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Caregiver Resources and Facilitation of Elderly Care Recipient Adherence to Health Regimens*

Published online by Cambridge University Press:  31 March 2010

Haya Greenberger
Affiliation:
Israeli Ministry of Health
Howard Litwin*
Affiliation:
Hebrew University of Jerusalem
*
Requests for offprints should be send to: / Les demandes de tirés-à-part doivent être addressées à: Howard Litwin, DSW, Paul Baerwald School of Social Work, Hebrew University of Jerusalem, Mount Scopus, Jerusalem IL-91905, Israel. (mshowie@mscc.huji.ac.il)

Abstract

We studied the relationship between caregivers' personal and social resources and facilitation of adherence by elderly care recipients to a prescribed health regimen. Adherence facilitation was measured among 240 caregivers on a 45-item instrument constructed for this research. The facilitation score was regressed on caregivers' role-specific self-concept (e.g., caregiver competence), informal social network support, utilization of the informal network as a lay referral system, formal network support, and reported health status of the care recipient. Background variables and health beliefs were considered as control variables. The resource variable best correlated with adherence facilitation was the personal resource of caregiver competence — perception of oneself as a good caregiver — followed by two social resources: support of the professional health care provider and the presence of a lay referral system (R2 = 0.37). Thus, although the care recipient is the beneficiary of adherence facilitation, the caregiving characteristics of the caregiver appear to affect its extent.

Résumé

Nous avons étudié la relation existant entre les ressources personnelles et sociales des soignants naturels et leur aptitude à encourager l'adhésion des patients âgés au traitement qui leur est prescrit. Cette aptitude a été mesurée chez 240 soignants naturels au moyen d'un instrument statistique à 45 volets conçu tout exprès pour cette recherche. Nous avons évalué, au moyen d'une analyse régressive, la perception que les soignants naturels ont de leur rôle (p. ex., de leur compétence), le soutien du réseau social informel, le recours au réseau informel comme système d'aiguillage non professionnel, le soutien du réseau formel, et l'état de santé de la personne soignée. Nous avons utilisé les variables sur les antécédents et les croyances en matière de santé comme variables de contrôle. La ressource personnelle la plus étroitement liée à l'aptitude à encourager l'adhésion au traitement était la compétence du soignant naturel – la perception de soi comme d'un bon soignant naturel – venaient ensuite deux ressources sociales : soutien du fournisseur de services de santé et existence d'un système d'aiguillage non professionnel (R2 = 0,37). Ainsi, bien que l'aptitude à encourager l'adhésion au traitement profite à la personne soignée, le degré d'adhésion semble dépendre des circonstances particulières du soignant naturel.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2003

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Footnotes

*

The study on which this article is based was carried out with the support of grants from “ESHEL”, the Association for the Planning and Development of Services for the Aged, and from the Municipality of Jerusalem.

