Hostname: page-component-848d4c4894-ttngx Total loading time: 0 Render date: 2024-05-19T12:06:17.430Z Has data issue: false hasContentIssue false

Caregiving Networks in Later Life: Does Cognitive Status Make a Difference?*

Published online by Cambridge University Press:  31 March 2010

Laurel A. Strain
Affiliation:
University of Manitoba
Audrey A. Blandford*
Affiliation:
University of Manitoba
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être adressées à : Audrey A. Blandford, Centre on Aging, 338 Isbister Building, University of Manitoba, Winnipeg, MB R3T 2N2. (audrey_blandford@umanitoba.ca)

Abstract

This study examines the caregiving networks of older adults, with particular emphasis on differences according to cognitive status (n = 303). Individuals with cognitive impairment were significantly more likely than those who were cognitively intact to receive assistance with personal care, linking with the outside world, and mobility. The types of network were generally similar for care receivers with cognitive impairment and those who were cognitively intact, although the percentage of networks comprised solely of the identified caregiver varied depending on the tasks. Coresidence of the caregiver and care receiver was more important than the care receiver's cognitive status for exclusive care by the identified caregiver. Having more ADL/IADL limitations was associated with a reliance on a network of the identified caregiver, in conjunction with other caregivers in several task areas. The findings highlight the complexity of sources of help in later life and the need for future research to consider the caregiving network as a whole.

Résumé

L'étude examine les réseaux de soins des personnes âgées, surtout en relation du statut cognitif (n = 303). Les personnes souffrant de diminution cognitive avaient une meilleure chance de recevoir de l'aide avec les soins personnels, les liens au monde extérieur et la mobilité que celles qui ont un statut cognitif intact. En général, les genres de réseaux sont les mêmes et pour les receveurs de soins ayant une diminution cognitive et pour ceux ayant un statut cognitif intact. Toutefois, le pourcentage des réseaux contenant seulement le soignant identifié peut varier compte tenu des tâches. Quant aux soins exclusifs du soignant identifié, la co-résidence du soignant et du receveur d'aide semble avoir une signification plus importante que le statut cognitif du receveur. Le fait d'avoir davantage de restrictions sur les activités de la vie quotidienne (AVQ) et des activités instrumentales de la vie quotidienne (AIVQ). était associé à une dépendance sur le réseau du soignant identifié concurremment avec d'autres soignants à périmètres de tâches multiples. Les résultats démontrent la complexité des sources d'aide disponibles au cours de la vie avancée et du besoin de recherches avancées afin d'étudier en entier le réseau des soins.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

The Manitoba Study of Health and Aging (MSHA) was funded primarily by Manitoba Health, with additional funding provided, through the Canadian Study of Health and Aging, by the Seniors Independence Research Program of the National Health Research and Development Program of Health Canada (Project No. 6606–3954-MC[S]). The results and conclusions are those of the authors and no official endorsement by Manitoba Health is intended or should be inferred. The contributions of MSHA Research Group members at the University of Manitoba's Centre on Aging are gratefully acknowledged.

