Monday, January 13, 2014

Dementia Caregiving in the Context of Late-Life Remarriage


Caring for family in stepfamily situations – in-laws and out-laws

As society changes, and blended families mature, there comes a time when caregiving can either be a wonderful time of caring and sharing, or a source of conflict. Complicating family dynamics are stepfamilies.

In some families, there is already conflict if the adult children are worried about their inheritance, or regarding decisions the new spouse might be making. Just as with spouses, who make decisions based on their relationship, they may conflict with adult children who disagree with certain decisions or worry about the cost of these decisions. Some adult children may be in denial about the entire situation. Too many seniors with dementia go undiagnosed.

Communication

Issues arise, from my experience, when an adult parent with dementia communicates with her family, and the other parent communicates with theirs. In some cases, seldom does a step-parent talk to their kids, as there is often a division of responsibility.

Silent Symptoms of Dementia

Especially difficult are children who do not see the same symptoms or side-effects the care recipient may feel, and are in denial about their existence.

Emotional Issues

"We learned from women in the study that those with higher levels of care-related disagreements with stepfamily members felt a significantly greater burden and feelings of depression related to care."

Dementia Caregiving in the Context of Late-Life Remarriage: Support 

Networks, Relationship Quality, and Well-being

The Journal of Marriage and Family examined sources of support for late-life wives whose husbands had a dementia-related diseaseCarey Wexler Sherman, lead author and a research investigator at the Institute for Social Research at the University of Michigan.

According to the convoy model, a person's social network, or convoy, provides a protective base that moves with the person through the life course. Convoys are understood to be responsive to normative developmental shifts as well as changes in situational characteristics. Convoys can be described in terms of their structural characteristics (i.e., network size and composition) as well as function, which refers to the exchange of different kinds of support (e.g., emotional, instrumental) between network members.

Research using the convoy model has documented that social support for older adults most often comes from existing social and familial networks and that such support is given according to levels of closeness (Antonucci, 1990; Antonucci, Birditt, Sherman, & Trinh, 2010). Thus, older adults generally turn to spouses, adult children, other close family members, and friends for support, with formal services being less preferred (Cantor, 1979). Nonetheless, although close social ties are the most common source of positive support, they are also a frequent source of negativity, including tension, conflict (Newsom, Rook, Nishishiba, Sorkin, & Mahan, 2005; Rook, 2001), and ambivalence (Birditt, Miller, Fingerman, & Lefkowitz, 2009; Connidis & McMullin, 2002; Luescher & Pillemer, 1998). Negative interactions and support appear to be particularly salient and influence well-being more significantly than positive interactions and support (Antonucci,2001).

Study Finds Wives Often Struggle With Stepchildren Over Caregiving

By JAN HOFFMAN

An unusual survey reports that older wives often hold their stepchildren responsible for caregiving problems.


The Family Disagreement Scale
This measure (Pearlin et al., 1990) assessed each participant's global perceptions of how much disagreement she had experienced with members of the family regarding care for the husband with dementia. 

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