Bangerter, Lauren R.

Giving support may be a stressful or rewarding experience, and little is known about how family members perceive giving support amid problems or crises. Using a sample of 226 mother–child dyads (mother mean age = 75.04 years; child mean age = 49.57 years), we examine how mothers and their middle-aged children perceive giving support in the context of life problems. Actor–partner interdependence models tested whether associations between problems and perceptions of support are moderated by frequency of support given and if associations were stronger for daughters or sons. Children perceived giving support to their mother as more stressful when they had more of their own problems and gave high levels of support. Daughters, but not sons, considered helping their mother more stressful when their mother had more problems and they gave high levels of support. Distinctions between mother–son and mother–daughter dyads demonstrate the merit of a dyadic approach to understanding mother–child relationships.

Background: A diagnosis of heart failure (HF) often requires a comprehensive lifestyle change to maintain disease stability. When patients with HF are married, the spouse frequently assumes the caregiving role. Our objectives were to describe the health of spouses of married patients with HF, and examine whether the health of a spouse impacts patient outcomes. Methods and Results: We identified 905 patients that were married at the time of incident HF diagnosis in Olmsted County, MN, from 2000 to 2012. Using Rochester Epidemiology Project resources, the patient and their spouse’s comprehensive longitudinal health histories were linked. Spousal health at patient HF diagnosis was assessed by comorbidity burden, self-reported difficulty with activities of daily living and prior hospitalizations. The associations of spousal health with patient outcomes and patient death with spousal outcomes were examined using Cox and Andersen–Gill models. Spouses of patients with HF were elderly (mean age, 71 years), often had comorbid conditions, and 16% had difficulty with ≥1 activities of daily living. After adjustment for patient age, sex, and comorbidity, there were no independent associations of spousal health and patient risk of death or hospitalization after HF diagnosis. However, the risk of hospitalization (adjusted hazard ratio, 1.34; 95% confidence interval, 1.11–1.60; P =0.002) and death (hazard ratio, 2.10; 95% confidence interval, 1.60–2.75; P <0.001) increased in the surviving spouse after patient death. Conclusions: We found no evidence that the health of a spouse impacts patient outcomes after HF diagnosis. However, after a patient with HF dies, their surviving spouse’s risk of hospitalization and death increases.

While dementia caregivers are regarded as a population with high unmet needs, there is little consensus as to how caregivers’ needs should be conceptualized and measured. This article describes how dementia caregivers’ needs are currently assessed in the scientific literature with the goal of suggesting guidelines for the enhancement of future measurement of caregiver needs. A review of 26 articles identified overarching themes within measurement approaches including variation in methodological rigor, proxy indicators of need, dual needs assessment of caregiver and person with dementia (PWD), and third-party needs assessment. We recommend future research dedicate theoretical attention to the conceptualization and classification of caregivers’ needs to build a stronger foundation for measurement. The measurement development process should capitalize on mixed-methodology and follow instrument development and validation guidelines set forth by measurement theory. Reliable and valid instruments are essential to developing services and policies that address dementia caregivers’ needs.

Abstract Purpose of the Study Middle-aged adults are often called upon to support aging parents. However, providing support to an aging parent with health problems and disability may be a stressful experience. This study asked whether giving everyday support to parents in the context of health problems and disability has implications for middle-aged children’s diurnal cortisol and daily mood. Design and Methods During four consecutive days, 148 middle-aged adults (mean age = 55) reported the support they gave to their parents and provided saliva 4 times a day (wake, 30 min post-wake, lunchtime, and bedtime). Multilevel models estimated within-person differences in positive affect (PA) and negative affect (NA), cortisol awakening response and area under the curve with respect to ground (AUC-G) as a function of giving same-day and previous-day support. We examined whether these associations are exacerbated when a parent has health problems or activities of daily living (ADL) needs. Results Middle-aged children had significantly higher next-day AUC-G on days after they gave support to parents with ADL needs. When participants gave support to parents with ADL needs, they had significantly greater same-day PA and lower next-day NA. Giving support to parents with health problems was associated with significantly higher next-day NA. Implications Giving support to parents is an ambiguous experience with implications for biological stress and daily mood. A biopsychosocial approach reveals under what conditions giving support to parents may become detrimental to health and well-being; this knowledge is essential for the development and implementation of interventions.