Social Support for Family Caregivers: Toward a Situation-Specific Theory

By Gilliand, Mary Palmore; Bush, Helen A. | Journal of Theory Construction and Testing, Fall 2001 | Go to article overview

Social Support for Family Caregivers: Toward a Situation-Specific Theory


Gilliand, Mary Palmore, Bush, Helen A., Journal of Theory Construction and Testing


Abstract: A phenomenological approach was used to understand the social support needed by caregivers of older dependent persons in the home. Seven women and four men, all Caucasian, ages 50 to 86years explained their daily lives as caregivers. Five of the care recipients had a diagnosis of dementia and/or Alzheimer's. Four types of support were determined: physical/psychological instructional, evaluational, and emotional. While the four types ofsupport were experienced among the eleven caregivers, instructional support was lacking, with only four caregivers able to receive information necessary to their role. Twenty-three sources were revealed with nurses, aides, friends, and support groups the most frequently mentioned. Properties of an emerging situation-specific theory of caring for the caregiver are presented.

Keywords: caregivers of older dependent persons, phenomenological research, situation-specific theory

Family caregivers are important in providing care for older dependent persons. More than 54 million Americans are currently caring for a dependent person at home or long distance (Ramshaw, 2001). Older individuals with health problems are increasingly in need of care at home which is provided by children and/or spouses. Care given by caregivers assists older ill persons to remain at home, thus seemingly decreasing the burden of the ill older individual on the health care system.

While the health care system is relieved of expensive care for the ill dependent person, the provision of care to the older dependent person does not come without costs to the caregiver and eventually to the formal health care system. The costs/ stressors have been documented as emotional, physical, social, and financial (Boland & Sims, 1998; Cobb, 1976; Kleffel, 1998; Ward-Griffin & McKeever, 2000; Worcester & Hedrick, 1997). Robinson (1997) maintained that caregivers are the untended but future hidden patients in the health care system. This warning emphasizes the need for effective strategies to reduce stressors that threaten the health of caregivers. Social support has been offered as a source for decreasing stressors, but more needs to be known about whether certain types of social support are crucial for adequate functioning in particular caregiving situations (Robinson, 1997). Additionally, knowledge is needed as to whether certain sources of support are more effective than other sources on stressors that threaten the physical and mental health of caregivers (Rose, 1997). Phenomenologically derived concept of social support, specific to the caregiver of the older dependent person in the home, are presented in this manuscript. Sources and types of support are delineated for caregivers.

EXTANT LITERATURE

Caregiving

Caregiving has been defined by various authors. Lindgren (1993) defined caregiving as a career comprised of hard work, social isolation, lack of time for self and family, and a financial drain. Caregiving is a solitary journey with the following stressors, for the caregiver: lack of support, fatigue, worry about the future, burden, isolation, and dwindling finances (Boland & Sims, 1996). Bar-David (1999) also defined caregiving as a journey with three phases: a caring capacity is developed at diagnosis of the care recipient; a self-care capacity emerges after institutionalization of the dependent person; and a caring capacity for others unfolds after the death of the care recipient. The caregiver needs support and information to understand the diagnosis of the care recipient, learn new skills, and change his/her own lifestyle.

Consequences of Caregiving

Stressors decrease the effectiveness of the caregiver's immune system; and caregivers do not seek help for their own physical and mental health problems (Robinson, 1997). Haley (1997) concurred that caregivers immune systems are impaired. Outward signs include clinically significant changes in mental and physical health e. …

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