References

American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (Rev. 3rd ed.). Washington, DC: Author.Google Scholar
Barrett, A.E., & Lynch, S.M. (1999). Caregiving networks of elderly persons: Variation by marital status. The Gerontologist, 39(6), 695704.CrossRefGoogle ScholarPubMed
Birkel, R.C., & Jones, C.J. (1989). A comparison of the caregiving networks of dependent elderly individuals who are lucid and those who are demented. The Gerontologist, 29(1), 114119.CrossRefGoogle ScholarPubMed
Caro, F.G., & Stern, A.L. (1995). Balancing formal and informal care: Meeting needs in a resource-constrained program. Home Health Care Services Quarterly, 15(4), 6781.CrossRefGoogle Scholar
Canadian Study of Health and Aging Working Group. (1994a). Patterns of caring for people with dementia in Canada. Canadian Journal on Aging, 13(4), 470487.CrossRefGoogle Scholar
Canadian Study of Health and Aging Working Group. (1994b). Canadian Study of Health and Aging: Study methods and prevalence of dementia. Canadian Medical Association Journal, 150(6), 899913.Google Scholar
Caserta, M.S., Lund, D.A., Wright, S.D., & Redburn, D.E. (1987). Caregivers to dementia patients: The utilization of community services. The Gerontologist, 27(2), 209214.CrossRefGoogle Scholar
Chappell, N.L., & Blandford, A. (1991). Informal and formal care: Exploring the complementarity. Aging and Society, 11, 299317.CrossRefGoogle Scholar
Crowell, S.J., Rockwood, K., Stolee, P., Buehler, S.K., James, B.M., Kozma, A., & Gray, J.M. (1996). Use of home care services among the elderly in eastern Canada. Canadian Journal on Aging, 15(3), 413426.CrossRefGoogle Scholar
Denton, M. (1997). The linkages between informal and formal care of the elderly. Canadian Journal on Aging, 16(1), 3050.CrossRefGoogle Scholar
Dwyer, J.W., & Coward, R.T. (1991). A multivariate comparison of the involvement of adult sons versus daughters in the care of impaired parents. Journal of Gerontology: Social Sciences, 46(5), S259S269.CrossRefGoogle ScholarPubMed
Ganguli, M., Seaberg, E., Belle, S., Fischer, L., & Kuller, L.H. (1993). Cognitive impairment and the use of health services in an elderly rural population: The MoVIES project. Journal of the American Geriatrics Society, 41(10), 10651070.CrossRefGoogle Scholar
Gill, C.E., Hinrichsen, G.A., & DiGiuseppe, R. (1998). Factors associated with formal service use by family members of patients with dementia. Journal of Applied Gerontology, 17(1), 3852.CrossRefGoogle Scholar
Grabbe, L., Demi, A.S., Whittington, F., Jones, J.M., Branch, L., & Lambert, R. (1995). Functional status and the use of formal home care in the year before death. Journal of Aging and Health, 7(3), 339364.CrossRefGoogle ScholarPubMed
Hawranik, P.G. (1998). The role of cognitive status in the use of inhome services: Implications for nursing assessment. Canadian Journal of Nursing Research, 30(2), 4565.Google ScholarPubMed
Hawranik, P.G. & Strain, L.A. (2001). Cognitive impairment, disruptive behaviors, and home care utilization. Western Journal of Nursing Research, 23(2), 148162.CrossRefGoogle ScholarPubMed
Keating, N., Fast, J., Frederick, J., Cranswick, K., & Perrier, C. (1999). Elder care in Canada: Context, content and consequences. Ottawa: Statistics Canada.Google Scholar
Kelman, H.R., Thomas, C., & Tanaka, J.S. (1994). Longitudinal patterns of formal and informal social support in an urban elderly population. Social Science and Medicine, 38(7), 905914.CrossRefGoogle Scholar
Lee, G.L., Dwyer, J.W., & Coward, R.T. (1993). Gender differences in parent care: Demographic factors and samegender preferences. Journal of Gerontology: Social Sciences, 48(1), S9S16.CrossRefGoogle ScholarPubMed
Lévesque, L., Cossette, S., Potvin, L., & Benigeri, M. (2000). Community services and caregivers of a demented relative: Users and those perceiving a barrier to their use. Canadian Journal on Aging, 19(2), 186209.CrossRefGoogle Scholar
