Academic journal article Social Work

Caregiving and Social Support in Two Illness Groups

Academic journal article Social Work

Caregiving and Social Support in Two Illness Groups

Article excerpt

Perception of social support as well as actual help received are important factors to assess in understanding the resource needs of people providing care to spouses diagnosed with chronic illnesses such as Alzheimer's and Parkinson's disease. How caregivers perceive and use social support resources has implications for planning and implementing social services for families of chronically ill older adults.

Whereas Parkinson's disease is characterized mainly by physical decline, Alzheimer's disease manifests primarily as loss of cognitive function. This article examines the differences in demographic characteristics and perceptions and use of social support between caregivers of spouses diagnosed with Alzheimer's disease and with Parkinson's disease (noncognitive type).

Literature Review

Providing ongoing care to people with debilitating illnesses creates strains on the person providing the care. People who rely on social support services depend on others to provide help, emotional support, affirmation, information, and personal assistance in times of crisis (Cantor, 1980). These resources have become essential for older married couples as they face the inevitable physical changes that occur with normal aging. For people experiencing chronic illness, social support becomes essential for maintaining independent functioning. Although the nature, meaning, and measurement of social support have been debated in the scientific literature (Kessler, Price, & Wortman, 1985), it is an important domain of inquiry in caregiving research. Social support can be defined as a multidimensional construct encompassing a multitude of relationships, behaviors, and consequences (Streeter & Franklin, 1991) and as a coping resource to mitigate the adverse psychological effects of stress (Cohen & Syme, 1985). When applied in the context of caregiving in long-term marriages, its consequences have been examined extensively in the social support literature. The review of the literature that follows is confined to studies examining health, stress, and caregiving relationships, because these are most relevant to the research reported.

Social support usually involves reciprocity over long periods of time, and although terms such as "social support" and "social support network" have had differing conceptualizations, it is important to understand the general term "social support" in relationship to successful adaptation to old age (Antonucci, 1990). Social support may also play a role in maintaining health and decreasing susceptibility to illness among elderly people, although such a conclusion may not apply uniformly in this large and heterogeneous population (Minkler, 1985). Monahan and Hooker (1995) reported that in a sample of spouse caregivers of people with Alzheimer's disease, higher levels of social support were associated with better health. Although the literature on the stress-buffering properties of supportive social relationships contains contradictory findings, recent evidence suggests that emotional support tends to reduce the deleterious effects of stress arising in more salient social roles but not of stressors that emerge in roles that are less important (Krause & Borawski-Clark, 1994).

Providing care to older family members is an important social role and indeed has become a normative role in adulthood. It is also an arena in which to examine social support, because caregiving is usually long-term and caregivers have needs for concrete and emotional assistance (Clipp & George, 1990). In the absence of the emotional support from a spouse, caregivers of people with chronic illness often face the adversity alone and are particularly vulnerable to the corrosive effects of caregiving responsibilities (Dean & Lin, 1977). Moreover, there are major gains from social support when assistance is available to buttress a caregiver's substantial social, psychological, and physical needs (Pilisuk & Parks, 1981). …

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