Social Support and Caregiving

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Social Support and Caregiving

• Gero 300
• Chapter 12
• Nov 2008

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Social Support

• Def. All forms of interactions with others. It
  has affective and emotional aspects-giving and
  receiving objects, services, affection, is
  esteemed and valued, belongs and has a sense of
  mutual obligation. SS is a measure of emotional
  connectedness with others.
• Includes concepts of group affiliations,
  interpersonal interactions, contacts and
  exchanges, all our social interactions (pos. neg
  and neutral).
• Trust and intimacy are part of the definition

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Social Support

• Social support refers to the functional content
  of social relationships such as emotional
  concern, instrumental assistance and exchange of
  information.
• Older Canadians report having companions and
  confidantes and often it is the same person who
  plays both roles.
• Social support networks, an entire web of
  relationships, for contact and exchange, helps
  with ADLs and IADLs when the elderly require
  this kind of assistance

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Definitions

• Social network-a set of relationships described
  in terms of structure (density and homogeneity)
• Social support-the functional content of social
  relationships such as emotional concern,
  instrumentality, information.
• Social integration (or isolation) the existence
  or quantity of relationships.
• Companionship (p 302) individuals with whom you
  can spend time and activity.
• Confidantes-sharing personal and emotional
  feelings

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Definitions

• Tangible and Instrumental assistance-activities
  of daily living-physical and personal care (p303)
• Instrumental activities of daily
  living-housework, meals, maintenance,
  transportation, shopping, banking.

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Popular Myths

• Working daughters have no time to care for
  elderly parents
• Low fertility rates have produced fewer potential
  caregivers
• Mobility has made distance a factor in
  care-giving
• Technology has left seniors behind

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Social Support

• Caregivers are seen as primary contacts for
  social support-average network is 30 people
  (p305)
• Marital relationships for seniors provide face to
  face contact, long term commitment, affection,
  group survival, common life-style, peer ties,
  social interactions. Married men tend to rely on
  their wives exclusively for emotional support.
• As baby boomers age divorce rates will increase
  as will of never married. Singles rely on
  parents, sibs and friends. Life long single-hood
  may promote self-reliance.

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Social Support

• Seniors today (80-85) have at least one living
  sib. Past 85 this drops to below 50. (p306)
• Sibs tend to stay in contact through the life
  cycle
• Over 80 of seniors have weekly contact with
  their children-visits, shared family times,
  leisure activities. Concept of intimacy at a
  distance-do not live with children but sustain
  close ties. This now includes emails, electronic
  contacts, cel phones. Women value child
  relationships more than men. Mother daughter ties
  are close with similar views.

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Social Support

• Read bottom page 306 on seniors interaction with
  grandchildren.
• Also note friendships who are age peers, similar
  in characteristics and socioeconomics with common
  experiences and transitions. Friends are age
  peers, similar in gender and socio-economic
  status. (p307)
• Majority of seniors therefore have high social
  interactions and many social ties. We know little
  of non-kin interactions and this requires further
  study. The convoy of social support (p307)

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Support and Well-Being

• Well-being is absence of physical or mental
  illness, happiness or health. Social support and
  positive well-being are linked and improve QOL
• Social support mediates stressful events,
  improves mental health, reduces mortality. Read
  (page 308-310)-research on social support.
• Social interaction can be both positive and
  negative-ineffective help, excessive
  intrusiveness, unwarranted help, unpleasant help

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SS

• Note that the socially competent may have easier
  access to social support, be more effective in
  negotiating the health care system and receiving
  optimal care and treatment.
• Students please read pages 311-313 on
  volunteering. Look at definitions of formal
  volunteer work vs informal. Stats bottom of page
  312-313
• Benefits page 313

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Caregiving

• Def. support to seniors due to health
  deterioration and lack of function which reduces
  independence. Informal care is unpaid assistance
  from informal networks vs formal caregiving.
• These networks provide 75-85 of total personal
  care received by seniors-those with long term
  health problems, temporary difficulties, family
  tradition. See data on page 314-315
• Primary Caregivers are mostly female(p316)

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Caregiving

• Roles of sons and daughters are different-females
  provide hands on and emotional care sons more
  supervision of fiscal issues and home
  maintenance. Gender issues predominate in the
  formal system as well. 8 of seniors provide care
  to other seniors-spouse or close friend,
  neighbour.
• Look at definition of serial care-giving p317
• Unmarried seniors most likely to receive no
  care-giving and assistance and may be in
  institutions

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Caregiver Burden

• Stress effects, care-giving consequences and
  impact.
• Burden is a bio-psycho-social-financial issue
  with objective and subjective components.
  (p318-320)
• Stress Process Model-background characteristics,
  outcomes, intra-psychic, economic. Review data in
  table 11.2 Fact Book

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Caregiving

• In BC 73 female and mean age is 52. 54 are
  wives and daughters. Often these people are
  caring for two people and have been doing so for
  two years or more. There are both primary and
  secondary care-givers (friends are typically
  secondary) Profile appears to be female, not in
  the work force, mid 50s. Spouses care for
  partners who are more frail with illness.
• Read page 321 for BC data on care-giver burden
  research

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Respite

• Pause or cessation of care-giving-in home relief,
  Adult Day Care, Respite beds. It may be linked to
  training or other community support. See research
  data on page 322-323

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Caregiving

• Caregivers follow a pattern of traditional
  gendered division of labor.
• Caregiver burden-physical, psychological,
  emotional, social and financial problems
  experienced by family members caring for impaired
  older adults. Note objective burden includes
  changes in routines, health and work demands and
  subjective burden includes emotional reactions
  such as morale, anxiety and depression

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Care-giving

• The burden of caring for the cognitively impaired
  includes items such as dealing with agitation,
  violence and abuse, incontinence, wandering, at
  risk behavior, hallucinations, embarrassing
  behaviors, sleep disturbances.
• Psychological impacts include guilt, worry,
  anxiety, loneliness, emotional stress and strain.
  Impacts on physical health. Adjustment of
  caregiver to the death of the senior.
• Read page 320rewards of care-giving

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Future Care-giving

• 2001-2031 steady increase in senior females
  without surviving children and therefore less
  informal support
• Absolute and relative increase in demand for
  formal support
• Increased awareness and demand for service by new
  senior population, might be impacted by
  compression ratios
• Complimenting the two systems of care and the
  ultimate economic costs and policy issues.