References

Administration on Aging. (n.d.) A profile of older Americans: 2002. Retrieved 22 September 2003 from http://www.aoa.gov/prof/statistics/profile/12_pf.aspGoogle Scholar
Amir, S., Rabin, C., & Galatzer, A. (1990). Cognitive and behavioral determinants of compliance in diabetics. Health and Social Work, 15, 144151.CrossRefGoogle ScholarPubMed
Andersen, R.M. (1995). Revisiting the behavioral model and access to medical care: does it matter? Journal of Health and Social Behavior, 34, 5470.Google Scholar
Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
Barnea, H., & Habib, J. (1992). Aging and development. Jerusalem: JDC-Brookdale Institute of Gerontology and Adult Human Development.Google Scholar
Bass, D.M., & Noelker, L.S. (1987). The influence of family caregivers on elders' use of in-home services: An expanded conceptual framework. The Journal of Health and Social Behavior, 28, 184196.CrossRefGoogle ScholarPubMed
Ben-Sira, Z. (1982). Lay evaluation of medical treatment and competence: Development of a model of the function of the physician's affective behavior. Social Science and Medicine, 16, 10131019.CrossRefGoogle Scholar
Berkanovic, E., & Telesky, C. (1982). Social networks, beliefs, and the decision to seek medical care: An analysis of congruent and incongruent patterns. Medical Care, 20, 10181026.CrossRefGoogle ScholarPubMed
Blazer, D., George, L., & Landerman, R. (1986). The phenomenology of late life depression. In Bebbington, P.E. & Jacoby, R. (Eds.), Psychiatric disorders of the elderly (pp. 143152). London: Mental Health Foundation.Google Scholar
Bowers, B. (1987). Intergenerational caregiving: Adult caregivers and their aging parents. Advanced Nursing Science, 9(2), 2031.CrossRefGoogle ScholarPubMed
Braithwaite, V.A. (1992). Bound to care. Sydney: Allen & Unwin.Google Scholar
Brookdale Annual Statistical Report. (2001). Jerusalem: JDC-Brookdale Institute of Gerontology and Adult Human Development.Google Scholar
Burrows, D.E. (1997). Facilitation: A concept analysis. Journal of Advanced Nursing, 25, 132137.CrossRefGoogle ScholarPubMed
Cain, C.J., & Wicks, M.N. (2000). Caregiver attributes as correlates of burden in family caregivers coping with chronic obstructive pulmonary disesase. Journal of Family Nursing, 6(1), 4668.CrossRefGoogle Scholar
Clark, M., & Huttlinger, K. (1998). Elder care among Mexican American families. Clinical Nursing Research, 7(1), 6481.CrossRefGoogle ScholarPubMed
Cornoni-Huntley, J.C., Foley, D.F., White, L.R., Suzman, R., Berkman, L.F., Evans, D.A., & Wallace, R.B. (1985). Epidemiology of disability in the oldest old: methodological issues and preliminary findings. Milbank Memorial Fund Quarterly / Health and Society, 63, 350376.CrossRefGoogle ScholarPubMed
Daley, J., Sindone, A.P., Hancock, I.L., & Change, E. (2000). The barriers in and adherence to cardiac rehabilitation: A critical literature review. Progress in Cardiovascular Nursing, 17(1), 817.CrossRefGoogle Scholar
Dean, K. (1986). Lay care in illness. Social Science and Medicine, 22, 275284.CrossRefGoogle ScholarPubMed
Devor, M., Wang, A., Revale, M., Feigal, D., & Ransdell, J. (1994). Compliance with social and safety recommendation in an outpatient comprehensive geriatric assessment program. Journals of Gerontology: Medical Sciences, 49(4), M168M173.CrossRefGoogle Scholar
George, L.K., & Gywther, L.P. (1986). Caregiver well-being: A multidimensional examination of family caregivers of demented adults. The Gerontologist, 26, 253259.CrossRefGoogle ScholarPubMed
Glasser, M., Prohasha, T., & Gravdal, J. (2001). Elderly patients and their accompanying caregivers on medical visits. Research on Aging, 23, 326348.CrossRefGoogle Scholar
Glasser, M., Rubin, S., & Dickover, M. (1991). The caregiver role: Review of family-physician relations and dementing disorders. In Stahl, S. (Ed.), The legacy of longevity: Health, illness, and long term care in later life (pp. 321337). Newbury, CA: Sage.Google Scholar
Gupta, R. (2000). A path model of elder caregiver burden in Indian/Pakistani families in the United States. International Journal of Aging and Human Development, 51, 295313.CrossRefGoogle ScholarPubMed
Haley, W.E., Clair, J., & Saulsbury, K. (1992). Family caregivers' satisfaction with medical care of their demented relatives. The Gerontologist, 32, 219225.CrossRefGoogle ScholarPubMed
Hasselkus, B.R. (1988). Meaning in family caregiving: Perspectives in family caregiver and professional relationships. The Gerontologist, 28, 320333.CrossRefGoogle ScholarPubMed
Haug, M.A. (1994). Elderly patients, caregivers, and physicians: Theory and research on health care triads. Journal of Health and Social Behavior, 35, 112.CrossRefGoogle ScholarPubMed
