A typology of caregiving spouses of geriatric patients without dementia: caring, worried, desperate

Abstract

Background: An increasing number of older people in Germany receive care at home from family members, particularly from spouses. Family care has been associated not only with subjective burden but also with negative effects on caregivers' health. A heterogeneous group, caregivers are confronted with individual situational demands and use different available coping strategies. To date, little is known about the relationship between burden and coping by spousal caregivers, particularly in the context of geriatric patients without dementia.

Objectives: The aim of this study is to explore the burden and coping strategies of caregiving spouses of geriatric patients without dementia and with a hospitalization within the last year. To help explore this population, a typology is presented that has been based on reported perceptions of home care burden and individual coping strategies. Furthermore, a case study is presented for each type of spousal caregiver.

Methods: The study used a concurrent mixed method design with a sample of nine spousal caregivers (mean age: 78.9 years). Four women and five men were recruited in an acute hospital setting during the TIGER study. Quantitative data were collected using a self-questionnaire and qualitative data were gathered through nine problem-centered interviews with spousal caregivers. The latter were subsequently analyzed utilizing the structured content analysis method. The data were then summarized to nine individual cases. Finally, the results were clustered using the empirically grounded construction of types and typologies. Each type of spousal caregiver is presented by a case study.

Results: Three types of caregiving spouses were identified: "The Caring Partner", "The Worried Manager" and "The Desperate Overburdened". These types differ primarily in the level of subjective burden and caregiving stress, the coping strategies, the motivation for caregiving, and expressed emotions.

Conclusions: The development of this new typology of caregiving spouses could help health care professionals better understand caregiving arrangements and thus provide more targeted advice.

Trial registration: The TIGER study was registered with clinicaltrials.gov: NCT03513159 . Registered on April 17, 2018.

Keywords: Burden; Caregiver; Coping; Partner; Typology.

Conflict of interest statement

T.G., C.S. and S.E. declare no conflict of interest. E.F. is an Associate Editor for BMC Geriatrics.

© 2021. The Author(s).

Figures

Fig. 1

Flow chart recruited caregivers

Fig. 2

Description of the exploratory design

Fig. 3

Typology of caregiving spouses by caregiver burden and the coping dimension. The vertical axis shows the extent of experienced burden and stress. A curved arrow-symbol in the graphic growing bigger upwards indicates the level of burden too. In the horizontal axis the respective coping dimensions are plotted. The big green dot represents the prototypical case of coping-type ‘Diverting’, the big yellow dot the prototypical case of coping-type ‘Seeking attention and care’ and the big red dot the prototypical case of coping-type ‘Negative emotional’. One always has to keep in mind also in the prototypes of our participants parts of the other two coping dimensions might also be present, but to a much lesser extent. The smaller dots symbolize mixed forms of coping strategies, whereby the colour indicates the predominant coping dimension