The gratifications, frustrations, and well-being of older women caring at home for husbands with Alzheimer's disease or a related disorder
Motenko, Aluma K.
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There is growing evidence of the burden of family care giving, particularly among spouses. but little attention has been paid to the gratifications experienced. A cross-sectional, non-probability, interview study conducted in Massachusetts of 50 wives ages 58 and older supports the hypothesis that caregivers who are more gratified have greater well-being and those who experience greater frustration are more distressed. The caregivers were gratified by having their husbands at home; by believing that caregiving involved reciprocity and nurturing; enjoying moments of warmth. comfort, and pleasure: having gratification from their emotional support systems; and experiencing no change in marital closeness since the illness. Caregivers at risk of mental health problems are those who are highly frustrated and not gratified by the care giving experience. The general frustrations of feeling overwhelmed, resentful, fearful and not resigned were associated with low well-being. Frustration of wives with husbands' ADL ability, with inadequate time for themselves. with constraints of caregiving, with household chore responsibility. and with changes in their emotional support systems also contributed to low well-being. Comparison of the sample with national studies all utilizing the Dupuy WellBeing Scale, shows that the majority of caregivers are in no more distress than the general adult population. Thirty-two percent, however, are in severe distress. Caregiver distress is associated primarily with anxiety, not with depression as widely believed. Distress is not associated with caregiver age or health or with patient illness characteristics, factors that should no longer be used in clinical circles to assess the status of caregivers. Maintaining continuity in preferences and patterns is important to the well-being of caregivers. The study findings can guide the mental health treatment of caregivers particularly as the data lends support to the theory that disruption in the lives of caregivers is a stressor.
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