Hills, G.A. (1998). Caregivers of the elderly: Hidden patients and health team members. Topics in Geriatric Rehabilitation 14(1), 111.CrossRefGoogle Scholar
Jackson, S.A. (1999). The epidemiology of aging. In Hazzard, W.R., Blass, J.P., Etting, W.H., Halter, J.B., & Ouslander, J.G. (Eds.), Principles of geriatric medicine and gerontology (4th ed., pp. 203205). New York: McGraw-Hill.Google Scholar
Jensen, J., Count, M.A., & Glanden, G.L. (1992). Elderly health attitudes and maintenance. Preventive Medicine, 21, 483497.CrossRefGoogle ScholarPubMed
John, R. Hennessy, C.H., Dyeson, T.B., & Garrett, M.D. (2001). Toward the conceptualization and measurement of caregiver burden among Pueblo Indian caregivers. The Gerontologist, 41, 210219.CrossRefGoogle Scholar
Kahana, E., Biegel, D.E., & Wykle, M.L. (1994). Introduction: Overview of the volume. In Kahana, E., Biegel, D.E., & Wykle, M.L. (Eds.), Family caregiving across the lifespan (pp. xiiixxvi). Thousand Oaks, CA: Sage.CrossRefGoogle Scholar
Katz, S., Ford, A.B., Moskowitz, B.A., Jackson, M.E., & Jaffe, M.W. (1963). The index of ADL: A standardized measure of biological and psychological function. Journal of the American Medical Association, 185, 914919.CrossRefGoogle Scholar
Kyngas, H., & Hentinen, M. (1995). Meaning attached to compliance with self care and conditions among young diabetics. Journal of Advanced Nursing, 21, 729736.CrossRefGoogle ScholarPubMed
Lawton, M., Moss, M., Kleban, M.H., Glicksman, A., & Rovine, M. (1991). A two factor model of caregiving appraisal and psychological well-being. Journals of Gerontology, 46(4), 181189.CrossRefGoogle ScholarPubMed
Levkoff, S.E., Cleary, P.D., Wetle, T., & Besdine, R.W. (1988). Illness behavior in the aged: Implications for clinicians. Journal of the American Geriatric Society, 36, 622629.CrossRefGoogle ScholarPubMed
Litwak, E. (1985). Helping the elderly: The complementary roles of informal and formal systems. New York: Guilford Press.Google Scholar
Litwin, H., & Auslander, G.K. (1993). Involvement of informal elderly-care networks in contacts with public social services. Journal of Social Work and Policy in Israel, 7–8, 720.Google Scholar
Lyness, J.M., Cox, C., Curry, J., Conwell, Y., King, D.A., & Caine, E.D. (1995). Older age and the underreporting of depressive symptoms. Journal of the American Geriatrics Society, 43, 216221.CrossRefGoogle ScholarPubMed
Lyons, K.S., Zarit, S.T., Sayer, A.G., & Whitlatch, C.J. (2002). Caregiving as a dyadic process: Perspectives from caregiver and receiver. The Journal of Gerontology, 57B(3), 195204.CrossRefGoogle Scholar
Miller, B. (1998). Family caregiving: Telling it like it is. The Gerontologist, 38, 510–13.CrossRefGoogle Scholar
Mitchell, J.M., & Kemp, B.J. (2000). Quality of life in assisted home living. The Journals of Gerontology: Psychological Sciences, 55B, P117P127.CrossRefGoogle Scholar
Navie-Waliser, M.N., Feldman, P.H., Gould, D.A. & Levine, C.L. (2002). When the caregiver needs care: The plight of vulnerable caregivers. American Journal of Public Health, 92, 409413.CrossRefGoogle Scholar
Olesen, V. (1989). Caregiving: Emerging challenges in the sociology of health and illness. Journal of Health and Social Behavior, 30(1), 110.CrossRefGoogle ScholarPubMed
Pearlin, L.I., Mullan, J.T., Semple, S.J., & Skaff, M.M. (1990). Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30, 583594.CrossRefGoogle ScholarPubMed
Philips, L.R. (1989). Elder-family caregiver relationships: Determining appropriate nursing interventions. Nursing Clinics of North America, 24, 795807.CrossRefGoogle Scholar
Shyu, Y.I. (2000). The patterns of caregiving when family caregivers face competing needs. Journal of Advanced Nursing, 31, 3545.CrossRefGoogle ScholarPubMed
Silliman, R.A. (2000). Caregiving issues in the geriatric medical encounter. Clinics in Geriatric Medicine, 16(1), 5160.CrossRefGoogle ScholarPubMed
Skaff, M., Pearlin, L., & Mullan, J. (1996). Transitions in the caregiving career: Effects of the sense of mastery. Psychology and Aging, 11, 247257.CrossRefGoogle ScholarPubMed
Slivinske, L.R., Fitch, V.L., & Mosca, J. (1994). Predicting health and social service utilization of older adults. Journal of Social Service Research, 20, 247257.CrossRefGoogle Scholar
Stollerman, G.H. (2000). Empowering the caregiver. Hospital Practice, 35(1), 615.CrossRefGoogle ScholarPubMed
Stone, R., Cafferata, G.L., & Sangl, J. (1987). Caregivers of the frail elderly: A national profile. The Gerontologist, 27, 616626.CrossRefGoogle ScholarPubMed
Warnock, H., & Kemle, K. (2002). Diagnosis of elusive disorders in the elderly: Psychiatric, thyroid and cardiac. Physician's Assistant, 26(4), 3846.Google Scholar
Young, R.F. (1994). Elders, families, and illness. Journal of Aging Studies, 8(1), 115.CrossRefGoogle Scholar