies used by family caregivers of dementia patients and caregivers' sense of burden were assessed. Burden scores were significantly correlated with spiritual support, an external coping strategy. When spiritual well-being is integrated with medical and psychosocial needs, the clergy and spiritual community can play an integral role in the care for families and dementia patients.     

The use of Internet technology for psychoeducation and support with dementia caregivers

A large randomized trial evaluated the benefits of online education, support, and self-care promotion for caregivers of persons with dementia. Anecdotal reports from participants indicated enjoyment of the materials, convenient access from home, and support from professionals and other caregivers. A substantial number of screened caregivers experienced obstacles of access, cost, and time regarding use of technology. Telephone options are being explored, and future caregiving generations are expected to have increased exposure and willingness to use computer technology, such as the program described here.     

Severe traumatic brain injury: some effects on family caregivers

This study assesses the effects of severe traumatic brain injuries on family members and functioning-a topic of interest for those working with survivors and their families. This issue is receiving increased attention as recent findings suggest that family adjustment influences outcome for brain-injured persons. The Family Environment Scale and the Profile of Mood States were completed by 25 individuals who had a family member with a severe traumatic brain injury. These scales were also completed by a comparison group of 32 individuals who had no brain-injured family member. In terms of family functioning, the findings suggest that, when a family member suffers a severe traumatic brain injury, depression may be elevated, along with a decreased ability to express feelings, decreased time and energy for social and recreational activities, and increased control in comparison to families without a brain-injured member. While this might contribute to family isolation which could last for many years, the overall finding of the present study was that caregiver families were coping adequately.     

The impact of family functioning on family racial socialization processes

This longitudinal study evaluated the relationship between family functioning and family racial socialization processes in a clinical sample of African American youth referred for drug abuse treatment. Participants were 77 African American adolescents and their parents. Results showed that participants assigned to structural ecosystems therapy experienced a greater increase in family racial socialization processes during treatment than participants assigned to the treatment as usual in community settings condition. Participants in structural ecosystems therapy also demonstrated a greater increase in family functioning than participants in community settings condition, and this improvement in family functioning mediated the relationship between treatment condition and family racial socialization processes. Research and clinical implications are discussed.     

The impact of illness on the family and the family's impact on illness

This paper discusses the influence that familial relationships can have on illness and the way in which illness can impact on the functioning of the family system. Developmental phases of illness, the family life cycle and chronic illness are all examined in relation to the family and it's functioning. The way in which health behaviours are adopted within families, and behavioural and genetic predispositions to illness are also discussed.