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Predictors of well-being in bereaved former hospice caregivers: The role of caregiving stressors, appraisals, and social resources

  • Allison M. Burton (a1), William E. Haley (a2), Brent J. Small (a2), Margaret R. Finley (a2), Marie Dillinger-Vasille (a2) and Ronald Schonwetter (a3)...

Abstract

Objective:

The current literature on caregiving and bereavement indicates that the relationship between these two common life events is complex and needs to be further studied in order to gain a more comprehensive understanding of their interaction.

Methods:

In the current project, 50 spouses of hospice patients with end-stage lung cancer or dementia were assessed while caregiving and at an average of 4 months after the death on a variety of measures, including caregiving stressors, appraisals, social resources, and well-being. A stress process model was utilized in order to examine which preloss factors were associated with postloss depression, life satisfaction, and grief.

Results:

Our results indicated that patient diagnosis (cancer or dementia) and caregiver appraisals (stressfulness of functional impairment and positive aspects of caregiving) were not predictors on any of our well-being outcomes. However, fewer months caregiving was a significant predictor of both higher depression and grief postloss. Additionally, lower levels of social activities, smaller social networks, and lower satisfaction with social support were significantly associated with higher postloss depression.

Significance of results:

Results support both the resource depletion and anticipatory grief hypotheses and suggest that short-term bereavement outcomes are different than factors that predict well-being while caregiving. Future studies should address whether long-term bereavement outcomes differ by baseline caregiving characteristics to guide intervention research.

Copyright

Corresponding author

Address correspondence and reprint requests to: Allison M. Burton, Center for Health Services Research in Primary Care, Durham VAMC/Duke University Medical Center, Hock Plaza, Suite 1105, Box 2720, 2424 Erwin Rd., Durham, NC 27705. E-mail: allison.burton@duke.edu