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E.M. (1984). Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's disease. Neurology, 34, 939944.CrossRefGoogle ScholarPubMed
Miller, B., & Guo, S. (2000). Social support for spouse caregivers of persons with dementia. Journal of Gerontology: Social Sciences, 55B(3), S163S172.CrossRefGoogle Scholar
Miller, B., & McFall, S. (1991). Stability and change in the informal task support network of frail older persons. The Gerontologist, 31(6), 735745.CrossRefGoogle ScholarPubMed
Manitoba Study of Health and Aging Research Group. (1995). Manitoba Study of Health and Aging final report: Technical section. Winnipeg, MB: Centre on Aging, University of Manitoba.Google Scholar
Noelker, L.S., & Bass, D.M. (1989). Home care for elderly persons: Linkages between formal and informal caregivers. Journal of Gerontology: Social Sciences, 44(2), S63S70.CrossRefGoogle ScholarPubMed
Norusis, M.J., & SPSS. (1999). SPSS Regression Models 10.0. Chicago: SPSS.Google Scholar
Ory, M.G., Hoffman, R.R., Yee, J.L., Tennstedt, S., & Schulz, R. (1999). Prevalence and impact of caregiving: A detailed comparison between dementia and non-dementia caregivers. The Gerontologist, 39(2), 177185.CrossRefGoogle Scholar
Peek, C.W., Zsembik, B.A., & Coward, R.T. (1997). The changing caregiving networks of older adults. Research on Aging, 19(3), 333361.CrossRefGoogle Scholar
Penning, M.J. (1990). Receipt of assistance by elderly people: Hierarchical selection and task specificity. The Gerontologist, 30(2), 220227.CrossRefGoogle ScholarPubMed
Penning, M.J. (2002). Hydra revisited: Substituting formal for self- and informal in-home care among older adults with disabilities. The Gerontologist, 42(1), 416.CrossRefGoogle ScholarPubMed
Penning, M.J., & Keating, N.C. (2000). Self-, informal and formal care: Partnerships in community-based and residential long-term care settings. Canadian Journal on Aging, 19(Suppl. 1), 75100.CrossRefGoogle Scholar
Penrod, J.D., Kane, R.A., Kane, R.L., & Finch, M.D. (1995). Who cares? The size, scope, and composition of the caregiver support system. The Gerontologist, 35(4), 489497.CrossRefGoogle ScholarPubMed
Stephens, M.P. (1993). Understanding barriers to caregivers' use of formal services: The caregiver's perspective. In Zarit, S.H., Pearlin, L.I., & Schaie, K.W. (Eds.), Caregiving systems: Formal and informal helpers (pp. 261272). Hillsdale, NJ: Elbaum Associates.Google Scholar
Stommel, M., Given, B.A., Given, C.W., & Collins, C. (1995). The impact of the frequency of care activities on the division of labor between primary caregivers and other care providers. Research on Aging, 17(4), 412433.CrossRefGoogle Scholar
Stone, R., Cafferata, G.L., & Sangl, J. (1987). Caregivers of the frail elderly: A national profile. The Gerontologist, 27(5), 616626.CrossRefGoogle ScholarPubMed
Stone, R.I. & Short, P.F. (1990). The competing demands of employment and informal caregiving to disabled elders. Medical Care, 28(6), 513524.CrossRefGoogle ScholarPubMed
Teng, E.L., & Chui, H.C. (1987). The Modified Mini-Mental State (3MS) Examination. Journal of Clinical Psychiatry, 48, 314318.Google ScholarPubMed
Tennstedt, S.L., McKinlay, J.B., & Sullivan, L.M. (1989). Informal care for frail elders: The role of secondary caregivers. The Gerontologist, 29(5), 677683.CrossRefGoogle ScholarPubMed
Tuokko, H.A., Frerichs, R., & Kristjansson, B. (2001). Cognitive impairment, no dementia: Concepts and issues. International Psychogeriatrics, 13(Suppl. 1), 183202.CrossRefGoogle ScholarPubMed
Zarit, S.H., Reever, K.E., & Bach-Peterson, J. (1980). Relatives of the impaired elderly: Correlates of feelings of burden. The Gerontologist, 20, 649655.CrossRefGoogle ScholarPubMed