References

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Aneshensel, C.S., Pearlin, L.I., Mullan, J.T., et al. (1995). Profiles in caregiving: The unexpected career. San Diego: Academic Press.
Bass, D.M. & Bowman, K. (1990). The transition from caregiving to bereavement: The relationship of care-related strain and adjustment to death. The Gerontologist, 30, 3542.
Boerner, K., Schulz, R., & Horowitz, A. (2004). Positive aspects of caregiving and adaptation to bereavement. Psychology and Aging, 19, 668675.
Bonanno, G.A., Wortman, C.B., Lehman, D.R., et al. (2002). Resilience to loss and chronic grief: A prospective study from pre-loss to 18 months post-loss. Journal of Personality and Social Psychology, 83, 11501164.
Carr, D. (2004). Black/White differences in psychological adjustment to spousal loss among older adults. Research on Aging, 26, 591622.
Carr, D., House, J.S., Wortman, C., et al. (2001). Psychological adjustment to sudden and anticipated spousal death among the older widowed. Journal of Gerontology: Social Sciences, 56B, S237S248.
Cleiren, M.P.H.D., van der Wal, J., & Diekstra, R.F.W. (1988). Death after a long term disease: Anticipation and outcome in the bereaved. Pharos International Autumn-Winter, 112–114, 136139.
Davis, C.G. & Nolen-Hoeksema, S. (2001). Loss and meaning: How do people make sense of loss? American Behavioral Scientist, 44, 726741.
Faschingbauer, T.R., Zisook, S., & DeVaul, R.A. (1987). The Texas Revised Inventory of Grief. In Biopsychosocial Aspects of Bereavement, Zisook, S. (ed.), pp. 111124. Washington, DC: American Psychiatric Association.
George, L.K. (1990). Caregiver stress studies—There really is more to learn. The Gerontologist, 30, 580581.
Goode, K.T., Haley, W.E., Roth, D.L., et al. (1998). Predicting longitudinal changes in caregiver physical and mental health: A stress process model. Health Psychology, 17, 190198.
Haley, W.E., LaMonde, L.A., Han, B., et al. (2001). Family caregiving in hospice: Effects on psychosocial and health functioning among spousal caregivers of hospice patients with lung cancer or dementia. The Hospice Journal, 15, 118.
Haley, W.E., LaMonde, L.A., Han, B., et al. (2003). Predictors of depression and life satisfaction among spousal caregivers in hospice: Application of a stress process model. Journal of Palliative Medicine, 6, 215224.
Haley, W.E., Roth, D.L., Coleton, M.I., et al. (1996). Appraisal, coping, and social support as mediators of well-being in Black and White Alzheimer's family caregivers. Journal of Consulting and Clinical Psychology, 64, 121129.
Katz, S., Ford, A.B., Moskowitz, R.W., et al. (1963). Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychological function. Journal of the American Medical Association, 185, 914919.
Krause, N. & Borawski-Clark, E. (1995). Social class differences in social support among older adults. The Gerontologist, 35, 498508.
Kwak, J. & Haley, W.E. (2005). Current research findings on end-of-life decision making among racially/ethnically diverse groups. The Gerontologist, 45, 634641.
Lawton, M.P. & Brody, E. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 179186.
Lawton, M.P., Moss, M., Fulcomer, M., et al. (1982). A research and service oriented multilevel assessment instrument. Journal of Gerontology, 37, 9199.
Lubben, J.E. (1988). Assessing social networks among elderly populations. Family and Community Health, 11, 4252.
McHorney, C.A. & Mor, V. (1988). Predictors of bereavement depression and its health services consequences. Medical Care, 26, 882893.
Minino, A.M. & Smith, B.L. (2001). Deaths: Preliminary data for 2000. National Vital Statistics Reports, 49 (12). Hyattsville, MD: National Center for Health Statistics.
Mullan, J.T. (1992). The bereaved caregiver: A prospective study of changes in well-being. The Gerontologist, 32, 673683.
Owen, J.E., Goode, K.T., & Haley, W.E. (2001). End of life care and reactions to death in African American and White family caregivers of relatives with Alzheimer's disease. Omega, 43, 349361.
Pearlin, L.I., Mullan, J.T., Semple, S.J., et al. (1990). Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30, 583594.
Phipps, E., Braitman, L.E., True, G., et al. (2003). Family care giving for patients at life's end: Report from the Cultural Variations Study (CVAS). Palliative & Supportive Care, 1, 165170.
Prigerson, H.G. & Jacobs, S.C. (2001). Traumatic grief as a distinct disorder: A rationale, consensus criteria, and a preliminary empirical test. In Handbook of Bereavement Research: Consequences, Coping, and Care, Stroebe, M.S., Hansson, R.O., Stroebe, W., et al. (eds.), pp. 563584. Cambridge, UK: Cambridge University Press.
Radloff, L.S. (1977). The CES-D scale: A self report depression scale for research in the general population. Applied Psychological Measurements, 1, 385401.
Raphael, B., Minkov, C., & Dobson, M. (2001). Psychotherapeutic and pharmacological intervention for bereaved persons. In Handbook of Bereavement Research: Consequences, Coping, and Care, Stroebe, M.S., Hansson, R.O., Stroebe, W., et al. (eds.), pp. 563584. Cambridge, UK: Cambridge University Press.
Sankar, A. (1991). Ritual and dying: A cultural analysis of social support for caregivers. The Gerontologist, 31, 4350.
Schulz, R. & Beach, S.R. (1999). Caregiving as a risk factor for mortality: The Caregiver Health Effects Study. Journal of the American Medical Association, 282, 22152219.
Schulz, R., Mendelsohn, A.B., Haley, W.E., et al. (2003). End of life care and the effects of bereavement among family caregivers of persons with dementia. New England Journal of Medicine, 349, 19361942.
Schulz, R., Newsom, J.T., Fleissner, K., et al. (1997a). The effects of bereavement after family caregiving. Aging & Mental Health, 1, 269282.
Schulz, R., Newsom, J.T., Mittelmark, M., et al. (1997b). Health effects of caregiving: The Caregiver Health Effects Study. Annals of Behavioral Medicine, 19, 110116.
Schulz, R., O'Brien, A.T., Bookwala, J., et al. (1995). Psychiatric and physical morbidity effects of dementia caregiving: Prevalence, correlates, and causes. The Gerontologist, 35, 771791.
Stroebe, W. & Schut, H. (1999). The dual process model of coping with bereavement: Rationale and description. Death Studies, 23, 197224.
Stroebe, W. & Stroebe, M.S. (1987). Bereavement and health: The psychological and physical consequences of partner loss. New York: Cambridge University Press.
Wood, V., Wylie, M.L., & Sheafor, B. (1969). An analysis of a short self-report measure of life satisfaction: Correlation with rater judgements. Journal of Gerontology, 24, 465469.

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